The Back Pain Doctor

Focused Shockwave Therapy (ESWT) Brisbane

Focused shockwave therapy (ESWT) is a non-invasive treatment that delivers focused acoustic pressure waves to injured tendon and soft tissue, used most often for chronic tendinopathies that have not settled with conservative care. We use a STORZ Medical focused shockwave system at our Brisbane clinic in Milton.
STORZ Medical DUOLITH SD1 focused shockwave system
We use a STORZ Medical DUOLITH focused shockwave system.

What it can help with

  • Plantar fasciitis
  • Calcific & non-calcific rotator cuff tendinopathy
  • Tennis & golfer's elbow
  • Greater trochanteric pain syndrome
  • Proximal hamstring tendinopathy
  • Achilles tendinopathy

Suitability depends on your individual diagnosis and is assessed at consultation.

Extracorporeal shockwave therapy (ESWT) delivers focused acoustic pressure waves to an area of injured tendon, soft tissue or bone. The mechanical stimulus is thought to promote local healing responses — including cell signalling, new blood-vessel formation and tissue remodelling — in tissues that have stalled in their recovery.

ESWT is most established for chronic tendinopathies that have persisted despite first-line measures such as activity modification, physiotherapy and time. It is non-invasive, performed in the clinic, and usually does not require an anaesthetic.

Shockwave is generally used as part of a wider management plan that continues to address the underlying load and biomechanics, rather than as a treatment given in isolation. Whether ESWT is appropriate for you depends on your specific diagnosis, and this is assessed at consultation.

What the evidence shows

ESWT has a substantial and growing evidence base for chronic tendinopathy. Multiple systematic reviews and meta-analyses support its use for upper-limb tendinopathy and rotator cuff tendinopathy, and it is widely used where conservative treatment — load management, physiotherapy and time — has not resolved symptoms. A 2024 meta-analysis of 18 randomised controlled trials found ESWT effective in relieving pain across upper-limb tendinopathy, including rotator cuff disease and lateral epicondylitis. Reported adverse effects are generally minor and short-lived, such as transient local soreness or redness. Evidence quality varies by condition, and ESWT is typically one part of a broader rehabilitation plan rather than a standalone cure.

Sources: Frontiers in Medicine (2024)

What to expect

Focused shockwave therapy is delivered as a short course of sessions, usually spaced around a week apart, with the exact number and settings tailored to your condition and response. Each session takes a short time, and most people need no anaesthetic and have no formal downtime, though some short-lived local soreness afterwards is common. We use a STORZ Medical focused shockwave system — focused shockwave delivers energy to a defined depth within the tissue, in contrast to radial (pressure-wave) devices that disperse energy more superficially. Your treatment plan and the current cost are discussed with you at consultation.

Frequently asked questions

What is the difference between focused and radial shockwave?
Focused shockwave concentrates acoustic energy at a defined depth in the tissue, whereas radial shockwave spreads a pressure wave more superficially from the skin surface. We use a STORZ Medical focused shockwave system, which allows the energy to be directed to deeper target tissues such as tendon attachments.
Does shockwave therapy hurt?
Treatment can be uncomfortable while the pulses are applied, and the intensity is usually adjusted to a level you can tolerate. Mild local soreness for a day or two afterwards is common and settles on its own.
How many sessions will I need?
ESWT is usually given as a course of several sessions about a week apart. The number depends on your condition and response, and is planned with you at consultation.
Is there any downtime?
Most people have no formal downtime and can return to normal daily activity. We may advise modifying higher-impact or heavy-loading activity for a short period.
Is it covered by Medicare or private health insurance?
ESWT for musculoskeletal conditions is generally an out-of-pocket cost and not covered by Medicare. Coverage can change, so we confirm the current position and cost with you beforehand.
When will I know if it has worked?
Improvement from ESWT typically develops over several weeks, often continuing after the course of treatment has finished. We arrange review to assess your response.

Ready for a clearer plan for your back or musculoskeletal pain?

Book an assessment with Dr Joshua Hatch.

Your assessment focuses on understanding the likely source of your pain and the most appropriate non-surgical options for your diagnosis, with the aim of reducing pain and improving function.

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