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What is extracorporeal shockwave therapy (ESWT)?
Extracorporeal shockwave therapy (ESWT) is a non-invasive, non-surgical treatment used to support healing and relieve pain caused by tendon related conditions.
ESWT uses targeted shockwaves of energy to stimulate blood flow to damaged tissue and encourage cell regeneration. This helps to promote healing and can reduce pain over time, particularly in conditions that haven’t improved with other treatments.
Our physiotherapy team at Guy’s Hospital and St Thomas’ Hospital provide expert assessment and treatment for a wide range of musculoskeletal conditions, from short-term injuries to long-term or recurring problems. The team has experience in sports injuries, occupational health, wellbeing management and post-surgical rehabilitation, ensuring treatment is tailored to your individual needs.
Experts in extracorporeal shockwave therapy
Our personalised physiotherapy solutions include:
- highly experienced musculoskeletal physiotherapists
- shockwave therapy package – 3 sessions from £322
- evidence-based treatment plans
Procedure details
Extracorporeal shockwave therapy (ESWT) is a non‑surgical treatment that uses targeted shockwaves of energy to treat damaged or painful tissue within a tendon.
The shockwaves stimulate increased blood flow to the affected area and encourage cell regeneration, helping to reduce pain and support the body’s natural healing process over time.
Who might benefit from ESWT?
Extracorporeal shockwave therapy (ESWT) may be suitable for people with tendon related conditions that haven’t improved with other treatments. It’s often used to treat pain caused by repetitive strain injuries, particularly in middle age or for people who remain physically active.
Our specialists may recommend ESWT if you’ve had symptoms for 3 to 6 months that haven’t responded to treatments such as physiotherapy or pain relief medication.
To discuss your symptoms and find out whether ESWT is suitable for you, please complete the enquiry form on this page. Our team will be in touch to arrange an appointment.
What conditions can be treated with extracorporeal shockwave therapy?
ESWT is commonly used to manage a range of long term tendon and soft tissue conditions, including:
- achilles tendinopathy
- greater trochanteric pain syndrome
- hamstring tendinopathies
- patella tendinopathies
- plantar fasciitis
- tennis elbow
Your physiotherapist will assess your symptoms and medical history to decide whether ESWT is right for you.
We will also offer ESWT alongside ongoing physiotherapy to strengthen your tendon and muscles while alleviating pain.
We’ll discuss extracorporeal shockwave therapy with you during a consultation to ensure it’s the correct treatment for you. If you’d like to enquire, get in touch with our helpful team and they’ll help you to arrange an appointment.
How does extracorporeal shockwave therapy treatment work?
During ESWT, a clinician uses a specialised shockwave machine to deliver low-energy sound waves directly to the affected area of your body.
A gel is applied to your skin to help the device move smoothly. The shockwaves pass through the skin and stimulate increased blood flow in the injured tissue. This helps to promote healing by encouraging cell regeneration and reducing pain and discomfort.
ESWT is generally well tolerated. While you may experience some discomfort during treatment, it should not cause high levels of pain. The clinician may start at a lower intensity during your first session and increase this gradually in later treatments if needed.
Benefits of extracorporeal shockwave therapy
Extracorporeal shockwave therapy (ESWT) may offer a number of benefits for people with long‑standing tendon conditions, including:
- stimulation of cell regeneration
- enhanced tissue healing
- improved range of motion and daily function
- minimal downtime following treatment
- long‑term pain relief
Our physiotherapists may use ESWT to help manage a range of painful tendon conditions, particularly when symptoms have not improved with other conservative treatments.
If you’d like to discuss whether extracorporeal shockwave therapy could help with your symptoms, please complete the online enquiry form on this page. Our team can review your enquiry and help arrange an appointment.
How successful is extracorporeal shockwave therapy?
Experts consider extracorporeal shockwave therapy to be an effective treatment for a range of painful tendon conditions.
Many patients experience a gradual improvement in symptoms, with benefits often becoming noticeable around 12 weeks after the first treatment session. Your clinician will advise on what outcomes you can expect based on your condition and treatment plan.
Risks of extracorporeal shockwave therapy
Although ESWT is non-invasive, there are some potential risks associated with it.
These include a small risk of:
- damage to surrounding soft tissue
- tendon or ligament rupture
These complications are uncommon. The majority of patients tolerate the treatment well and find it effective in helping to manage pain and support recovery.
Alternative treatments to extracorporeal shockwave therapy
Depending on your symptoms and diagnosis, clinicians may recommend other treatment options, including:
- ice therapy
- orthotics (podiatry)
- physiotherapy
- ultrasound-guided steroid injections
If you have questions about the treatment process or would like to speak to one of our physiotherapists, please complete the enquiry form on this page. Our team can support you with next steps, including arranging an appointment.
Pricing
The cost of extracorporeal shockwave therapy depends on your individual treatment plan, including the number of sessions recommended by your clinician.
Full pricing details for physiotherapy treatments are available on our physiotherapy services page, where you can view the current price list.
Extracorporeal shockwave therapy (ESWT) FAQs
To help you understand the process of ESWT, here are some of the questions we most commonly get asked by patients.
Your clinician will tell you of any specific preparations you must follow before attending your ESWT appointment.
Wear loose-fitting clothing that allows your clinician to easily access the affected area.
They will advise you to stop taking non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen before your appointment and for the full course of treatment, as it may increase the risk of bruising and impact the effectiveness of the treatment.
On average, extracorporeal shockwave therapy takes between 5 and 15 minutes per session. Most people need 3-5 sessions of extracorporeal shockwave therapy once per week.
Once your treatment is completed, you should limit physical activity for at least 48 hours. This rest helps to promote healing and allows your body to recover completely from the procedure.
Your physiotherapist or doctor will provide personalised advice about when you can restart your usual activities.
After completing ESWT, you should be able to go home immediately. Try to take it easy and avoid strenuous activities for the first 48 hours.
Extracorporeal shockwave therapy has some mild side effects, including:
- bruising
- burning sensation
- dizziness
- increased sensitivity
- numbness
- skin redness
- swelling
Do not put ice on the treated area. Take pain relief medication only when advised by a medical professional.
ESWT should not be painful, but some people experience mild to moderate discomfort during the session. Sensitivity varies between individuals and treatment areas. The intensity can be adjusted by the clinician to help keep you comfortable.
ESWT may not be suitable if you:
- are taking anticoagulation (blood thinning) medication
- have a bleeding disorder, such as haemophilia
- have a metal implant in the treatment area
- have had a steroid injection in the affected area within the last 12 weeks
- have a diagnosed tendon tear
- have an infection in or around the joint
- are pregnant or trying to conceive
- are under 18
- have epilepsy
A clinician may recommend ESWT when other conservative treatments haven’t provided sufficient relief. It is often offered as part of a broader treatment plan and may be combined with ongoing physiotherapy to strengthen the tendon and surrounding muscles while reducing pain.
Whether ESWT is suitable for you will be discussed during your consultation. Your clinician will assess your symptoms, medical history, and previous treatments before recommending the most appropriate next steps.
If you’d like to enquire, fill in our online enquiry form and our team can help you arrange an appointment.
Reviewed regularly to reflect clinical best practice
Last reviewed: 04 September 2025
Locations
Extracorporeal shockwave therapy is available in the following locations:
Meet our physiotherapists
Our physiotherapy specialists can provide extracorporeal shockwave therapy to target you damaged tissue. They provide advanced care for a wide range of conditions.