Shockwave Therapy: What It Treats and How It Feels
Shockwave therapy delivers rapid acoustic pulses into a small area of soft tissue through a handheld applicator. It is used mainly for stubborn tendon problems that have not settled with loading alone: the Achilles, the plantar fascia, the gluteal tendons at the outer hip, and the tendons at the elbow. Each site takes only a few minutes.
Most people describe it as uncomfortable rather than painful. It is delivered as a course over several weeks and is intended to sit alongside a loading program rather than replace it, so the structure being targeted and the measure used to judge the course should both be stated at the start. It is avoided over open growth plates in children and during pregnancy.
For more information about shockwave therapy, contact the Bukit Damansara (KL) main center: WhatsApp+60 17 269 1873 Call+603 2093 1000
Key Takeaways
- Acoustic pulses into soft tissue: Shockwave therapy delivers controlled pressure waves through the skin into tendons, fascia and other soft tissues. It is non-invasive and involves no needles or surgery.
- Best studied for tendon problems: The strongest research is for plantar fasciitis, Achilles and other tendinopathies, and calcific tendinitis of the shoulder. Evidence for other uses is limited.
- Used alongside exercise: At Chiropractic Specialty Center (CSC), it sits within a program that includes physiotherapy exercise and, where the assessment supports it, chiropractic care.
- Settings matter: The number of pulses, the energy level and the exact tissue targeted affect both comfort and tissue response, so the parameters are chosen after assessment.
Why Careful Application of Shockwave Therapy Matters
How shockwave therapy is given matters as much as the device itself. Settings that are too aggressive, or too many pulses over one area, can leave the tissue more irritated for a few days rather than less. At CSC, the parameters are chosen after assessing the specific tissue, your tolerance and the overall care plan, and the clinician adjusts the intensity and pulse number during the session.
Research has examined how shockwave may affect tendon healing, calcific deposits and scar tissue. The most consistent findings are for chronic tendon problems and for calcific tendinitis of the shoulder, where the calcium deposits were partly or fully resorbed in a proportion of cases. Shockwave therapy does not regenerate cartilage, and individual responses vary.
Shockwave Therapy Assessment at Two KL Centers
Whether shockwave therapy suits a particular tendon or soft-tissue problem is decided after an assessment at either center of Chiropractic Specialty Center. The team can also explain how many sessions a course usually involves and how it fits with your exercise program.
- Bukit Damansara (KL, main center): Call +603 2093 1000 or WhatsApp +60 17 269 1873 to see the Bukit Damansara / KL center.
- Bandar Sri Damansara (KL): Call +603 6262 5777 or WhatsApp +60 12 455 6939 to see the Bandar Sri Damansara center.
Musculoskeletal Conditions Commonly Discussed Alongside Shockwave Therapy
Shockwave therapy is best studied for tendon and fascia problems. It is sometimes discussed for other soft-tissue problems around the joints and spine, where the evidence is thinner and it plays, at most, a small part in a wider plan:
- Shoulder: Calcific tendinitis and rotator cuff tendon problems are among the better-studied uses. See shoulder pain.
- Elbow: Tennis elbow and golfer’s elbow are common reasons it is considered. See elbow pain.
- Hip: Tendon pain at the outer hip, known as greater trochanteric pain syndrome, has been studied. See hip pain.
- Knee: Patellar tendon problems have the most research at the knee. For most knee pain care, exercise and loading remain the main approach.
- Heel and ankle: Plantar fasciitis and Achilles tendon problems. See also ankle and foot concerns.
- Back and neck muscles: Shockwave therapy does not treat a disc. When the muscles around a slipped disc, or those involved in back pain or neck pain, stay tight and tender, it may occasionally be used on those muscles, while exercise and manual care carry the plan.
For other problems in the lower limb, see leg pain.
