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What is Shockwave Therapy?

Shockwave Therapy is FDA Approved!


Extracorporeal Shockwave Therapy is the umbrella term used to describe devices that deliver a shockwave or pressure wave into the human body.


There are two types of devices, Focused Shockwave Therapy and Radial Pressure Wave Therapy devices (FSWT and R-PWT). The main difference between these devices are depth of penetration and intensity.



Focused Shockwave Therapy (FSWT)

Radial Pressure Wave Therapy (R-PWT)


Other terms like Softwave or Extracorporeal Pulse-Activated Therapy (EPAT) are marketing terms used to describe Shockwave Therapy. All you or your clinician need to know is if the device is a Focused or Radial device and if it is the right device for your condition.



The type of condition you are treating will help the clinician pick the right device. Most orthopedic problems will be more effectively treated with Radial Pressure Wave Therapy.


Radial Pressure Wave Therapy has also been called Radial Shockwave Therapy, although this is not the correct term. Most conditions or problems are effectively treated with Radial Pressure Wave Therapy as it is a lower intensity and treats more shallow conditions less than 2 inches deep. There are less concerns with R-PWT, has no known side effects and is considered very safe.

Focused Shockwave Therapy = Higher Intensities and Deeper 

Radial Pressure Wave Therapy = Lower Intensities and Shallow



Shockwave Therapy is very safe! There are no known side effects or complications with Radial Pressure Wave Therapy.


That said, we do not do Shockwave treatments over malignant cancer cells or over a developing baby.


Picking the right device for your problem starts with an evaluation. A diagnostic ultrasound can help diagnose the right tissue to treat as well as the depth.


Start with an evaluation by a Physical Therapist, medical doctor or chiropractor.


What conditions does Shockwave Therapy treat?


Approved standard indications 
Chronic Tendinopathies
Calcifying tendinopathy of the shoulder
Tennis Elbow (Lateral epicondylopathy of the elbow)
Hip Bursitis (Greater trochanter pain syndrome)
Jumper’s Knee/Patellar tendinopathy
Achilles tendinopathy/Tendonitis
Plantar Fasciitis, with or without heel spur
Delayed bone healing
Bone Non-Union (pseudarthroses)
Stress fracture
Avascular bone necrosis without articular derangement
Osteochondritis Dissecans (OCD) without articular derangement
Skin Pathologies
Delayed or non-healing wounds 
Skin ulcers
Non-circumferential burn wounds 

Common empirically-tested clinical uses
Rotator cuff tendinopathy without calcification
Golfer’s Elbow (Medial epicondylopathy of the elbow)
Pes-Anserinus tendinopathy syndrome/Anterior Knee Pain Syndrome
Peroneal tendinopathy
Foot and ankle tendinopathies
Trigger Finger
Osgood Schlatter disease: Apophysitis of the anterior tibial tubercle 
Tibial stress syndrome (shin splint)
Knee Osteoarthritis and other Osteoarthritis
Myofascial Pain Syndrome

Bone marrow edema

Exceptional indications – expert indications 
Dupuytren disease
De Quervain disease
Urologic pathologies
Pelvic chronic pain syndrome (abacterial prostatitis)
Erectile dysfunction/Peyronie disease

Experimental Indications
Heart Muscle Ischemia
Peripheral nerve lesions
Pathologies of the spinal cord and brain
Periodontal disease 
Complex Regional Pain Syndrome (CRPS)


What does Shockwave Therapy do?


Shockwave Therapy


Increases the molecule Lubricin, that lubricates our tissues, lasting days and decreasing friction!

Stimulates cells to release growth hormones that effect the growth of blood vessels, skin cells, bone, and collagen or connective tissue.

Stimulates stem cells.

Increases microcirculation or new small blood vessel growth.

Switches our immune system from inflammation to healing.

Stimulates our nerves and increases the number of nerve cells that support the lining or myelin sheath.

Releases nitric oxide (NO), a great molecule that has many great effects. It increases blood flow, increases metabolic or our cells activity, promotes more blood vessel growth, and has an anti-inflammatory effect.

Shockwave Therapy also has an antibacterial effect. It kills bacteria and helps wounds heal faster.


How successful is Shockwave Therapy?


Success rates of Shockwave Therapy depend on the type of condition being treated. Studies of the same condition as plantar fasciitis will show different success rates. 


Shockwave Therapy success rates range from 75% - 90% effectiveness.


Most research averages around 5 treatment sessions, and in our experience most conditions do very well within 5 treatments. Some conditions can get better more quickly, while other conditions might require more.


In a study on chronic low back pain patients Shockwave Therapy was compared to steroid injections and radiofrequency ablation of the low back joint nerves, both using x-ray guidance in an operating room. Radiofrequency lesioning burns the nerves to your spinal joints so that they don’t send pain information anymore. These patients were followed for months after and the two groups that did the best for the longest was Shockwave Therapy and RF ablation for pain reduction and return to activities.

Shockwave Therapy Does Not Hurt!


What would you pick for treatment for your lower back pain? A tissue regenerative treatment that is painless, or a more expensive and invasive treatment such as steroid injections that reduce healing and have a negative effect on our tissue, or burning your nerves? Shockwave Therapy is more cost-effective and stimulates healing.


Shockwave Therapy should be tried before steroids or more invasive surgical procedures.


Increase the success rate of Shockwave Therapy by preventing re-injury!


Your chance of success increases when the mechanisms of re-injury, such as a joint or tissue problem that needs correcting or an activity that is injuring your tissue, continue. Combining Shockwave Therapy with good Physical Therapy to restore normal joint motion and coaching can help increase your success.


Check out Tissue Regenerative Therapy to learn more.

Does Health Insurance Pay for Shockwave Therapy?


While Shockwave Therapy is FDA approved and there are billing codes for treatment, insurances have not started to pay for Shockwave Therapy.


Cornerstone Physical therapy charges between $100 to $150 per Shockwave Therapy session. Treatment conducted by a Physical Therapist that includes manual medicine and coaching with Shockwave Therapy is 150 dollars per treatment for Cornerstone Members. (Membership is free!) More straightforward cases are more cost effective at 100 dollars per session.


The range of costs vary from up to $500 per session to as low as $100. This article will hopefully help you decide how to pick the right clinic for your condition.


At Cornerstone we want you to succeed, and that is why we only allow our Shockwave clients to purchase a package of 5 treatment following a detailed evaluation by one of our Physical Therapists.


You can use your Health Savings account to pay for Shockwave Therapy.


What is Shockwave Therapy?