“Increasing evidence suggests that extracorporeal shockwave treatment (ESWT) is safe and effective for treating several musculoskeletal disorders,” according to a 2018 review published by the Journal of Bone and Joint Surgery. The medical community is embracing extracorporeal shockwave therapy (ESWT) like never before. A go-to option for athletes looking for faster healing and recovery for decades, ESWT is now being used to help everyday people rev up natural healing for better, more active lives without surgery. You may have ESWT on your radar if you know someone who’s made an amazing recovery from pain after trying this treatment. ESWT may also be on your mind if you’re desperately searching for a holistic, non-invasive way to treat an injury after being told that surgery is necessary.

During shockwave therapy, pulsations send mechanical waves transmitted through a device with a metal head. Of course, many patients who have undergone this painless, fast treatment would prefer to say that it works like “magic.” The story behind how ESWT became an effective treatment for musculoskeletal conditions is an interesting one! ESWT has actually been used to break up kidney stones with great success for decades. Doctors eventually wondered if this treatment’s ability to break up kidney stones and restore blood flow to blockage points could carry over to scar tissue. It could!

People are sometimes apprehensive when they first hear about ESWT because they assume that “shockwave” therapy is something that’s painful, experimental, and anecdotal. The reality is that doctors have been using ESWT successfully for nearly 40 years. ESWT also has approval from the Food and Drug Administration (FDA) for the treatment of certain conditions. What’s more, insurance companies are increasingly extending coverage to include ESWT treatments. The push toward covering holistic treatments like ESWT is happening because insurance companies are discovering that the effectiveness of ESWT for treating injuries actually helps to cut costs associated with surgery, hospital visits, and complications by resolving pain using a noninvasive, safe, and effective option!

It’s clear that ESWT is becoming an important treatment for managing pain and mobility issues. However, knowing that ESWT is popular still doesn’t give patients considering this option a window into what to expect when they actually show up for their appointments. Are you curious to discover if ESWT is something that can help you finally heal from an injury that is causing you to live with pain, stiffness, reduced range of motion, or reduced mobility? Take a look at a comprehensive guide to extracorporeal shockwave therapy that’s going to help you decide if this treatment is what you’ve been looking for to finally get relief!

The Basics of Extracorporeal Shockwave Therapy

Extracorporeal shock wave therapy (ESWT) is a non-surgical therapy that uses shockwaves to help stimulate the healing of soft tissue. It can be used for essentially any pain affecting any area of the musculoskeletal system. The “nutshell” explanation of why shockwave therapy works is that it creates micro-traumas at the site of your injury to help activate your body’s own natural healing abilities. You’re sending a signal for increased oxygen flow and blood flow to activate cellular regeneration. A study on the biological effects of extracorporeal shock wave therapy (ESWT) on tendon tissue ultimately found that ESWT significantly stimulated the ingrowth of neovascularization associated with increased expressions of angiogenic growth indicators in tendon, bone and tendon-bone interface. The easy way of looking at it is that ESWT helps to bring the damaged tissue “back to life” with increased vascular activity. Here are the “selling points” for pivoting to ESWT if an injury isn’t responding to first-level treatments like icing and rest:

  • Reduces pain.
  • Reduces inflammation.
  • Breaks up scar tissue.
  • Speeds up healing!
  • Creates new cells for healthy tissue.
  • No downtime required!
  • Reduces overall treatment costs for many people!
  • No anesthesia required.
  • Virtually no downtime.

While ESWT is effective, it’s never invasive. It can also be used by people at all stages of “injury.” ESWT can actually be brought in using one of two viewpoints. First, some patients prefer to use ESWT as a way to avoid surgery. A scenario would be that a patient has been told that a chronic case of golfer’s elbow that has left them in a state of extreme pain and stiffness can only be resolved by surgery at this point. The patient may also be relying on pain killers just to be able to get through the day. This is something that we see often in our office. In many cases, the patient is told by a friend or doctor that ESWT may be worth “one last try” before they book their date for surgery. It’s very common for this last-ditch effort to turn into the treatment that ultimately creates the results that the patient was unable to get using other treatments. Many are able to cancel their surgery consultations after finding relief after the first appointment!

