Advanced Specialist Shock wave Therapy In London
Shock Wave Therapy (ESWT) — Non-Invasive Treatment for Chronic Pain and Tendon Injuries
Extracorporeal Shock Wave Therapy (ESWT) is a non-invasive treatment that uses focused acoustic sound waves to stimulate the body’s natural healing response in damaged tendons, ligaments, and soft tissue. At Physio1stUK, our physiotherapists use ESWT to treat chronic, stubborn conditions that haven’t responded to rest, stretching, or standard physiotherapy alone — helping patients avoid steroid injections or surgery where possible.
ESWT is recognised by the National Institute for Health and Care Excellence (NICE), which has issued specific guidance supporting its use for conditions including plantar fasciitis, Achilles tendinopathy, and tennis elbow.
What Is Shock Wave Therapy and How Does It Work?
“Extracorporeal” simply means “outside the body” — a handheld device delivers high-energy acoustic pulses through the skin to the injured area, without needles or incisions.
Once delivered, these shockwaves trigger several biological repair processes:
– **Angiogenesis** — new blood vessels form around the injury, improving circulation and oxygen supply to the damaged tissue
– **Mechanotransduction** — mechanical energy from the shockwaves is converted into cellular signals that switch on the body’s repair mechanisms
– **Controlled microtrauma** — the therapy creates tiny, controlled micro-injuries that prompt the body to treat the area as needing active repair, restarting a healing process that had stalled
– **Breakdown of calcific deposits** — in conditions like calcific tendinopathy of the shoulder, shockwaves help disperse calcium build-up within the tendon
– **Pain gate modulation** — many patients notice a reduction in pain sensitivity within the first few sessions, thought to be linked to desensitisation of local pain receptors
Conditions We Treat With ESWT
Our physiotherapists commonly use shockwave therapy for:
Plantar fasciitis (chronic heel pain from degeneration of the plantar fascia)
Achilles tendinopathy
Tennis elbow (lateral epicondylitis) and golfer’s elbow (medial epicondylitis)
Patellar tendinopathy (“jumper’s knee”)
Calcific tendinopathy of the shoulder
Greater trochanteric pain syndrome (hip bursitis-type pain)
Proximal hamstring tendinopathy
ESWT is typically recommended once conservative treatments — rest, orthotics, stretching, anti-inflammatory medication, or manual physiotherapy — haven’t fully resolved symptoms after several weeks, which is why it’s often described as a treatment for “refractory” (treatment-resistant) tendon conditions.
What to Expect During a Session
– **Session length:** Most sessions take 5–15 minutes per treated area
– **Course of treatment:** A typical course is 3–6 sessions, usually spaced one to two weeks apart, since the tissue needs time to respond between treatments
– **Sensation:** You may feel a tapping or mild discomfort during treatment, and some soreness for a day or two afterwards — this is a normal part of the healing response, not a sign of harm
– **No anaesthesia required:** ESWT is typically performed without local anaesthetic, as several studies suggest this doesn’t affect the treatment’s effectiveness
– **Immediate vs. cumulative effect:** Some patients feel pain relief after the first session, but the full benefit builds cumulatively across the whole course — it’s important to complete the recommended sessions even if early improvement feels good
Benefits of Shockwave Therapy
**Pain relief** — By stimulating nerve desensitisation and reducing inflammation, ESWT can meaningfully reduce chronic pain from tendinopathies and heel conditions.
**Accelerated tissue healing** — The angiogenesis and cell signalling triggered by treatment support faster, more complete repair of damaged tendons and soft tissue.
**Breaks down calcific deposits** — For calcific tendinopathy, ESWT can help disperse the calcium build-up that causes ongoing irritation and restricted movement.
**Non-invasive alternative** — Because it avoids surgery, injections, and medication, ESWT carries a lower risk profile and typically requires no recovery downtime.
Safety and Contraindications
- ESWT is generally safe when delivered by a trained physiotherapist, but it isn’t suitable for everyone. You should tell your physiotherapist before treatment if you:
- Are pregnant (treatment is avoided over the abdomen and pelvis)
- Have a bleeding or clotting disorder, or take anticoagulant medication
- Have a tumour or history of malignancy near the treatment site
- Have a cardiac pacemaker or other implanted electronic device
- Have an active infection at the treatment site
- Your physiotherapist will carry out a full assessment before your first session to confirm ESWT is appropriate for your condition.
Why Choose Physio1stUK for Shockwave Therapy
Our physiotherapists assess each patient individually before recommending ESWT, ensuring it’s used where the evidence — and NICE guidance — supports it, and combined where appropriate with a broader rehabilitation plan (strengthening, stretching, and load management) rather than used as a standalone quick fix.
**Ready to start your recovery?** [Book a Shock Wave Therapy assessment](https://www.physio1stuk.com/book-appointment/) with one of our physiotherapists today.
Frequently Asked Questions
**Is shockwave therapy painful?**
Most patients feel a tapping sensation and mild discomfort rather than sharp pain. Any soreness afterwards is usually mild and settles within a day or two.
How many sessions will I need?
Most treatment courses involve 3–6 sessions spaced one to two weeks apart, though this varies depending on your condition and how you respond.
How quickly will I see results?
Some patients notice improvement after the first session, but full results typically build over the complete course of treatment — it’s important not to stop early even if you feel better.
Is ESWT covered by NICE guidance?
Yes. NICE has published specific guidance supporting the use of extracorporeal shockwave therapy for conditions including plantar fasciitis and Achilles tendinopathy.
Who shouldn’t have shockwave therapy?
ESWT isn’t recommended during pregnancy, or for patients with bleeding disorders, active infections, tumours near the treatment site, or cardiac pacemakers. A full assessment is carried out before treatment begins.