Episode overview
One of the biggest questions people ask before trying shockwave therapy is simple: “Is it going to hurt?”
In this episode, we answer that question clearly. Shockwave therapy can be uncomfortable, but most patients tolerate it very well. You should feel it, but it should not feel unbearable. For many people, the feeling is around a 4 out of 10 during treatment.
We also talk about why the first visit can feel the most tender, how the settings can be adjusted, why most treatment plans are once a week for 6 weeks, and why results may keep improving for up to 90 days.
Who this episode is for
This episode is for you if you have pain that will not go away, especially:
- Heel pain or plantar fasciitis
- Achilles tendon pain
- Tennis elbow or golfer’s elbow
- Jumper’s knee
- Hip tendon pain
- Chronic shoulder pain
- Tendon pain that keeps coming back
- A stubborn injury that has not fully healed
It is also for you if you are interested in shockwave therapy but nervous that it might be too painful.
The short answer
Shockwave therapy is usually tolerable, but you should feel it.
Most patients describe it as:
- Tapping
- Deep pressure
- Tenderness over the injured area
- Mild soreness
- A “good hurt” that is strong but manageable
A common target is around a 4 out of 10 on the pain scale. That means it is strong enough to feel like we are working on the right tissue, but not so strong that you dread the treatment.
Key takeaways
- Shockwave therapy can be uncomfortable, but most people tolerate it well.
- You should feel the treatment, but it should not be unbearable.
- The settings can be adjusted by changing the speed, force, and intensity of treatment.
- More pain does not always mean better results.
- The first visit is often the most tender because the tissue is usually the most irritated at the start.
- Most plans are 6 visits, once per week.
- Results can keep improving for up to 90 days after treatment.
- If the issue is not fully resolved after shockwave, other options like cold laser, dry needling.
Why shockwave therapy can feel uncomfortable
Chronic injuries are often sensitive because the tissue has been irritated for a long time. There may be scar tissue, adhesions, poor blood flow, or tendon irritation.
When shockwave therapy is applied to that exact spot, you may feel tenderness because we are working on the tissue that is actually causing the problem.
That does not mean something is wrong. In fact, the tender area can often help identify the source of the pain.
Is the first visit the worst?
For many patients, yes.
The first treatment may feel the most tender because the tissue is at its most irritated point. There may be more scar tissue, more adhesions, and more guarding in the area.
As the tissue starts to respond, many patients can tolerate deeper or stronger treatment in later visits. The goal is not to “beat up” the tissue. The goal is to give the body the right healing signal.
Can the treatment be adjusted?
Yes.
Shockwave therapy is not a “no pain, no gain” treatment. If it feels too intense, the settings can be changed. We can adjust the speed, force, and pressure to make the treatment more tolerable while still giving the tissue a useful stimulus.
The treatment should fit the patient, not the other way around.
What happens after treatment?
After shockwave therapy, many patients feel:
- Mild soreness
- Temporary tenderness
- A feeling similar to a workout
- Less stiffness over time
- Better movement as the plan progresses
Most people return to normal daily activity right away. It is smart to avoid testing the area with a hard workout the same day.
How many treatments are needed?
Most treatment plans are:
- 6 total sessions
- Once per week
- Over about 6 weeks
Research commonly supports a short series of treatments, and for many conditions, doing more than about 6 sessions does not appear to add much extra benefit.
That is why the goal is not endless treatment. The goal is a smart plan with a clear stopping point.
Why results may keep improving
Shockwave therapy works by stimulating the body’s healing process. That means results do not always stop when the treatment stops.
Many patients continue improving for up to 90 days after the final visit because the body is still remodeling and repairing the tissue.
So if you are better after visit 6, but not perfect, that does not always mean the treatment failed. It may mean your body is still working.
What if shockwave helps but does not fully fix it?
If you improve but are not fully where you want to be, the next step depends on what is still driving the problem.
Options may include:
- Cold laser therapy
- Dry needling
- Rehab exercises
- Better footwear
- Training changes
- Activity modification
- Further evaluation of the tissue or joint involved
The goal is to evaluate, treat, measure progress, and adjust the plan.
“I tried rest, stretching, meds, or therapy, but the pain keeps coming back.”
FAQ
Does shockwave therapy hurt?
It can be uncomfortable, but most patients tolerate it well. A common feeling is around a 4 out of 10.
Should I feel it?
Yes. You should feel the treatment, especially over the injured tissue. But it should not be unbearable.
Can the treatment be made easier?
Yes. The speed, force, and pressure can be adjusted to make the treatment more tolerable.
Does more pain mean better results?
No. More pain does not always mean better healing. The goal is the right dose, not the most painful dose.
Is the first visit the worst?
For many people, yes. The first visit can be the most tender because the tissue is usually the most irritated at the start.
Can I drive afterward?
Yes. Most patients can drive and return to normal daily activity right away.
Is there downtime?
Most people do not need downtime, but it is smart to avoid hard workouts on the treated area the same day.
Does shockwave therapy use needles?
No. Shockwave therapy does not use needles or injections.
Does shockwave hurt more than dry needling?
It depends on the person and the area being treated. Some people prefer shockwave because there are no needles. Others feel dry needling is quicker. The right choice depends on the tissue causing the pain.
How many visits do I need?
Most plans are 6 visits, once per week.
When will I know if it worked?
Some people feel changes early, while others notice steady progress over several weeks. Results can keep improving for up to 90 days after the final visit.
Next step
If chronic pain is keeping you from walking, exercising, working, or enjoying life, the next step is to find out if shockwave therapy is right for you.
At the Scoliosis Center of Louisiana in Lafayette, shockwave therapy is offered as part of a complete musculoskeletal plan.
Call or text 337-453-5199 to get scheduled and you can read the whole article
Serving Lafayette, Youngsville, Broussard, Scott, Carencro, and surrounding Acadiana communities.
