Extracorporeal Shockwave Therapy (ESWT)
At CityIR, we use shockwave therapy to accelerate healing for musculoskeletal injuries and chronic pain conditions that haven’t responded to conventional treatment. Our clinic offers both focused and radial shockwave — two complementary technologies that allow us to treat a wide range of tissue depths and pathologies with precision.
Shockwave therapy is non-invasive, drug-free, and requires no downtime. Most sessions take 15–20 minutes, and patients can return to their normal activities immediately.
What Is Shockwave Therapy?
Shockwave therapy uses energy-dense acoustic waves to stimulate your body’s natural healing response at the cellular level. The mechanical energy promotes new blood vessel formation, accelerates tissue repair, breaks down calcifications and scar tissue, and reduces chronic inflammation — addressing the root cause of pain rather than masking symptoms.
Originally developed to break down kidney stones, shockwave technology has been refined over decades and is now one of the most well-researched regenerative treatments available for musculoskeletal conditions.
How It Works: Mechanism of Action
Shockwave therapy triggers several biological responses that promote healing:
- Neovascularization — Stimulates the formation of new blood vessels, restoring circulation to damaged tissue
- Collagen production — Promotes the synthesis of new collagen fibers, essential for tendon and ligament repair
- Calcification breakdown — Dissolves calcium deposits in tendons and soft tissue
- Inflammation reduction — Reduces chronic inflammatory processes that perpetuate pain
- Trigger point release — Breaks up myofascial trigger points and reduces muscle tension
- Stem cell activation — Stimulates the release of growth factors that support tissue regeneration
Focused vs. Radial Shockwave: Two Tools, One Goal
At CityIR, we offer both focused and radial shockwave therapy. Each technology has distinct advantages, and using the right one — or a combination of both — depends on the specific condition being treated.
Focused Shockwave Therapy (ESWT)
Focused shockwave generates high-intensity acoustic waves that converge at a precise point deep within the tissue. This allows us to target specific structures — such as a damaged tendon or calcified deposit — without affecting surrounding tissue.
- Penetrates deep tissue (up to 12 cm)
- Precise targeting of tendons, bone interfaces, and deep structures
- Ideal for tendinopathies, calcifications, and non-union fractures
- Backed by extensive clinical research
Radial Shockwave Therapy (RSWT / EPAT)
Radial shockwave disperses acoustic pressure waves over a broader surface area from the point of application. This makes it highly effective for treating superficial conditions, muscle tension, and larger treatment zones.
- Broader treatment area for superficial conditions
- Effective for muscle spasms, trigger points, and fascial restrictions
- Well-suited for conditions like plantar fasciitis, IT band syndrome, and bursitis
- Comfortable treatment with minimal discomfort
Many conditions benefit from a combination of both technologies in the same session, and we tailor each treatment to the individual patient.
Conditions We Treat with Shockwave Therapy
Shockwave therapy has been successfully used to treat a wide range of musculoskeletal conditions, including:
- Plantar fasciitis and heel pain
- Achilles tendinopathy
- Patellar tendinopathy (jumper’s knee)
- Tennis elbow (lateral epicondylitis)
- Golfer’s elbow (medial epicondylitis)
- Rotator cuff tendinopathy and calcific tendinitis
- Frozen shoulder (adhesive capsulitis)
- Hip bursitis (greater trochanteric pain syndrome)
- Shin splints (medial tibial stress syndrome)
- Myofascial trigger points and chronic muscle tension
- IT band syndrome
- TMJ pain and dysfunction
- Scar tissue and fascial adhesions
- Non-union and delayed-union fractures
If your condition isn’t listed, contact us — shockwave therapy may still be an appropriate option as part of a comprehensive treatment plan.
What to Expect During Treatment
Your provider will evaluate your condition and determine the appropriate shockwave type, energy level, and treatment area. Here’s what a typical session looks like:
- Assessment — Your therapist identifies the treatment area through palpation and clinical evaluation
- Preparation — A coupling gel is applied to the skin to ensure efficient energy transfer
- Treatment — The shockwave applicator is applied to the area. You may feel a tapping or pulsing sensation. Most patients tolerate the treatment well without anesthesia
- Done — Sessions typically last 15–20 minutes. There is no downtime and no restriction on activity afterward
A typical treatment protocol involves 4–6 sessions, scheduled once or twice per week, depending on the condition. Many patients notice improvement after just a few sessions, with optimal results developing over the following weeks as tissue regeneration continues.
