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What Is Shock Wave Therapy? The High-Energy Treatment for Muscle and Tendon Pain

Board-certified physiatrist

Published Updated 6 min read

A physical therapist using a focused shockwave handpiece on a patient’s neck and shoulder
In this article

Shock wave therapy, or extracorporeal shock waves, is a newer technology used to treat musculoskeletal pain. It delivers fast results, each treatment session is quick, and it is safe. So what exactly is shock wave therapy? Today, let’s get to know it better.

What Is Shock Wave Therapy?

The full name of shock wave therapy is Extracorporeal Shock Wave Therapy (ESWT). It is a technology based on physical mechanisms that generates high-energy shock waves directed deep into the body’s tissues to stimulate the repair process — promoting the release of growth factors and the formation of new blood vessels — so that chronically inflamed or injured tissue can repair itself faster and more effectively.

Benefits of Shock Wave Therapy

  1. Stimulates new blood vessel formation: This increases blood supply and oxygen delivery to the injured tissue, promoting better tissue repair.
  2. Corrects the chronic inflammatory process: By deliberately triggering a controlled inflammatory response, it activates mast cell function and improves the healing of the injury.
  3. Releases muscle trigger points.
  4. Breaks down calcified deposits: Those formed as a result of tendon injury.
  5. Reduces pain: By lowering levels of substance P, the neurotransmitter responsible for pain signals.
Thai-language infographic on focused shockwave: the device and the three steps by which it stimulates tissue repair

Types of Shock Waves

There are two types of shock wave therapy:

  1. Focused shock wave (fESWT) — Its energy source is electrical, such as electromagnetic, electrohydraulic, or piezoelectric, depending on the manufacturer. Focused shock waves deliver high-energy waves that reach deeper and more strongly into the tissue than radial shock waves.
Table comparing focused and radial shockwave by how they work, how deep the energy reaches, and the conditions they suit

It is suitable for people with muscle tightness, or with tendon and muscle injuries at both superficial and deep levels.

  1. Radial shock wave (rESWT) — Its energy source comes from compressed air inside the device (pneumatic), which fires a projectile into the applicator head to strike the area of skin in contact with it. The impact force is greatest at the skin surface and the wave’s energy decreases as it travels deeper. It is suitable for people with superficial tendon pain or muscle tightness.

Who Is Shock Wave Therapy Suitable For?

  • Rotator cuff syndrome (inflamed shoulder tendons)
  • Elbow tendinitis (golfer’s elbow, tennis elbow)
  • Patellar tendinitis (knee tendon inflammation)
  • Achilles tendinitis
  • Plantar fasciitis (inflamed or overused plantar fascia)
  • Myofascial pain syndrome and muscle/fascia pain (Office Syndrome)
  • Sports injuries (stress fracture, shin splints, sports injury)
  • Anyone with muscle, tendon, or joint pain
Thai-language poster “Who is focused shockwave for?” showing five pain areas: shoulder, elbow, neck and shoulders, heel, and knee

Shock wave therapy is safe and the chance of side effects is low. However, for those with blood clotting disorders or taking anticoagulant medications, pregnant women, people with vascular occlusion conditions, cancer patients, and those with neuropathy, I recommend consulting a physician before undergoing shock wave therapy to assess the risks and the suitability of treatment.

If you have muscle or tendon pain and want to consult a rehabilitation medicine specialist, or are interested in shock wave therapy, come see me at Freesia Rehab Clinic, a rehabilitation and physical therapy clinic on Rama 3.

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