Shockwave therapy uses precisely targeted acoustic pressure waves to stimulate musculoskeletal tissue beneath the skin. The device sends pulses into a targeted tissue or muscle; the waves are adjusted for depth and intensity so they can reach tissue that sits deeper than conventional manual treatment can address.
Shockwave is thought to work by stimulating a local healing response in the treated tissue. The exact mechanism is still being studied, and we would rather describe it that way than overstate what is settled.
Being specific here matters, because shockwave is marketed very broadly.
Chronic plantar fasciitis has the strongest evidence, and it is the one musculoskeletal indication with an FDA approval behind it. The Swiss DolorClast system we use is FDA-approved as a non-surgical option for chronic proximal plantar fasciitis in patients 18 and older, with symptoms of six months or more, who have not improved with conservative care. In the trial supporting that approval, 61% of treated patients met the study's success threshold at three months versus 42% with placebo. Pooled research across eleven randomized trials shows average pain reductions of roughly 2.8 to 3.0 points on a 10-point scale.
Lateral epicondylitis (tennis elbow) has moderate support — a pooled pain reduction of roughly 0.9 points at three months, with no significant improvement in grip strength, and the benefit no longer statistically significant by six months.
Calcific rotator cuff tendinopathy shows meaningful improvement in shoulder function scores, with a notably stronger signal from higher-energy focused treatment than from low-energy settings.
For several other conditions shockwave is commonly used for, the evidence is weaker. Recent sham-controlled research on Achilles tendinopathy, for example, found no benefit over sham at 6 or 12 weeks. We will tell you where your condition sits on that spectrum rather than quoting you a blanket success rate.
BodyPro is one of the few offices in Los Angeles running both types of shockwave technology. Focused shockwave (our Piezowave system) concentrates energy at a precise depth, which matters for structures sitting well below the surface. Radial shockwave (the Swiss DolorClast®) spreads energy across a broader, more superficial area, suited to larger muscle groups and tissue closer to the surface.
To be straightforward about it: head-to-head research has not found either type superior to the other for pain or function. Having both is not a claim that our results are better — it means the choice of device is made based on your anatomy and the depth of the tissue involved, rather than by which machine happens to be in the room.
Shockwave is used for a range of acute and chronic musculoskeletal pain. Conditions we commonly treat include:
Outside chronic plantar fasciitis, this use is off-label — meaning it is accepted clinical practice but not part of an FDA-approved indication. That is true of most shockwave use anywhere, and we think you should hear it from us.
You lie on a treatment table in a position similar to the one used for soft tissue work on the area being treated. Gel is applied so the device glides smoothly, and the depth and intensity of the waves are adjusted as we go.
You will feel it. Most patients describe a dull ache during treatment, and some find the first minute over a tender attachment point genuinely uncomfortable — we adjust intensity based on what you tell us. Afterward you may have temporary soreness, some redness, and occasionally minor bruising in the treated area, typically settling within a day or two. A typical session runs 20 to 30 minutes and you can return to normal activity the same day.
For chronic plantar fasciitis, the protocol behind both the FDA trial and the research literature is three sessions spaced one to two weeks apart. Dr. Arash Noor assesses each patient case by case and typically recommends a series of three to six sessions, 7 to 14 days apart, depending on the condition and the tissue involved.
Be cautious of anyone selling a twelve-session package before treatment has started. The evidence base is built on short courses.
In the research, shockwave performs best as part of a program that includes progressive loading of the affected tissue — not as a passive treatment received while nothing else changes. Progressive strengthening has the strongest long-term track record for tendinopathy of any intervention.
We treat shockwave as the tool that reduces pain enough to do that work properly. Expect to be given exercises, because that is the part that produces durable change.
Shockwave has a good safety record. Serious long-term adverse effects are not a feature of the research literature; reported side effects are minor and transient — temporary pain, redness, swelling, small bruises. It requires no anesthesia and no incision.
It is not appropriate for everyone. Shockwave is generally avoided over certain areas and in certain conditions, including some bleeding disorders, active infection in the area, and during pregnancy. This is part of what your first visit establishes.
If you have acute or chronic pain in a muscle, tendon, or joint, shockwave may be worth considering — and if your condition is one where the evidence is thin, we will tell you that instead. At BodyPro Chiropractic & Sports Medicine we treat everyone from professional athletes to people whose pain is simply making daily life harder. Contact us to set up an appointment and we will give you a straight answer about whether you are a candidate.
This page is general information, not medical advice. Musculoskeletal pain has many possible causes requiring different treatment. Talk to a qualified clinician about your specific situation.