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Shockwave Therapy

Shockwave is a procedure where sound waves are passed through your skin to an area of the body that is causing pain. Someone who receives shockwave therapy may suffer chronic pain caused by a musculoskeletal condition or chronic tendon problems.

Also known as: extracorporeal shockwave therapy (ESWT or ECSWT for short)

Everything you need to know

Shockwave is a procedure where sound waves are passed through your skin to an area of the body that is causing pain. Someone who receives shockwave therapy may suffer chronic pain caused by a musculoskeletal condition or chronic tendon problem such as:

  • Plantar fasciitis (Plantar fasciopathy)
  • Heel spurs
  • Achilles Tendon (Achilles tendinopathy or tendonitis)
  • Calcium deposits in your shoulder rotator cuffs (Shoulder calcific tendinosis or calcific tendonitis)
  • Tennis elbow (Lateral epicondylitis)
  • Golder’s elbow (Medial Epicondylitis)
  • Jumper’s knee (Patella tendinopathy)
  • Hip pain (caused by greater trochanteric pain syndrome)
  • Inflammation in the tendons at the back of your thigh (Proximal hamstring tendinopathy)

Before therapy

After an injury or if you notice symptoms such as pain and stiffness flaring up, it’s important to get checked out by a doctor and have a comprehensive assessment. In the first instance, you should see a GP or physiotherapist. However, if your symptoms are affecting a specific body-part, you may wish to book an appointment with a specialist consultant. Usually, your doctor will refer you for a scan, such as an X-ray, to help confirm your diagnosis.

Depending on the extent of your issue, your doctor may recommend an injection to help reduce your pain and inflammation, as well as a course of physiotherapy. If your symptoms continue after physiotherapy and injections, your doctor may suggest shockwave therapy. Shockwave therapy is a non-invasive treatment that is carried out by a specially-trained physiotherapist.

You will have to avoid taking anti-inflammatory (NSAIDs) drugs such as ibuprofen for two weeks before your treatment and throughout the treatment period.  If you are unsure whether your medicines contain NSAIDs, please check with your doctor, a nurse or pharmacist. Shockwave treatment takes several weeks, with each session one week apart. Try to make sure you are available for the entire course of treatment to avoid too long a break between sessions.

On the day of your treatment, you can eat and drink as normal. Wear comfortable clothing that gives your therapist easy access to the area being treated. Each session will only last 10 minutes, but allow yourself 30 minutes per appointment to cover check-in and check-out times.

During therapy

On the day, you should come to our Therapies Department, where you will be greeted by your therapist. Once you are settled in your room, treatment can start. You will not need to get changed, but your therapist will need to access the painful area, so make sure you wear loose, comfortable clothes.

Your therapist will start by locating the painful area through palpation. The physiotherapist will then put some water-based gel on the area and place a handheld probe on the area. The gel is applied to the skin to ensure good transmission of the shockwave. The shockwave machine works by delivering sound waves to the painful area. These increase blood flow, thereby accelerating the body’s natural healing process. The machine can be quite noisy but should not be too painful; rather, it should feel like a strong vibration.

The soundwaves will be applied for around 5 minutes and you will usually need 3-5 sessions before you notice an improvement in your symptoms. Sessions should be weekly and no more than 2 weeks apart. Over time, your body’s tolerance to the soundwaves will increase, meaning you can tolerate more intense shockwaves. Over time, your tendon strength will also increase, thereby leading to a reduction in your pain.

After therapy

After your treatment session, you can carry on your day as normal. However, you may feel a mild ache for the rest of the day. To help reduce your pain, take some pain relief, such as Paracetamol before and after your session.

Do not use anti-inflammatory medications such as Ibuprofen, Aspirin or Diclofenac and don’t use ice packs as these counteract the body’s inflammatory and healing process stimulated by the shockwave treatment. Some people will notice a reduction in their pain immediately, but long term effects are normally seen after three months of a full treatment course alongside physiotherapy.

All patients will be reviewed by their referring doctor after having completed the course of shockwave treatment.

How to pay for your treatment

If you’re… paying for yourself

Did you know you don’t need private medical insurance to come to St John & St Elizabeth Hospital? As a self-pay patient, you can access safe, outstanding quality health care at times to suit you.

For scans and tests, as well as to see most consultants, you’ll still need to be referred by a medical professional like your GP, but as a self-pay patient, the process is more straightforward. You won’t need authorisation from an insurance provider, and you’ll have greater choice of therapist and appointment times.

Shockwave treatment costs £140 per session or £395 for a package of three. As with any type of physiotherapy, you will need to receive multiple sessions to feel the comprehensive benefits of treatment.

If you’re… insured

St John & St Elizabeth Hospital is approved by all major medical insurance companies. If you have a personal private health insurance policy, or your company provide it for you, you can use it to pay for your care from your initial consultation through to treatment, surgery and aftercare such as physiotherapy. Not all private health insurance plans cover the same things. It’s very important to check exactly what you are covered for with your insurance provider.



Your treatment journey will normally start with a GP appointment. They will refer you for physiotherapy or to a specialist consultant. You may also refer yourself to a physiotherapist or consultant. Your doctor may also refer you for a scan, such as an ultrasound or x-ray to help confirm a diagnosis.


Treatment plan

You will usually start with more conservative treatment methods such as physiotherapy exercises and then injections to help reduce pain and inflammation. If your symptoms do not improve after an injection, shockwave therapy can be recommended.


Shockwave therapy

You will usually have a course of 3 to 5 sessions. These will be weekly.



Once your shockwave sessions have finished, you will have a follow-up appointment with the doctor that referred you. Here, you will discuss how the treatment has helped and potential next steps.

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