Extracorporeal shockwave therapy uses acoustic waves to stimulate your body’s healing processes. This therapy is considered safe and effective and can be used across various musculoskeletal conditions.

Stubborn injuries that feel like they never fully heal are the prime candidates for extracorporeal shockwave therapy (ESWT). This noninvasive procedure can help stimulate your body’s natural regenerative and healing processes without surgical intervention.

Doctors use an ESWT device to deliver targeted acoustic (shock) waves to the site of your injury. These waves create a pressure field in your tissue that places your cells under a controlled level of mechanical stress. Stress within your cells stimulates regenerative processes, like the release of growth factors, which are chemical messengers that promote tissue regeneration.

Depending on the condition being treated, your doctor will use one of two types of ESWT:

  • Focused ESWT: used for precise, deep-tissue penetration
  • Radial ESWT: used for broad area effects within surface-level tissues

ESWT is considered noninvasive and generally safe for most people. The regenerative properties stimulated by ESWT have a variety of benefits, including:

ESWT is used across a variety of musculoskeletal conditions, or conditions affecting your bones, muscles, and connective tissues.

According to therapeutic guidelines from the International Society for Medical Shockwave Treatment, conditions typically treated with ESWT include:

Many medical conditions may be candidates for ESWT if there’s a need for improved tissue healing. Doctors typically recommend ESWT when other first-line therapies haven’t been effective enough, pain is persistent and long term, or when you want to reserve surgery as the absolute last option.

ESWT is considered to be an effective, evidence-based treatment, but its exact success rates vary across the conditions it’s used to treat, and more research is necessary. Other recent studies agree:

  • A 2016 retrospective study examining ESWT for plantar fasciitis saw a 98% success rate among participants at the 1-year mark post-treatment, with only an 8% plantar fasciitis recurrence rate.
  • Research from 2018 found widespread success in the use of ESWT across multiple medical conditions affecting the tendons, with statistically significant improvements seen among each treatment group.
  • A review from 2022 notes that ESWT success rates for tendon conditions typically range from 65% to 91%.

Talk with a doctor to get the best information on how ESWT may be able to help reduce your pain or speed healing.

ESWT is safe with minimal side effects and almost no severe complications when used appropriately.

If side effects do develop, they generally include:

In rare cases, ESWT may contribute to tendon loosening or rupture when tissue degeneration is already present and significant, or the therapy is applied incorrectly.

ESWT should not be applied:

  • near pregnancies
  • over cancerous tumors
  • at sites of infection
  • in certain vascular disorders
  • near metal implants
  • with bleeding disorders
  • in conjunction with certain medications, like corticosteroid injections

ESWT insurance coverage can vary depending on your individual insurance provider and policy. You can find out whether this procedure is covered by contacting an insurance representative at the company holding your policy.

Medicare does not cover ESWT and considers it “not reasonable and necessary” for the treatment of musculoskeletal conditions.

Extracorporeal shockwave therapy (ESWT) is a noninvasive medical procedure that uses acoustic waves to trigger regenerative processes in your body’s musculoskeletal system. It’s used across a wide variety of conditions affecting the muscles, connective tissues, and bones.

Not everyone is a candidate for ESWT, and insurance may not cover the costs of this conservative treatment. You can find out more about ESWT and whether it’s right for you by speaking with your doctor.