Back Pain Doctor

Shockwave Therapy Brisbane

Shockwave therapy is a non-invasive, in-clinic treatment for persistent tendon and soft-tissue pain. We deliver both forms — radial and focused — at our Milton clinic in Brisbane, using STORZ Medical systems. Which one you have depends on the tissue we are treating, and this page explains that choice.

Shockwave is a stage-three treatment in our staged care pathway. That means it is considered once the diagnosis is clear and a progressive loading programme has had a genuine trial, usually around three months. For many people the loading work is enough on its own and shockwave is never needed. Where it is used, the trial evidence consistently favours shockwave combined with loading over either alone.

Radial vs focused

They are both called shockwave. They are not the same treatment.

The difference is physical, and it decides which one suits your problem. Many clinics offer only one and describe it simply as "shockwave". We think you should know which you are being offered and why.

Radial Focused (ESWT)
What it is A ballistic pressure wave generated by a projectile striking an applicator on the skin. A true acoustic shock wave that converges at a focal point set at a defined depth.
Where the energy is greatest At the skin, falling away with depth. At the focal depth inside the tissue, which is set for the target.
What we use it for Muscle and fascia — tender paraspinal, gluteal, calf and forearm tissue. Tendon, joint, ligament and bone.
Typical course Four to six sessions, about a week apart. Four to six sessions, about a week apart.
Anaesthetic or downtime Neither. Mild local soreness for a day or so is common. Neither. Mild local soreness for a day or so is common.
Strength of evidence Reasonable in plantar heel pain; thinner elsewhere, and rarely compared head to head with focused. Substantial across chronic tendinopathy, including insertional presentations and calcific tendinopathy.
Radial shockwave For muscle and fascia. Read what it involves, the transmitters we use and what the evidence supports. Read more Focused shockwave (ESWT) For tendon, joint, ligament and bone. Read the mechanism, the evidence and the sources behind it. Read more

Conditions where shockwave is most often considered

Each condition page sets out where shockwave sits for that specific diagnosis, alongside every other option we offer — including the ones we would not recommend for it.

Plantar heel pain (plantar fasciitis) One of the best-supported indications. Achilles tendinopathy Good trial support, particularly mid-portion. Tennis and golfer's elbow Focused, where the tendon attachment is the target. Calcific rotator cuff tendinopathy Focused is well established here. Greater trochanteric pain syndrome Reasonable support alongside exercise. Proximal hamstring tendinopathy Considered where loading has stalled.

What shockwave will not do

It will not regenerate cartilage, reverse osteoarthritis or repair a structural tear. It is not a treatment for a fresh injury. It is not a substitute for a diagnosis, and it is not a substitute for the loading work — across the trials, shockwave plus loading beats shockwave alone.

If a clinic offers you shockwave without first establishing what is actually causing your pain, that is the part worth questioning. Our position on treatments we consider poorly supported is set out on our evidence page.

Frequently asked questions

What is the difference between radial and focused shockwave?
Radial shockwave is a ballistic pressure wave that is strongest at the skin and weakens with depth, so it is used mainly for muscle and fascia. Focused shockwave is a true acoustic shock wave that converges at a set depth inside the tissue, so it is used for tendon, joint, ligament and bone. They are commonly both called shockwave, but they are different treatments with different evidence, and the right one depends on where your painful structure sits.
Does shockwave therapy actually work?
For chronic tendinopathy the evidence is reasonably strong. Multiple randomised trials and systematic reviews report improvement in pain and function when shockwave is combined with a progressive loading programme, and in several tendon presentations that combination has outperformed loading alone. Plantar heel pain and mid-portion Achilles tendinopathy are the best-supported indications. Outside tendon problems the evidence is weaker and we will say so for your specific diagnosis.
Is shockwave therapy painful?
Most people describe it as uncomfortable rather than painful. The intensity is adjusted during the session to a level you can tolerate, and any soreness afterwards usually settles within a day. No anaesthetic is used and there is no formal downtime.
How many shockwave sessions will I need?
A typical course is four to six sessions about a week apart. Change is usually gradual across the course rather than immediate, and often still developing for some weeks after the final session. The exact number depends on your condition and your response, and is planned with you at consultation.
Is shockwave therapy covered by Medicare in Australia?
There is no specific Medicare item number for shockwave therapy itself. It is delivered as part of a musculoskeletal treatment plan during a standard GP consultation, so the appointment is billed under the time-based GP consultation items, which attract a Medicare rebate. Appointments are not bulk billed, so an out-of-pocket gap applies, and we confirm current fees with you beforehand.
Who should not have shockwave therapy?
Suitability is assessed individually. Pregnancy, treatment over a nerve or major vessel, active infection in the area, some bleeding disorders and anticoagulation are among the things we check before proceeding. Shockwave is also not a treatment for a fresh injury — it is used for persistent problems.
Is shockwave therapy a replacement for rehabilitation?
No. Across the trial evidence, shockwave performs best when it is combined with a progressive loading programme, not when it is used on its own. We treat it as an adjunct for problems that have not settled after a genuine trial of diagnosis-specific rehabilitation, usually around three months.

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

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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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