Soft-Tissue Structures That May Respond to Shockwave Therapy
Movement depends on several connective-tissue structures working together. Shockwave therapy is discussed in relation to tissues such as:
- tendons that attach muscles to bones
- ligaments that stabilize joints
- fascia surrounding muscles
- muscles responsible for joint movement and stability
When these tissues are irritated or overloaded, they can lose tolerance to load. Rehabilitation aims to rebuild that tolerance after individual assessment.
Tendons
Tendons are often affected by repetitive stress and overuse. Shockwave therapy is most often discussed for tendon and fascia problems such as:
- irritation of the plantar fascia in the heel, known as plantar fasciitis
- tendon strain near the elbow, including tennis elbow and golfer’s elbow
- rotator cuff tendon problems in the shoulder, including calcific tendinitis
- Achilles tendon problems near the ankle
- patellar tendon problems at the knee
Tendons adapt to load, so shockwave therapy is used alongside a progressive loading program rather than instead of one. More on tendon problems is on the tendonitis page.
Fascia and Connective-Tissue Mobility
Fascia forms a continuous connective-tissue network around muscles, nerves and joints. Healthy fascia lets muscles glide smoothly during movement, while repetitive strain, injury or prolonged posture can make it feel stiff and sensitive.
Shockwave therapy is well studied for the plantar fascia in the heel; evidence for fascia elsewhere in the body is limited.
How Shockwave Therapy Is Applied at CSC
Shockwave therapy sessions are brief and carried out in the clinic. During a session:
- a conductive gel is applied to the skin
- the applicator is positioned over the targeted area
- acoustic pulses are delivered into the tissue
The clinician adjusts the intensity, frequency and number of pulses based on the tissue being addressed, your comfort and the overall rehabilitation goals. Excessive application can irritate the tissue instead of helping it, so the settings stay within ranges chosen for your presentation.
Potential Roles of Shockwave Therapy in Rehabilitation
Shockwave therapy is used within a broader rehabilitation program, not as a stand-alone treatment. For a stubborn tendon, it may settle symptoms enough for the loading program to progress. It is commonly paired with physiotherapy exercise and manual therapy when the assessment indicates it may be useful. Research has examined its effects on tendon healing, calcific deposits and scar tissue; individual responses vary, and it does not regenerate cartilage or other tissues.
What Individuals May Notice During Treatment
Most shockwave therapy sessions last only a few minutes. During the session, you may feel rhythmic tapping or vibration in the treated area, and the intensity can be adjusted to keep it tolerable.
Afterward, some people notice temporary soreness or redness in the treated area for a day or two. The clinician will explain what activity is sensible after the session.
Situations Where Shockwave Therapy May Not Be Appropriate
Shockwave therapy may not be recommended in certain circumstances, including:
- open wounds or skin infection in the treatment area
- pregnancy
- open growth plates in children
- bleeding disorders or blood-thinning medication
- certain implanted electronic medical devices
- specific bone conditions
- other medical considerations evaluated by a clinician
A qualified clinician decides whether shockwave therapy is appropriate after taking a history, examining you and, when relevant, reviewing imaging.
Integrating Shockwave Therapy with Physiotherapy and Chiropractic Care
At Chiropractic Specialty Center, shockwave therapy is rarely used alone. A rehabilitation program may also involve:
- physiotherapy rehabilitation exercises
- chiropractic spinal and joint care
- manual soft-tissue techniques
- movement retraining
Combining these approaches lets the clinicians address both joint mechanics and the surrounding soft tissues. Shockwave therapy is included only when the assessment shows a tendon or soft-tissue problem it is suited to. More on the coordinated model is on the chiropractic combined with physiotherapy page.
Development of Shockwave Therapy in Musculoskeletal Rehabilitation
Shockwave technology was first developed to break up kidney stones. Researchers later observed effects on bone and soft tissue, which led to the use of extracorporeal shockwave therapy for musculoskeletal problems.
Since then, ESWT has been widely studied in sports medicine and physiotherapy for tendon and connective-tissue conditions. The research continues to evolve, and findings are always interpreted alongside your own examination and goals.
