The Shockwave Sting: What to Expect
Shockwave therapy, or Extracorporeal Shockwave Therapy (ESWT), is a non-invasive treatment that uses high-energy acoustic waves to stimulate healing in musculoskeletal conditions. It is commonly used for chronic tendon injuries, plantar fasciitis, and calcific shoulder tendinitis. During a session, a handheld device delivers rapid pulses of energy to the affected area, increasing blood circulation, breaking down calcifications, and stimulating cell regeneration. Most patients feel a series of quick, repetitive pulses, often described as a dull ache, pressure, or sharp tapping sensation. The level of discomfort varies based on:
- The treatment area (bony areas tend to be more sensitive).
- Energy level settings (higher intensities may cause more discomfort).
- Personal pain tolerance (some people are naturally more sensitive).
While some discomfort is expected, severe pain is not the goal. Shockwave therapy should be tolerable, even if slightly unpleasant.
Normal vs. Concerning Pain: Know the Difference
Pain is a common concern for patients undergoing shockwave therapy. However, it’s important to distinguish normal treatment sensations from problematic pain.
Expected & Normal Pain
- A dull ache or mild discomfort during the session, which lessens as the body adapts.
- A temporary increase in soreness for 24–48 hours post-treatment.
- A “good pain” feeling, similar to deep tissue massage or post-workout soreness.
Red Flag Pain: When to Be Concerned
- Sharp, intense pain that worsens with each pulse, rather than subsiding.
- Severe swelling, bruising, or extreme tenderness after treatment.
- Pain persisting for more than a few days without signs of improvement.
If you experience extreme discomfort, your therapist may need to adjust the intensity or explore alternative approaches.
Should You Continue or Stop?
Mild discomfort during and after therapy is not a reason to stop—it’s often a sign that the treatment is effectively targeting damaged tissue. Most patients notice a significant improvement in pain levels after 3–5 sessions.
However, consider pausing or adjusting treatment if:
- The pain is too intense to tolerate, even at lower settings.
- Your symptoms worsen over time instead of improving.
- You have an underlying medical condition that makes you more sensitive to shockwave therapy (e.g., nerve disorders or severe osteoporosis).
Always discuss concerns with your healthcare provider before discontinuing treatment.
Making Shockwave Therapy More Comfortable
If you find shockwave therapy too painful, here are ways to minimize discomfort:
- Lowering the intensity: Therapists can start with lower energy levels and gradually increase them as your body adapts.
- Using numbing agents: Some clinics apply topical anesthetics to sensitive areas before treatment.
- Hydration and rest: Drinking plenty of water flushes out metabolic waste, reducing post-treatment inflammation.
- Spacing out sessions: Allowing more recovery time between treatments can help minimize lingering soreness.
- Proper positioning: Adjusting body alignment during treatment can prevent excessive pressure on sensitive spots.
Many patients find that discomfort decreases with each session as their tissues begin to heal.
The Verdict: Pain Isn’t Always a Bad Sign
Experiencing some level of pain during shockwave therapy is normal and often beneficial. It means the treatment is triggering a healing response. However, severe or prolonged pain should not be ignored. Working closely with your therapist to adjust intensity and manage discomfort can ensure safe, effective recovery. If pain becomes unmanageable, explore alternative approaches to ensure your healing journey remains on track.