North Texas Musculoskeletal Medicine

Enhancing the body's innate ability to heal

Regenerative Orthopedics Osteopathic Manipulation

Extracorporeal Shock Wave Therapy

Extracorporeal Shock Wave Therapy (ESWT) is a noninvasive, FDA-approved technology that uses shock waves to treat chronic, painful conditions of the musculoskeletal system. The procedure has also proven to be extremely effective for improved penile function.  ESWT produces intense, short energy waves that travel faster than the speed of sound. This shock wave, in turn, generates pulses of high pressure sound that travel through the skin, initiating tissue repair. ESWT can often heal even chronic conditions that the body has previously been unable to repair on its own.  The weak shock waves interact with deep tissue where they cause mechanical stress and microtrauma that stimulate the body to jump into action.

ESWT for musculoskeletal injury

The body responds to the shock waves with production of fibroblasts — cells responsible for repair of connective tissues, such as tendon, ligaments, and fascia. Shock waves also simulate the body to produce new blood vessels that increase the delivery of nutrients to the affected area.  This increased metabolism in the tissue promotes healing and subsequent dissolution of calcium deposits. Pressure from the shock waves creates cavitation bubbles, or small empty cavities behind an energy front. As these bubbles burst, they create a force strong enough to break up calcium deposits formed by chronic injury to soft tissue.

ESWT initially diminishes pain through what is known as hyper-stimulation anesthesia. This occurs when the nerves sending signals of pain to the brain are stimulated so much that their activity diminishes, thereby decreasing or eliminating pain. This effect is usually short lived. ESWT is effective in diminishing pain over longer periods of time through stimulation of the "gate-control" mechanism, activating a "reset" button that re-calibrates pain perception.

ESWT for treatment of erectile dysfunction

In Europe, ESWT has been used for many years to improve overall penile function, not only erectile dysfunction.  With age, blood vessels in all parts of the body deteriorate. ESWT stimulates the body to repair old vessels and generate growth of new blood vessels from pre-existing ones, a process call angiogenesis. This arterial growth often results in increased penis size and improved function.  The mechanical pressure on the tissue generated by the shock wave creates an increase in cell membrane permeability, improving microscopic circulation. Patients report more sensitive and sustained erections.

Shimpi et al in a 2017 study of Extracorporeal Shock Wave Therapy report the following results: 

ESWT significantly improves the cavernosal artery velocity, thereby supporting the theory of angiogenesis. ESWT improves all the domains of IIEF including Erectile Function, Sexual Desire, Sexual Satisfaction, Orgasm and Overall Satisfaction. There is a significant improvement in the pain and penile curvature, and reduction in the plaque size. No adverse effects have been recorded.  Read more....

ESTW radically changes treatment of erectile dysfunction. Many patients suffering from ED respond to oral treatments options, including oral phosphodiesterase type 5 inhibitors (PDE5i) and intracavernosal injections of vasodilating agents. However, these medications are unable to alter the underlying pathophysiology of the erectile mechanism. They are usually taken on demand, prior to the sexual act, and do not improve spontaneous erections.  Read more...



ESWT: Procedure Snapshot

The procedure itself is simple and safe. Gel is placed on the treatment area and the pressure-wave applicator is moved over the treatment area for about 10-15 minutes. Patients usually experience benefit after 1-2 treatments and there is no down time.


ESWT is used to safely treat a wide array of acute and chronic musculoskeletal pain, stress fractures and reduction of scar tissue.  It promotes bone and tendon healing.  ESWT is also a radically new option for enhancement of penile function.

Conditions treated include:

  • Achilles pain
  • Back pain
  • Elbow pain (lateral and medial)
  • Erectile dysfunction
  • Frozen shoulder
  • Hamstring issues
  • Hip pain
  • Knee pain
  • Muscle and connective tissue
  • Neck Pain
  • Overuse injuries
  • Scar tissue treatment
  • Shin splints
  • Shoulder pain activation
  • Tendon injuries
  • Tennis and golfer’s elbow