The second scenario involves someone who has already had surgery to correct an issue like golfer’s elbow. Many people who get surgery for musculoskeletal pain find that the pain issue isn’t resolved. What’s more, they may experience worsening stiffness and inflammation during the recovery period. The medical community refers to this as having “failed conventional medical therapy.” These patients can also potentially benefit from ESWT. That’s because ESWT can help to promote the healing of soft tissue after surgery. Surgery can often create additional scarring at the site of the injury that leaves a patient feeling worse. ESWT may help to speed up post-surgical healing by ramping up blood flow. The bottom line is that patients should know that the ship for ESWT hasn’t necessarily sailed just because they were talked into surgery. Even patients who aren’t suffering from surgical complications can often benefit from post-surgical ESWT as a way to simply promote faster healing!


What Conditions Does EST Treat?

ESWT first gained acceptance in the mainstream medical world after it was shown to be an effective treatment for plantar fasciitis. Plantar fasciitis is a painful condition affecting the bottom of the foot that is caused by an inflammation of the thick band of tissue connecting the heel bone and toes. While ESWT is now one of the most common treatments for creating long-term relief for plantar fasciitis, this is just one application of many. In fact, many insurance companies today now approve ESWT for use in treating dozens of conditions impacting the musculoskeletal system. Take a look at just some of the conditions and injuries being treated by ESWT by doctors and clinics all around the country:

  • Rotator-cuff pain.
  • Back pain.
  • Knee arthritis.
  • Lateral epicondyle (tennis elbow).
  • Medial epicondyle (golfer’s elbow).
  • Patellar tendonitis (jumper’s knee).
  • Achilles tendonitis.
  • Carpal tunnel syndrome.
  • Carpometacarpal joint osteoarthritis.
  • Chronic pelvic pain.
  • Diabetic nephropathy.
  • Myofascial pain syndrome of the trapezius.
  • Myofascial pelvic pain syndrome.
  • Sacroiliac joint pain.
  • Shoulder tendinitis (frozen shoulder).
  • Hammer toe.
  • Tibialis tendinitis.
  • Hip bursitis.

The beauty of ESWT for patients is that it’s never too late to activate healing following some type of injury or trauma. Many patients are able to find relief years after they experience their first symptoms. However, using ESWT in the early stages of scar formation can make a big difference! That doesn’t mean that ESWT should be considered a first-line treatment following an injury. It’s very important for people who have been injured through things like sports collisions or auto accidents to seek emergency medical treatment. Treatments like rest, icing, bracing, taping and therapeutic exercises can be essential for preventing scar tissue from building up in the first place. However, ESWT can be very effective when brought in as a part of a wider treatment plan because it can help to spur cellular regeneration at the site of the injury to ensure that scar tissue doesn’t settle. That boosted recovery time can be especially important for athletes looking to get back in action without risks for increased pain, reduced mobility, or repeated injuries.

What Does the Research Say About ESWT?

This is where the story of ESWT gets really exciting! There’s been a deluge of studies coming out of the clinical world in recent years demonstrating the benefits of ESWT for various injuries and medical conditions. Let’s start with ESWT’s benefits for pain.

A study from 2020 looked at the use of ESWT for coccydynia. This a chronic condition that’s characterized by pain in the tailbone that is caused by injuring or straining the coccyx, the surrounding muscles or the surrounding ligaments. People often develop coccydynia from things like sitting for long hours at a computer, slipping on the ice in the winter or falling while rollerblading. This particular study from 2020 found that ESWT provided dramatic pain control for patients. In fact, 79.4 percent of patients included in the study experienced significant decreases in pain after ESWT.

The evidence actually gets more promising as we look at more studies. ESWT has been shown to be especially promising for the treatment of a musculoskeletal disorder called calcific tendonitis of the shoulder. This condition is most commonly known as “frozen shoulder.” It’s characterized by shoulder pain and stiffness that can make it impossible for a person to use their shoulder, arm, and hand on one side. Traditionally, care providers will try to use large needles to remove calcium deposits while rinsing the area with sterile saline. ESWT provides a noninvasive, needle-free alternative that may actually produce much better results. In a 2012 study, the success rate for patients using ESWT to treat frozen shoulder was as high as 91 percent. In addition, this study reports that complications stemming from ESWT are considered to be negligible.

