Shockwave therapy is most commonly used to treat chronic tendon injuries and foot pain that haven’t responded to other treatments. It works by delivering acoustic pressure waves through the skin into damaged tissue, triggering the body’s own repair processes: new blood vessel growth, cell regeneration, and changes in pain signaling. The technology has expanded beyond its original use for kidney stones into orthopedics, men’s health, and wound care.
Tendon and Joint Conditions
The largest body of evidence supports shockwave therapy for chronic tendon problems. The International Society for Medical Shockwave Treatment recognizes several specific conditions as appropriate uses: plantar fasciitis (with or without a heel spur), Achilles tendinopathy, lateral epicondylitis (tennis elbow), calcifying tendinopathy of the shoulder, patellar tendinopathy (jumper’s knee), and greater trochanter pain syndrome at the hip.
What these conditions share is a tendon or connective tissue that has been injured, failed to heal properly, and become a source of chronic pain. Shockwave therapy essentially restarts the healing process. The acoustic waves stimulate cells to proliferate and migrate into the damaged area, promote the growth of new blood vessels to bring nutrients to the tissue, and alter pain pathways so the area becomes less sensitized over time. For bone-related problems like calcific deposits in the shoulder, focused shockwave therapy can also encourage bone-forming cells to activate, helping break down and remodel the calcification.
Plantar fasciitis is one of the best-studied applications. In a study published in the Annals of Rehabilitation Medicine, the short-term success rate was about 63%, climbing to 80% at long-term follow-up. That pattern is typical: many patients see modest improvement initially, with results continuing to build over weeks and months as the tissue remodels.
Erectile Dysfunction
Low-intensity shockwave therapy has generated significant interest as a treatment for erectile dysfunction. The idea is that delivering gentle acoustic waves to penile tissue stimulates new blood vessel growth, improving the blood flow that’s essential for erections. A large Cochrane review looked at 21 studies involving 1,357 men between the ages of 39 and 65 who had experienced erectile dysfunction for anywhere from 3 months to nearly 6 years.
The results were mixed. In the short term (3 months or less), shockwave therapy showed a small improvement in erectile function, but the effect may not have been noticeable enough for men to feel a meaningful difference. Over the longer term, improvements were slightly better. Penile rigidity showed a similar pattern: modest short-term gains that weren’t always large enough to matter in practice.
The Cochrane researchers expressed low confidence in these findings. Study quality was inconsistent, different clinics used different shockwave protocols, and results varied widely from study to study. Nine of the 21 studies received funding from device manufacturers. So while the treatment is widely marketed for ED and appears safe (side effects were uncommon), the evidence that it works well enough to notice remains uncertain.
Wound Healing
Shockwave therapy is being explored as a tool for chronic wounds that resist standard treatment, particularly diabetic foot ulcers. The same biological mechanisms that help tendons heal (increased blood flow, cell migration, tissue regeneration) could theoretically accelerate wound closure. In a randomized trial published in The Journal of Foot and Ankle Surgery, researchers compared standard wound care alone against standard care plus shockwave therapy over six weeks. More ulcers healed in the shockwave group, with patients roughly 3 to 4 times more likely to achieve wound closure, but the difference didn’t reach statistical significance in this relatively small 48-person study. This remains a promising but still-developing application.
Focused vs. Radial: Two Types
Not all shockwave therapy is the same. The two main types differ in how deep they penetrate and how they distribute energy, which makes each better suited to different conditions.
- Radial shockwave therapy uses compressed air to fire a projectile inside a handpiece, creating a wave that spreads outward from the skin surface. It penetrates about 3 to 4 centimeters deep and covers a wider area with lower intensity. This makes it well suited for superficial or near-surface problems like Achilles tendinopathy, tennis elbow, and plantar fasciitis.
- Focused shockwave therapy uses electromagnetic energy directed through a cone of crystals, concentrating the wave into a precise point. The focal depth is adjustable from 2 to 30 centimeters, with higher peak intensity. This type works better for deeper structures like the hamstring, pelvis, or hip, and can also target bone-related conditions like calcific shoulder deposits.
Your provider will choose the type based on how deep the problem sits and how concentrated the energy needs to be. Some clinics have both devices, while others offer only one.
What a Treatment Session Looks Like
A typical shockwave session lasts about 15 minutes. The provider applies gel to your skin (similar to an ultrasound), places the handpiece against the treatment area, and delivers a series of rapid pulses. You’ll feel a tapping or snapping sensation that ranges from mildly uncomfortable to moderately painful depending on the intensity and location. No anesthesia is needed for most protocols.
Most treatment plans involve multiple sessions, often up to six. You may notice a decrease in pain shortly after the first session, but it’s common for pain to return within one to two weeks before improving again. This temporary flare reflects the inflammatory healing response the therapy is designed to trigger. Full results often take several weeks to months to develop, which is why long-term outcomes tend to be better than short-term ones across studies.
Recovery between sessions is minimal. Most people return to their normal activities the same day, though high-impact exercise on the treated area is generally limited for a short period.
Cost and Insurance Coverage
Shockwave therapy is generally not covered by insurance plans. At UCHealth, for example, a full treatment package of up to six sessions costs $550. Prices vary by clinic and region, but most practices charge somewhere between $100 and $300 per individual session, or offer bundled pricing. If you have a Health Savings Account or Flexible Spending Account, those funds can typically be used to cover the cost.
The lack of insurance coverage reflects the fact that for several applications, particularly erectile dysfunction and wound healing, the evidence base is still building. For musculoskeletal conditions like plantar fasciitis and tendinopathies, the evidence is stronger, but coverage policies haven’t caught up uniformly.