Is Shockwave Therapy Right for You?
Shockwave therapy may be a good fit if you:
- Have a chronic tendon injury that hasn’t responded to rest, physical therapy, or injections
- Experience persistent pain from a musculoskeletal condition
- Want a non-invasive alternative to surgery
- Are looking for a drug-free approach to pain relief
- Have calcific tendinitis or scar tissue limiting your mobility
During your initial evaluation, we’ll determine whether shockwave therapy is appropriate for your specific situation and build a treatment plan tailored to your goals.
Frequently Asked Questions
Is shockwave therapy painful?
Most patients describe the sensation as a tapping or pulsing feeling. Some areas may be mildly uncomfortable, particularly over inflamed or calcified tissue, but the treatment is generally well-tolerated. No anesthesia is needed.
How many sessions will I need?
A typical protocol involves 4–6 sessions, though this varies based on the condition and your individual response. Your provider will discuss the expected timeline during your evaluation.
When will I see results?
Some patients notice improvement after the first few sessions. Because the treatment stimulates biological healing processes, optimal results often develop over several weeks following the completion of your treatment course.
What’s the difference between focused and radial shockwave?
Focused shockwave delivers concentrated energy to a precise point deep in the tissue — ideal for tendons and calcifications. Radial shockwave disperses energy over a broader area near the surface — ideal for muscles, fascia, and trigger points. We use both at CityIR and select the right tool based on your condition.
Are there any side effects?
Side effects are minimal. Some patients experience mild redness, swelling, or soreness in the treated area for a day or two. There are no long-term side effects and no downtime.
Is shockwave therapy covered by insurance?
Coverage varies by plan and condition. Contact our office to discuss pricing and payment options — we’re happy to help you navigate this.
Is shockwave therapy the same as ultrasound?
No. Ultrasound therapy gently warms tissue using low-intensity continuous sound waves. Shockwave therapy delivers high-energy acoustic pulses that trigger biological repair responses, including new blood vessel formation, stem cell activation, and calcification breakdown. While both use sound energy, the mechanisms and clinical outcomes are fundamentally different.
Is shockwave therapy the same as a TENS unit?
No. Although shockwave can feel electric, a TENS unit sends low-voltage electrical impulses to temporarily block pain signals without treating the underlying condition. Shockwave therapy uses mechanical acoustic energy to stimulate actual tissue regeneration, collagen remodeling, and long-term healing at the cellular level.
Shockwave Therapy vs. Surgery vs. Injections
| Condition | Shockwave Therapy | Surgery | Injections |
|---|---|---|---|
| Partial Rotator Cuff Tear | 4–6 sessions, minimal downtime, no incisions | Surgical repair + 4–6 months recovery and rehab. Risk of scar tissue and infection | Temporary relief. Repeated cortisone injections weaken tendons over time |
| Plantar Fasciitis | 4–6 sessions, walk same day, high success rate | Fascial release + 6–10 weeks non-weight-bearing. Risk of arch collapse | Short-term relief. Risk of fat pad atrophy with repeated injections |
| Tennis Elbow | 4–6 sessions, quick return to activity | Surgery + 4–6 months recovery. Typically reserved after 6–12 months of failed treatment | Studies show worse long-term outcomes than no treatment at all |
| Calcific Shoulder Tendinitis | Breaks down calcium deposits over 4–6 sessions. Often resolves completely | Arthroscopic removal + months of rehab under general anesthesia | Cannot dissolve calcifications. Only masks pain temporarily |
| Achilles Tendinopathy | Stimulates collagen remodeling over 4–6 sessions | Surgical debridement + 3–6 months recovery. Risk of re-rupture | High rupture risk with cortisone near the Achilles tendon |
| Joint Arthritis | 4–6 sessions, stimulates cartilage repair signaling, maintains mobility | Joint replacement + extensive rehab. Permanent hardware | Temporary relief. Does not address underlying degeneration |
Get Started
If you’re dealing with chronic pain or a musculoskeletal injury that hasn’t improved with conventional treatment, shockwave therapy may be the next step. Contact us to schedule an evaluation at our Manhattan or Great Neck office.
Shockwave Therapy for Men’s Health
Focused ESWT is also clinically supported for a range of men’s health and urogenital conditions, including:
- Erectile dysfunction
- Peyronie’s disease
- Chronic pelvic pain syndrome
- Post-prostatectomy erectile rehabilitation
- Hard flaccid syndrome
- Penile sensitivity and sensation loss