An analysis of nine studies involving nearly 1,000 patients that was released in 2017 found that shockwave therapy can relieve pain related to chronic plantar fasciitis while fitting all the criteria to be considered an ideal alternative option. What’s more, the benefits of ESWT aren’t just based on the self-reporting perceptions of patients. Researchers have used ultrasound imaging to observe how ESWT produces morphologic changes related to plantar fasciitis!

What to Expect When Getting ESWT?

ESWT is a great option for anyone who is simply uncomfortable with invasive medical treatments. In fact, “extracorporeal” actually means “outside the body.” Only the outer layer of your skin will come into contact with the tool used to administer this treatment! Let’s talk about what to expect when booking an appointment for ESWT.

First, you’ll have a consultation to ensure that you’re a good candidate for this treatment. The nice thing about ESWT is that it’s typically a treatment that’s appropriate for everyone simply based on the fact that it’s such a gentle treatment that doesn’t generally produce any side effects. Once you’ve been established as a good candidate for ESWT, you’ll have your first appointment. No numbing or anesthesia will be required during the treatment because there’s generally no pain involved. Some patients do find that there’s a little bit of discomfort when the instrument is being placed on trigger-point areas that are typically tender.

This is a treatment that’s done right in our office during normal business hours that takes between 10 minutes and 30 minutes. Yes, an ESWT appointment can be scheduled on a lunch break. Some patients will feel slight pulsations on their skin while the instrument is being used. However, it’s important to note that one of the benefits of shockwave therapy is that only the area being treated will come into contact with the instrument. ESWT allows your medical provider to very strategically apply waves at the exact site of your injury without involving any other part of your body.

Does ESWT have any side effects? It’s the most common question we get about this therapy. The short answer is that ESWT doesn’t generally produce any side effects. However, some patients will experience some slight bruising, swelling, redness or tenderness following treatments. These will all resolve within a few hours. While there isn’t technically any downtime needed following shockwave therapy, you may be instructed to “take it easy” for a day following your treatment. You won’t necessarily want to go straight to picking up heavy moving boxes after an ESWT session for a frozen shoulder.

Many patients begin to experience pain reductions immediately following ESWT. This is owed to the rush of blood to the area that takes place almost instantly. However, patience really is required when waiting to see the full results of ESWT. A treatment plan will typically involve one treatment a week for several weeks. You may not see the full results for months due to the fact that it can take time for cellular turnover to give you “restored” tissue in the area of your injury. The big benefit of using ESWT over a treatment option like surgery is that you don’t have to go through the frustrating experience of getting worse before you get better. While you may not wake up ready to take on the world without pain the day after having ESWT, you’ll still be able to get out of bed! There’s no need to take time out of life for recovery the way you would need to if you chose to go with surgery instead. ESWT also costs just a fraction of what a patient would pay for surgery. It’s important to remember that an injury may have taken months or years to get to the point that it’s at when you begin ESWT. It could take just as long for the tissue to go through a reverse process of undoing the scar tissue that has built up over time.

Should You Try Extracorporeal Shockwave Therapy in Denver, Colorado?

This is a very exciting treatment for patients sufferings from musculoskeletal disorders because it gets right down to the root of the pain to regenerate tissue instead of simply helping you to “cope” with pain the way that so many common pain treatments do! ESWT offers a way for patients to undo tissue scarring and damage by activating the body’s own natural process for regenerating tissue. Unfortunately, the body often can’t achieve this on its own without some help when scar tissue is dense enough to prevent oxygen flow and blood flow from reaching an area.

We’re thrilled to be able to offer our patients access to extracorporeal shockwave therapy right here in Denver, Colorado. Led by Dr. Trent Artichoker, Denver Chiropractic offers cutting-edge treatments focused on helping our patients to achieve long-term healing. Dr. Artichoker specializes in helping patients to recover from accident injuries, sports, injuries, neck pain, back pain, choric-usage injuries, and extremity pain. Denver Chiropractic is the only practice in Colorado currently offering the Swiss-made Dolorclast® machine that sets the standard for precision and quality! Book an appointment with us today to explore the regenerative benefits of ESWT for the injury that’s keeping you down!