Ultrasound-Guided ESWT is an advanced, non-surgical treatment that uses high-intensity pressure waves to stimulate the body’s natural healing process and repair damaged tissues — without injections, medication, or surgery.

Shock waves are powerful pressure movements—similar to those produced by an explosion, earthquake, or a plane breaking the sound barrier—applied safely in medicine to treat chronic pain and musculoskeletal injuries.

With real-time musculoskeletal ultrasound guidance, our physiotherapists can accurately locate the injured tissue and direct the shockwaves precisely, ensuring safe, focused, and effective treatment.

ESWT is highly effective for plantar fasciitis, tennis elbow, rotator cuff tendinopathy, Achilles tendinitis, jumper’s knee, chronic muscle or fascial tightness and more!

ESWT works through two key mechanisms:

• Direct shockwave impact - trigger new tissue and bone formation.
• Cavitation effect - stimulate cellular repair, enhance blood vessel growth, and accelerate pain relief and healing.

Together, these effects activate powerful biological responses:

✅ Reduce pain
✅ Decreases inflammatory response
✅ Promote tissue regeneration
✅ Increases blood circulation
✅ Breaks down calcifications
✅ Stimulates collagen production
✅ Speeds up the overall healing process

While Extracorporeal Shockwave Therapy (ESWT) is generally safe and effective, certain conditions make it unsuitable or require special caution.

❌ Absolute Contraindications

ESWT should not be performed in the following cases:

• Pregnancy
• Active infection or osteomyelitis
• Malignant tumor in the treatment area
• Over major blood vessels, nerves, or open wounds
• Pacemakers or implanted electronic devices
• Over joint replacements or metallic implants
• Active thrombosis or blood clotting disorders
• Epiphyseal (growth) plates in children/adolescents

⚠️ Relative Contraindications (Require Caution)

should be used with caution in cases of:

• Coagulopathy or ongoing anticoagulant therapy (e.g., Warfarin use)
• Recent corticosteroid injection in the treatment area
• Lung or pleura within treatment focus (e.g., upper ribs)
• Brain or spinal cord tissue near treatment site
• Current use of NSAID
• Impaired cognition or inability to communicate pain/discomfort

It is generally not recommended to take non-steroidal anti-inflammatory drugs (NSAIDs) (e.g., ibuprofen, naproxen, aspirin) before treatment.
🔹 NSAIDs reduce inflammation, which is a key part of the healing process triggered by ESWT.
🔹 Using NSAIDs before treatment may reduce ESWT’s effectiveness.

Yes, but it’s important to wait about 6 weeks after the injection before starting treatment. This gives your tissues time to heal safely.

For optimal results, ESWT often requires higher energy levels (EFDs). However, these can be painful and may limit how much energy can be safely applied.

While local anesthesia can reduce discomfort, it also blocks the nerve responses essential for ESWT’s healing effects — reducing its overall effectiveness.

Using our EMS High Power Laser Therapy(HPLT) before ESWT enhances both comfort and therapeutic outcomes.

HPLT works by:
✅ Rapidly reducing pain
✅ Lowering inflammation
✅ Improving circulation

Applying HPLT before ESWT allows patients to tolerate higher therapeutic doses without anesthesia:
🔹 Up to 50% more ESWT energy tolerated after 5 minutes of HPL
🔹 Up to 100% more energy tolerated with a 1-hour interval

This means a pain-free, biologically effective ESWT session — maintaining its full healing response while improving comfort.

Clinical Advantages

✅ Greater comfort — less pain, no need for anesthesia
✅ Stronger biological response — enhanced tissue repair and regeneration
✅ Fewer sessions — faster recovery
✅ Higher patient satisfaction — better outcomes and compliance