Shockwave Therapy: How Does It Work?

If you’ve been dealing with ongoing heel pain, arch pain or Achilles tendon discomfort, you may have heard of shockwave therapy. It is a non-surgical treatment used for certain persistent foot and ankle conditions, particularly when other treatments have not provided enough relief.

But what exactly is shockwave therapy, and how does it work?

What Is Shockwave Therapy?

Shockwave therapy, also known as Extracorporeal Shockwave Therapy (ESWT), uses a specialized device to deliver acoustic pressure waves into targeted tissues through the skin.

Despite its name, it does not involve electrical shocks or surgery. Instead, the treatment uses mechanical sound waves to stimulate a response in the affected area.

Shockwave therapy is commonly considered for certain long-standing tendon and soft tissue conditions, including persistent heel pain.

How Does Shockwave Therapy Work?

When tissues experience repeated strain, they can become painful and symptoms may persist even after rest or other treatments.

Shockwave therapy delivers mechanical energy to the affected area. Researchers believe this stimulation may influence several processes within the body, including:

• Cellular activity: Encouraging responses involved in tissue maintenance and repair.

• Local circulation: Influencing blood vessel activity in the treated area.

• Pain reduction: Affecting how pain signals are processed by the nervous system.

The exact mechanisms are still being studied. Shockwave therapy does not guarantee healing, but research suggests it may help reduce pain and improve symptoms for some people.

What Conditions Can Shockwave Therapy Help With?

Shockwave therapy is often considered for certain persistent foot and ankle conditions.

Plantar Fasciitis

The plantar fascia is a strong band of tissue along the bottom of the foot that helps support the arch. When it becomes irritated, it can cause heel pain, especially with the first steps in the morning or after sitting for a while.

For persistent plantar heel pain, shockwave therapy may be an option when other treatments have not provided sufficient improvement.

Achilles Tendinopathy

The Achilles tendon connects the calf muscles to the heel bone and helps you walk, run and jump. Repeated strain can contribute to pain and stiffness, particularly during activity or after periods of rest.

Shockwave therapy may be considered for certain cases of persistent Achilles tendon pain, depending on the individual’s symptoms and assessment.

What Does the Science Say?

Research has investigated shockwave therapy for several musculoskeletal conditions, particularly plantar fasciopathy, a common cause of persistent heel pain.

A 2024 systematic review and meta-analysis found evidence that both focused and radial shockwave therapy may reduce pain associated with plantar fasciopathy. However, researchers also noted that treatment settings can affect outcomes and that further high-quality research is needed.

This means shockwave therapy may be helpful for some patients, but it is not a guaranteed solution. Results can vary depending on the condition, treatment approach and individual response.

Shockwave therapy is best considered as one possible part of a broader treatment plan.

What Should You Expect During Treatment?

Before treatment begins, your chiropodist will assess your symptoms and medical history to determine whether shockwave therapy may be appropriate.

During a session, a handheld applicator delivers pressure waves to the targeted area. You may feel tapping or some discomfort, especially around sensitive tissue.

Treatment is generally provided over several sessions, although the number and spacing depend on the condition being treated. Some people notice improvement relatively early, while others may take several weeks to experience changes.

Temporary tenderness, redness, swelling or bruising can occur following treatment. Your chiropodist will explain what to expect and provide guidance about activity afterwards.

Is Shockwave Therapy Right for You?

Shockwave therapy is not suitable for everyone. Your symptoms, medical history and the condition being treated all help determine whether it is an appropriate option.

An assessment can help identify the likely cause of your pain and whether shockwave therapy, footwear changes, exercises, orthotics or another treatment approach may be beneficial.

The Bottom Line

Persistent foot and heel pain can affect everything from walking and standing at work to exercising and participating in sports.

Shockwave therapy uses mechanical pressure waves to stimulate a response in targeted tissues. Research suggests it may help manage certain conditions, particularly persistent plantar heel pain, although results vary between individuals.

At Footprint Health & Wellness, an assessment can help determine the cause of your symptoms and whether shockwave therapy may be an appropriate part of your treatment plan.