Extracorporeal Shockwave Therapy (ESWT)

In this article, you will learn about Extracorporeal Shockwave Therapy (ESWT) and its application in treating various musculoskeletal conditions. Discover how this FDA approved non-invasive treatment harnesses acoustic waves to stimulate tissue regeneration and promote healing responses within the body.

Are you looking for effective relief from musculoskeletal pain? Consider scheduling an appointment at Brotzman Sports Medicine in Austin, Texas. Our experienced practitioner specializes in ESWT and a range of other innovative treatments to help you regain mobility and alleviate discomfort.

S. Brent Brotzman, MD

Orthopedic & Sports Medicine Specialist located in Austin, TX

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What is Musculoskeletal ESWT?

Musculoskeletal extracorporeal shock wave therapy (ESWT) is a type of physical medicine used to treat several musculoskeletal conditions. It is a non-invasive treatment that was developed from extracorporeal shock wave lithotripsy (ESWL), a treatment that uses ultrasound acoustic shock waves to break down kidney stones.

During extracorporeal shockwave therapy, your provider will use a small pneumatic device that emits gentle acoustic waves near the skin. These acoustic waves deliver precise, short bursts of energy to targeted tissues. These waves penetrate tissue layers, causing micro-stress at the site of injury.

By inducing micro-stress in the tissue, these pulses stimulate a healing response in the body, promoting tissue regeneration and the formation of new blood vessels, known as angiogenesis.

Studies have shown up to a 300% increase in blood flow to treated areas. Additionally, this therapeutic approach activates local stem cells and growth factors, initiating a fresh healing process even when previous attempts have been unsuccessful. The therapeutic benefits of shockwave therapy lie in its ability to bolster tissue regeneration and promote the development of new blood vessels at the site of application. 

There are multiple years of multiple random controlled studies, showing a very high success cure rate with musculoskeletal ESWT.

Types of Shockwave Therapy

There are two different types of musculoskeletal shockwave therapy: focused shockwaves (f-ESWT) and radial shockwaves (r-ESWST).

These treatments work in two different ways. F-EWST works by sending focused sound waves to a specific injured area. Focused sound waves penetrate deeper into the body’s tissues.

 R-ESWT produces radial pressure waves that cover a wider area. Radial therapy produces more superficial shockwaves that can treat a wider area of pathology.

What Conditions Can Be Treated with ESWT?

ESWT can be used to treat the following conditions:

    • Plantar fasciitis and heel spurs
    • Achilles tendinitis pain and tendinopathy micro and postoperative
    • Achilles healing
    • Patellar tendinitis (jumper’s knee)
    • Hip trochanteric bursitis and hip tendonitis
    • Medial epicondylitis (golfer’s elbow)
    • Lateral epicondylitis (tennis elbow)
    • Chronic soft tissue inflammation
    • Impingement syndrome (shoulder)
    • Peripheral neuropathy
    • Tendon calcifications
    • Muscle spasm (lumbar, leg, etc.)
    • Hamstring tendinitis
    • Facial rejuvenation of soft tissue
    • Thumb basal joint arthritis
    • Osteoarthritis of joints
    • Stress fractures and delayed union of fractures
    • Myofascial pain syndrome
    • Patellofemoral syndrome/knee
    • Shin splints
    • Heavy scars and burns
    • Articular cartilage stimulation in joint arthritis

What Happens During an ESWT Procedure?

You will begin by lying down and exposing the injured area. Then, your provider will apply a special gel to the skin of the affected area. This gel allows the shock waves to penetrate deeper into the skin.

The provider will then use an extracorporeal shockwave therapy machine to apply shock waves to the injured area. He will place the machine against the skin and turn the instrument on. The machine sends rapid impulses to the affected area. The treatment doesn’t usually cause pain.

Treatment usually lasts between 10 and 15 minutes. Once the treatment is over, you will be encouraged to limit physical activity for at least 2 weeks.

Does ESWT Work?

ESWT has been used in clinical practice since the 1980s and has shown excellent benefits for various musculoskeletal issues. Trials have shown ESWT to be effective in 85% or more cases. Recent technological advances have further improved its efficacy. EWST is FDA-approved to treat multiple musculoskeletal conditions.

Shockwave therapy often works better when used with other forms of therapy, such as physical therapy. ESWT treatments are usually recommended for at least 4 to 6 weeks to achieve the best results. More treatments may be required depending on the severity of the injury.

Side Effects of ESWT

Extracorporeal shockwave therapy is a safe, effective therapy that can be used for many conditions. Most people will not experience any serious side effects. However, some potential side effects could include the following:

  • Discomfort or pain during treatment
  • Pain following treatment
  • Swelling 
  • Numbness
  • Red skin
  • Bruising

Limitations of ESWT

There are just a few areas in which extracorporeal shockwave therapy should not be used. ESWT is not recommended for the following:

  • Treating lung tissue
  • Used on an open growth plate in children
  • Patients who are hemophiliac or who are on anticoagulant (blood thinner) therapy
  • Malignant tumors
  • Close to implanted cardiac stents and implanted heart valves
  • Directly over the cement-metal interface of the joint implant.

Schedule an ESWT Appointment Today

Are you ready to experience the benefits of extracorporeal shockwave therapy for yourself? Schedule your appointment today at Brotzman Sports Medicine in Austin, TX, and take the first step towards effective relief and accelerated healing.

Contact our office today to learn how you can prepare for shockwave therapy sessions ahead of time. Don’t let musculoskeletal pain hold you back—reclaim your active lifestyle with our expert care!

Medically reviewed by
S. Brent Brotzman, MD


Words from our patients