How Effective Is Shockwave
Therapy? 

What is the RESEARCH Saying About Shockwaves?

There is important research about advanved treatment shockwave therapy. Shockwave therapy is a growing fielding with an exploding medical research database. This advanced treatment is beneficial for chronic injuries and stubborn pain conditions. However: There are some conditions that it works for and other conditions that it does not.

The Science

A review ( 106 studies), identified the effectiveness and safety of shockwave therapy This review found some very relevant findings:

Shockwave therapy is effective and supported by the data
88% on radial and 82% of focused shockwave therapy showed positive results
Shockwave therapy is safe
There were no reports of serious adverse events
Application without sufficient energy adversely effects the outcome
There is no favour of radial or focused shockwave therapy
Optimal treatment protocol seems to be 2000 impulses at the highest energy tolerated

The Science

Tennis Elbow

Shockwave therapy is effective for tennis elbow
Surgery for tennis elbow should not be an option before repeated shockwave therapy

Mid portion Achilles (Korakakis)

Radial shockwave is comparable to eccentric exercises of the tendon

Radial shockwave is superior to wait and see approach

Insertional Achilles

Radial shockwave is superior to eccentric load training
Suggested protocol: 2000 shocks, 2.5 bar, 3 weekly sessions

Shockwave and Knee Tendinopathy:

Focused shockwave is superior to anti-inflammatory meds, exercise, knee strap, modification of activity levels) at long-term follow-up (2–3 years)

Advanced treatment of focused and radial shockwave are effective.


Shockwave and Lateral Hip Pain

Radial shockwave is superior to stretching and strengthening at short and mid-term follow-up

Corticosteroid injection is superior to radial ESWT at short-term (1 month)

Radial shockwave is better than corticosteroid injection at mid-term and long-term follow-up

Limitations of Research

Is there anything that suggests some research is lacking for ESWT?
Research is steadily evolving and changing. There are limitations including the type of shockwave device being used, energy levels, patient profile, and targeted zone.

All of these are hard to control in the literature. Importantly, clinicians can educate their patients and set out realistic expectations for treatment.