Ultrasound Guided Extracorporeal Shock Wave Therapy (ESWT) is a non-invasive treatment for tendons and muscles pain caused by injuries and repetitive use.

ESWT is most commonly used for tendinosis at the shoulder (rotator cuff), elbow (tennis elbow and golfer’s elbow), hamstring origin, patella (jumper’s knee), Achilles tendon or the plantar fascia (heel spur). It can also be used in ligaments and muscles. Before treatment, an accurate diagnosis is essential, which will usually require a diagnostic ultrasound or MRI scan.

EWST is recommended for patients who have not recovered after at least three months of traditional treatment such as anti-inflammatory medications, injections (autologous blood, Platelet-Rich Plasma or corticosteroid) and physical therapy. The effects of ESWT may be felt only after a series of 3-4 treatments, though some patients report immediate pain relief. Four out of five patients report significant improvement in pain after treatment.


If possible, wear clothing that allows easy access to the area that is being imaged.


The ultrasound will be done by a sonographer. First, clear gel is applied to the area of concern to help the ultrasound glide easily over your skin. The sonographer will confirm your diagnosis and find the how large the affected area is.

The radiologist will then plan treatment to target the affected area, and you can ask them any questions.

If needed, more gel is applied, and the ESWT probe is placed over the area. Extracorporeal means “outside the body”. There are no needles involved, and you will quickly get used to the sensation. The treatment takes approximately 10 minutes, and we schedule 3 to 4 treatment sessions at weekly intervals.

An ongoing rehabilitation program should be guided by your surgeon, sports doctor, GP, physiotherapist or podiatrist.

Risks / Side effects

No serious complications have been reported using low-energy ESWT. Short-term effects include redness of the skin for a few days or minor bruising in 3% of patients. Mild discomfort at the site of ESWT is common but is generally no more severe than the pain experienced during use. The procedure should not be done on patients with malignancy, deep veins thrombosis, or pregnancy.

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