Focused shockwave therapy, or ESWT, uses acoustic pressure waves directed at a painful tendon or soft-tissue region. It is most often considered for persistent problems such as plantar fasciitis, Achilles tendinopathy, tennis elbow, rotator cuff tendinopathy or calcific tendinopathy.

It is not a magic reset, and it is not right for every condition. Its role is usually to support a broader plan that includes diagnosis, load management and rehabilitation.

Before treatment starts

The first step is confirming the likely pain source. Two people can have similar symptoms for different reasons, so we consider the history, examination and any relevant imaging.

We also check whether shockwave is appropriate. Certain situations, such as pregnancy over the treatment area, local infection, some bleeding risks or specific nerve and vascular concerns, may change the plan.

During the appointment

Treatment is delivered with a handheld applicator over the target area. It can feel uncomfortable, but it should be tolerable. The intensity is usually adjusted to the person and the tissue being treated.

Sessions are relatively short. A course often involves several treatments spaced over weeks, although the exact plan depends on the condition and response.

After treatment

Some people feel temporary soreness for a day or two. Heavy loading is usually avoided immediately afterwards, but complete rest is not the goal. The rehabilitation plan matters because tendons still need progressive loading to become more resilient.

What results should you expect?

Improvement is usually gradual rather than instant. Some people notice change within a few weeks, while others take longer. If the diagnosis is wrong or the load problem is not addressed, shockwave is less likely to help.

You can read more on our focused shockwave therapy page.

The bottom line

Shockwave therapy can be useful for selected persistent tendon and soft-tissue problems. It works best when it is part of a clear diagnosis and a sensible loading plan.