Plantar fasciitis & heel pain
The most studied musculoskeletal use of shockwave, and the one patients ask for by name. Best evidence is in heel pain that has been there more than three months.
Read more →Home/Shockwave
Now offeringShockwave therapy in Morgan Hill
Radial pressure wave therapy for stubborn tendon and fascia pain — the kind that hasn’t responded to rest, stretching or months of hoping it settles on its own.
What it actually is
The device delivers rapid acoustic pressure waves into tissue through a handpiece pressed against the skin. A projectile is accelerated by compressed air, strikes an applicator, and that impact transmits a pressure wave into the tissue underneath.
Worth being precise about the name, because the marketing in this field is loose: this is a radial pressure wave device, sometimes called radial shockwave or RPW. Energy is highest at the skin and disperses as it travels, which makes it well suited to superficial targets — the plantar fascia, the elbow tendons, the Achilles. It is a different machine from focused ESWT, which converges energy at depth and is used for deeper or calcific problems. Neither is better in the abstract; they suit different tissue depths.
How it’s thought to work
Chronic tendon problems are largely not an inflammation story. The tissue has become disorganised and poorly supplied with blood, and it has stopped remodelling the way healthy tendon does. The proposed mechanism for shockwave is mechanical: the pressure waves appear to increase local blood flow, stimulate new small-vessel formation and collagen synthesis, and interrupt the pain signalling in the area.
In plain terms, the working theory is that it nudges a stalled repair process back into motion. “Thought to” and “appear to” are doing real work in those sentences — the mechanism is still being argued about in the literature, and any clinic telling you exactly how it works is overstating what’s known.
It only works alongside loading
This is the part most clinics leave out. The evidence is strongest when shockwave is combined with a progressive loading programme — the tendon still has to be asked to do work in order to rebuild. Shockwave seems to open a window; the exercises are what actually remodel the tissue. Every course here comes with a loading plan, and if you won’t do the exercises, this probably isn’t worth your money.
What the evidence supports
Shockwave has been studied most heavily in chronic plantar fasciitis and lateral epicondylitis (tennis elbow), where meta-analyses have generally found it outperforms placebo for pain and function. There is reasonable support in mid-portion Achilles tendinopathy and calcific rotator cuff problems. It is not a cure-all, effect sizes vary between studies, and head-to-head comparisons with other treatments are genuinely mixed — recent reviews place it broadly in the same territory as several alternatives rather than clearly ahead of them.
The pattern across the research is consistent on two points: it tends to do better in chronic problems (three months or longer) than acute ones, and it does better combined with exercise than alone.
On what the device is cleared for. In the United States, radial pressure
wave devices of this type are generally cleared for increasing local blood flow, tissue
stimulation and the temporary relief of minor muscle aches and pain — not as a
treatment for any named condition. That is a meaningful distinction, and we’d rather
state it than imply otherwise.
[VERIFY the exact wording of your device’s FDA clearance and make
sure every claim on this page and its condition pages stays inside it. This is the single
most common compliance failure in shockwave marketing.]
A session
What to expect
- Assessment first — shockwave suits some presentations and not others
- Gel applied, then the handpiece worked over the area
- about 2,000 impulses per area, intensity dialled up to your tolerance
- Roughly five to ten minutes of actual treatment per area
- A deep tapping sensation, strongest over the tender spot
- Your loading exercises reviewed and progressed
- Walk out and carry on with your day — no downtime
Cost
Pricing
- Single session$125
- Course of four$495 for a course of four
- Typical coursethree to six sessions
- InsuranceUsually not covered
[VERIFY both figures before publishing. Most patients need a course, so price the course as the headline and the single session as the exception.]
Why here
Shockwave sits naturally alongside the rest of the care in this practice. The tissue gets the mechanical stimulus, the joint above and below gets assessed and adjusted, and if your healing is being held back by sleep, stress or nutrition, that conversation is already happening in the same room.
What it’s used for
Best suited to stubborn, superficial soft tissue
Radial pressure waves lose energy with depth, so the good targets are the ones close to the surface.
Tennis & golfer’s elbow
Lateral and medial elbow tendinopathy. Superficial, easy to target accurately, and often stubborn to rest alone.
Read more →Achilles tendinopathy
Mid-portion Achilles problems in runners and walkers, where shockwave is usually paired with a progressive calf loading programme.
Read more →Other soft-tissue targets
Patellar tendinopathy (jumper’s knee), greater trochanteric pain at the outer hip, shin and calf trigger points, and shoulder tendinopathy. [VERIFY which of these Dr. Diana will actually treat with this device.]
Safety
When shockwave isn’t appropriate
Screening for these is part of your assessment. Tell Dr. Diana about all of them even if you think they’re unrelated.
Not treated
- Pregnancy, where the treatment area is anywhere near the abdomen or pelvis
- Over a known or suspected tumour
- Severe clotting disorders, or high-dose anticoagulant therapy
- Over open growth plates in children and adolescents
- Active infection in the area, or an open wound
- A fresh fracture, or a recent cortisone injection in the same site
- Directly over a pacemaker or implanted device
Discuss first
- Any anticoagulant or antiplatelet medication, including aspirin
- Diabetes with reduced sensation in the feet
- Nerve entrapment or significant numbness in the area
- Recent steroid use, oral or injected
- A pain presentation that hasn’t been diagnosed yet
[Dr. Diana should review both lists against her device manufacturer’s contraindications and amend as needed.]
Before you book
Shockwave questions, answered straight
Does it hurt?
It’s uncomfortable rather than painful, and only while the handpiece is moving. Most patients describe a deep tapping or pecking sensation that gets more noticeable over the tender spot — which is useful, because it helps locate the problem. Intensity is dialled up gradually and we work at the highest level you can tolerate comfortably. Tell Dr. Diana to ease off and she will; pushing through pain isn’t the point.
How many sessions will I need?
Typically three to six, spaced about a week apart. Chronic problems that have been there for months usually need the full course. If you’ve had no change at all by the third session, we’ll stop and reassess rather than keep selling you sessions — shockwave doesn’t suit every presentation.
Is it a substitute for exercise?
No, and this is the most important thing on this page. The evidence for shockwave is strongest when it’s combined with progressive loading — the tendon still has to be asked to do work in order to remodel. Shockwave appears to help create the window; the exercises are what rebuild the tissue. Any clinic offering shockwave with no exercise plan is selling you half a treatment.
How soon will I feel a difference?
Some patients feel easier within a few days; for others it takes until the third or fourth session, and it’s common to feel a bit more sore for 24–48 hours after a session before it settles. Tendon remodelling is measured in weeks to months, so the honest answer is that this is not a quick fix.
Are there side effects?
Usually mild and short-lived: temporary soreness, some redness, occasionally slight bruising or a bit of numbness or tingling in the area. These typically settle within a day or two. You’ll be told what to expect before the first session.
Does insurance cover it?
Generally not — shockwave is almost always a cash service, and we quote it up front. Some patients can use HSA or FSA funds. [VERIFY: HSA/FSA eligibility, and whether any accepted plan reimburses this.]
Is this the same as the shockwave used for erectile dysfunction?
No. That is a different application using different devices and protocols, and it is not something offered here. This page is about musculoskeletal use — tendons, fascia and the soft tissue around joints.
Find out whether shockwave fits your case
It suits some presentations and not others. An assessment first, an honest answer second, and a course of sessions only if it makes sense.