Shockwave therapy delivers mechanical energy into tissue and is commonly considered for selected tendon and soft-tissue problems. It is not appropriate for every person or every painful area, so screening should occur before treatment.
Key points
- Treatment should not be applied over certain vulnerable structures or areas with active serious pathology.
- Bleeding risk, anticoagulant use and significant bruising tendency should be discussed.
- Pregnancy, recent surgery, infection and suspected fracture require appropriate screening.
- Pain without a clear diagnosis should not automatically be treated with shockwave.
What a physiotherapy assessment can add
The clinician should identify the target tissue, check whether shockwave is indicated, review medical history and explain expected discomfort and alternatives.
Practical next steps
Ask why shockwave is being recommended and what active rehabilitation will accompany it. Tendon recovery usually also requires appropriate loading and activity modification.
When to seek medical care
Seek medical assessment for severe unexplained pain, suspected fracture, infection, rapidly increasing swelling or neurological symptoms before considering shockwave.