If you would like to see costs before a visit, CSC publishes its chiropractic fees and physiotherapy fees in full.
Understanding Extracorporeal Shockwave Therapy
The term extracorporeal means “outside the body,” indicating that the therapy is applied externally rather than internally.
Shockwave therapy uses acoustic pressure waves that travel through soft tissues. When these waves reach connective tissues, they interact with the cellular environment within the treated area. This interaction may support circulation within targeted tissues, connective-tissue activity, neuromuscular coordination, and tissue mobility.
A handheld device generates the acoustic pulses, and the treatment head is placed against the skin over the area being addressed.
Difference Between Extracorporeal Shockwave Therapy and Ultrasound Therapy
Both modalities are used in physiotherapy. ESWT delivers higher-pressure acoustic pulses, while therapeutic ultrasound uses oscillating sound waves of different characteristics. The two approaches are selected according to the tissue presentation and the overall plan; neither is universally superior. For further detail on ultrasound, see the dedicated page on therapeutic ultrasound.
For a child or teenager with a sports injury, the guide to chiropractic care for children explains how care is chosen for a growing body, with exercise and gentle methods at its center.
References and Evidence Context
These peer-reviewed sources support the general, evidence-aligned statements on this page. They do not prove that every method or device suits every condition. Condition-specific references appear on the linked pages.
| Condition studied | What the evidence supports | Source |
|---|---|---|
| Midportion Achilles tendinopathy | Shockwave added to eccentric loading outperformed eccentric loading alone at four months | Rompe et al., 2009 |
| Chronic plantar fasciitis | Radial shockwave reduced heel pain versus sham at 12 weeks | Gerdesmeyer et al., 2008 |
| Calcific tendinitis of the shoulder | Pain and function improved, with partial or complete resorption of calcification in a proportion of cases | Ioppolo et al., 2013 |
| Orthopedic conditions, broad review | Effects vary by condition and by protocol; reported adverse events are minor and transient | Schmitz et al., 2015 |
| Musculoskeletal disorders, overview | Describes the proposed mechanisms and where the evidence is strongest | Wang, 2012 |
- Rompe JD, Furia J, Maffulli N. Eccentric loading versus eccentric loading plus shock-wave treatment for midportion Achilles tendinopathy: a randomized controlled trial. Am J Sports Med. 2009;37(3):463-470.
- Gerdesmeyer L, Frey C, Vester J, et al. Radial extracorporeal shock wave therapy is safe and effective in the treatment of chronic recalcitrant plantar fasciitis: results of a confirmatory randomized placebo-controlled multicenter study. Am J Sports Med. 2008;36(11):2100-2109.
- Ioppolo F, Tattoli M, Di Sante L, et al. Clinical improvement and resorption of calcifications in calcific tendinitis of the shoulder after shock wave therapy at 6 months’ follow-up: a systematic review and meta-analysis. Arch Phys Med Rehabil. 2013;94(9):1699-1706.
- Schmitz C, Császár NBM, Milz S, et al. Efficacy and safety of extracorporeal shock wave therapy for orthopedic conditions: a systematic review on studies listed in the PEDro database. Br Med Bull. 2015;116(1):115-138.
- Wang CJ. Extracorporeal shockwave therapy in musculoskeletal disorders. J Orthop Surg Res. 2012;7:11.
None of these references evaluates a care program at Chiropractic Specialty Center. Each one can be checked through its free PubMed record.
The Author of Shockwave Therapy: What It Treats and How It Feels
Shockwave Therapy: What It Treats and How It Feels was written by Yama Zafer, D.C., who has 30+ years in chiropractic and physiotherapy and founded Chiropractic Specialty Center in Kuala Lumpur in 2006.
Last Updated: Shockwave Therapy: What It Treats and How It Feels
Shockwave Therapy: What It Treats and How It Feels was last reviewed and updated on September 25, 2026.
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