Introduction
This leaflet explains what ESWT is, how it can help you, what risks it might have, and what to expect from your treatment.
You will be considered for Extracorporeal Shockwave Therapy once you have completed 3 months of exercise-based rehabilitation under the guidance of a physiotherapist at the George Eliot Hospital.
What is ESWT?
ESWT is a treatment that uses special sound waves, called shockwaves, to help an injured part of your body heal. These shockwaves are made outside your body and passed through the skin using a small device held in the therapist’s hand.
The shockwaves are loud, low-energy sound waves. They are mechanical (not electrical), and you can hear them during the treatment.
What is ESWT used to treat?
ESWT can help people who have had pain in their tendons (the strong cords that connect muscles to bones) for a long time. It is used for:
- Plantar fasciitis (pain in the bottom of the heel)
- Patellar tendinitis (also called jumper’s knee)
- Achilles tendinopathy (pain in the tendon at the back of your ankle)
- Gluteal tendinopathy/Greater Trochanteric Pain Syndrome (pain on the side of your hip)
- Hamstring tendon pain (pain in the tendons at the back of your thigh)
Why should I have ESWT?
You might be offered ESWT if your tendon has been sore for months and other things like rest, painkillers, ice, insoles, exercises, or physiotherapy haven’t helped.
ESWT might stop the need for injections or surgery.
How does ESWT work?
The shockwaves help your body heal naturally. They start a small response inside the injured area, which brings more blood and active healing cells to the spot. This can help your body fix the problem more quickly.
It can also affect the nerves, which may help reduce pain, especially if you’ve had the problem for a long time.
Who will perform the procedure?
A trained physiotherapist who has had special training will carry out your ESWT.
What should I expect during treatment?
You will lie down, and a water-based gel will be put on your skin where the treatment is needed.
You will hear a loud, repeating sound (a bit like a woodpecker) and feel a firm tapping on the area being treated.
The treatment takes about 5 to 10 minutes.
Usually, you will have 1 treatment per week for 3 weeks. This gives your body time to react and heal between treatments. Treatments shouldn’t be more than 2 weeks apart.
Will I feel any pain during treatment?
You might feel some discomfort or pain. The treatment will start gently and then be turned up to a level you can manage.
If it hurts too much, the therapist can turn it down or move the device to a different spot.
Stopping treatment
If you don’t like the treatment, you can stop at any time.
Is it safe and does it work?
The National Institute for Health and Care Excellence (NICE) says ESWT is usually safe. Sometimes people get mild side effects during or after treatment like red skin, bruising, numbness or funny feelings and pain.
These usually go away within a week.
Some studies show that ESWT helps reduce pain and improve movement. Other studies don’t.
That means it doesn’t work for everyone. Your pain might stay the same or even get worse.
What do I do after ESWT?
After treatment, you can do normal daily activities.
But don’t do hard or painful activities like jogging, running, jumping or hopping for 48 hours afterwards.
Everyone is different, so your physiotherapist will give you advice that is right for you.
What should I do if I have pain after treatment?
You probably won’t need painkillers. But if you do, and you are allowed to take them, you can use paracetamol or the ones your doctor has given you.
Do not use Ibuprofen, Naproxen, or ice, as these might stop the healing process.
If you are worried after treatment, contact your physiotherapist during working hours.
If it’s urgent or outside normal hours, call your GP, NHS 111, or go to Out of Hours. If you suddenly get a lot of pain or can’t use the body part, go to A&E.
How fast does ESWT work?
Some people feel better straight away. The area may feel a bit numb, but this may only last a short time.
Usually, people feel more improvement after the second or third treatment.
It’s important to know that healing takes time. It might take weeks or months to get better.
Is there anything I need to do during treatment?
Yes – ESWT works best when you keep doing your exercises at home. You should keep going with these exercises during and after treatment.
Will I have a follow-up appointment?
Yes. You’ll have a check-up around 6 weeks after your last treatment to see how you are doing.
You may be offered 3 more sessions if your pain has improved but not gone away.
You may also get a questionnaire at 6 weeks, 3 months, and 1 year to see how well ESWT has worked for you.
Are there any other treatment options?
Yes. If you don’t want to try ESWT or it doesn’t help, other options include more physiotherapy or seeing an orthopaedic doctor (sometimes they may suggest surgery)
Are there any reasons someone should not have ESWT?
Yes, some people should not have ESWT. Your physiotherapist will talk to you about this when offering the treatment.
Please tell them if you are unsure or want to know more.
Giving consent to your treatment
We want you to help make decisions about your care.
You will talk to your physiotherapist about ESWT and your other choices.
Before starting, we’ll make sure you understand what ESWT is and that you agree to go ahead.
If you want to know more about how we check for consent, ask your physiotherapist.
Further sources of information
NICE has written advice for people having ESWT:
For hip pain:
For heel pain:
For Achilles pain:
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