Shockwave & SoftWave Therapy: Straight Answers

Shockwave therapy — properly called extracorporeal shockwave therapy (ESWT) — uses acoustic pressure waves generated outside the body and delivered into tissue through the skin. It is non-invasive, uses no needles and no incisions, and has been studied mainly in chronic tendon and soft-tissue conditions.

SoftWave® is a specific brand of shockwave device used in musculoskeletal care. It produces acoustic shockwaves electrohydraulically and distributes energy across a broad treatment area rather than concentrating it at a single deep focal point. It is one technology within the wider shockwave category.

Not exactly. Shockwave therapy is the broad category; SoftWave is one specific technology within it. Devices differ in how they generate acoustic energy and how that energy is distributed through tissue, so research on one device does not automatically transfer to another.

Acoustic pressure waves pass into tissue and create mechanical stimulation there. Laboratory and animal research has proposed mechanisms including new blood vessel formation, release of growth factors and modulation of pain signalling. Much of that mechanistic evidence is preclinical, so it describes proposed mechanisms rather than guaranteed clinical effects.

Most people describe the sensation as tapping, pulsing or pressure. Sensation varies by person, by body area and by device settings, and mild discomfort may occur during or after treatment. It would be inaccurate to describe it as completely painless for everyone.

The treatment portion of a visit is generally short — commonly several minutes per area — with additional time for assessment and discussion. Exact session length depends on the area being treated and the clinician's plan, so the clinic is the right source for specifics.

This varies by condition, chronicity and individual response, and it is determined by the treating clinician after evaluation. We deliberately do not publish a visit count or protocol on this site, because doing so would be guessing about your care.

Shockwave therapy is non-invasive and does not involve needles, anaesthesia or incisions. Activity guidance afterwards varies by condition and individual, and should come from the treating clinician.

Chronic tendon and soft-tissue problems are the categories most commonly discussed: plantar fasciitis and heel pain, Achilles tendinopathy, rotator cuff and calcific shoulder tendinopathy, tennis and golfer's elbow, gluteal tendinopathy at the hip, patellar tendon problems at the knee, and overuse injuries in active adults. Candidacy is always determined by evaluation.

Plantar fasciitis is one of the most-studied shockwave indications. Several randomised, placebo-controlled trials report reduced heel pain with active treatment, while others found no significant difference from sham. The evidence is genuinely mixed, which is why an individual evaluation matters.

It has been studied in patellar tendinopathy and knee osteoarthritis with mixed results — a 2022 meta-analysis suggested benefit for patellar tendinopathy, while a randomised trial in in-season jumping athletes found none. Knee pain has many possible causes, and shockwave is not automatically appropriate for all of them.

The strongest shoulder evidence is in chronic calcific rotator cuff tendinitis, where a randomised controlled trial published in JAMA found high-energy focused treatment associated with reduced calcium deposit size and improved function versus placebo. Other shoulder conditions have less specific evidence.

Research in lateral epicondylitis conflicts: a 2005 randomised trial reported improved pain and grip strength versus placebo, while a 2002 double-blind trial found no benefit over sham. Differences in dosing and technique may explain part of the disagreement.

It has been studied mainly in chronic mid-portion Achilles tendinopathy, usually in combination with an eccentric loading program, with randomised trials reporting improvements in pain and function. Insertional Achilles problems behave differently and need their own assessment.

Shockwave therapy is used in sports medicine settings, typically for chronic tendon and soft-tissue problems and typically alongside rehabilitation. A 2023 systematic review in the British Journal of Sports Medicine describes generally supportive but variable-quality evidence in athletes and physically active individuals.

No. Therapeutic ultrasound uses continuous or pulsed sound waves, usually to produce thermal and low-level mechanical effects. Shockwave therapy delivers discrete, high-amplitude acoustic pressure pulses with a very rapid rise in pressure. They are different physical phenomena with different research bases.

No. Laser therapy delivers light energy; shockwave therapy delivers acoustic pressure waves. They are separate modalities and their evidence bases are separate as well.

Radial pressure wave devices are typically pneumatic: a projectile strikes an applicator and the resulting pressure wave spreads out from the skin surface, with energy highest at the surface. SoftWave generates shockwaves electrohydraulically and distributes energy over a broader area within tissue. The two are not interchangeable, and study results from one device type should not be assumed to apply to another.

SoftWave devices hold FDA clearances, and the exact cleared language matters. Class I indications include relief of minor muscle aches and pains, temporary increase in local blood circulation, and activation of connective tissue. A separate Class II 510(k) clearance covers treatment of chronic, full-thickness diabetic foot ulcers within defined limits. FDA clearance for those indications is not a claim of clearance for every musculoskeletal condition discussed on this site — see our FDA transparency section for details and sources.

We do not publish pricing on this site, because fees depend on the treatment plan established at the clinic. Total Health Chiropractic in Coralville can give you current, accurate information — call (319) 338-7025.

Coverage varies by plan and we will not guess about yours. Ask Total Health Chiropractic directly and confirm with your insurer before making a decision.

Treatment featured on this site is provided at Total Health Chiropractic, 2201 E. Grantview Dr. #202, Coralville, IA 52241 — serving Iowa City, Coralville and surrounding Johnson County communities. Iowa City Shockwave is an educational resource, not a separate clinic.