Enhancing the body's innate ability to heal

North Texas Musculoskeletal Medicine

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. ESWT produces an intense, very short energy wave, traveling faster than the speed of sound that creates the shockwave. This shockwave generates pulses of high pressure sound that travel through the skin (extracorporeal or outside the body),which initiates tissue repair. ESWT can often heal, even in chronic cases, areas where the body has demonstrated a previous inability to heal on its own.

ESWT is thought to work by inducing microtrauma to the affected tissue. This microtrauma initiates a healing response by stimulating the body to produce fibroblasts — cells responsible for the healing of connective tissues, such as tendon, ligaments, and fascia. It also simulates the body to produce new blood vessels,which increases the delivery of nutrients to the affected area.

ESWT: Procedure Snapshot

The procedure itself is very 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. This stimulates cells in the body known as fibroblasts, which are responsible for the healing of connective tissues such as tendon, ligaments, and fascia.The shockwave exerts a mechanical pressure on the injured tissue, which has been shown to create an increase in cell membrane permeability that increases microscopic circulation. The increased metabolism within the treated tissues promotes healing and subsequent dissolution of calcium deposits.

In addition, pressure from the ESWT 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 is where 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 (but not always) short lived. It is also believed to diminish pain over longer periods of time through stimulation of the "gate-control" mechanism,which activates a sort of "reset" button that recalibrates pain perception.


ESWT is used to safely treat a wide array of acute and chronic musculoskeletal pain as well as stress fracture and scar tissue, and it enhances bone and tendon healing. Patients usually experience benefit after 1-2 treatments and there’s no down time.

Conditions treated include:

  • Achilles pain
  • Back pain
  • Elbow pain (lateral and medial)
  • 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