Shockwave Therapy (SWT) is a non-invasive treatment using acoustic waves for chronic musculoskeletal conditions like tendinopathies and plantar fasciitis. The procedure is generally safe, and severe pain is rare. Patients often experience a temporary increase in discomfort, which signals the activation of the body’s natural healing process. Understanding the difference between expected soreness and abnormal pain is important for managing expectations.
The Sensation During Shockwave Therapy
The physical experience during the shockwave procedure is often described as a strong, rhythmic vibration or a deep, localized thumping sensation. This sensation is caused by acoustic energy pulses traveling into the targeted tissue. Patients typically feel intense pressure rather than sharp pain during the treatment.
The intensity is directly related to the energy level, which the practitioner adjusts to remain tolerable. Treatment over bony prominences, such as the heel or elbow, may feel more intense than treatment on fleshier areas. While uncomfortable, the sensation should not be intolerable and is distinct from residual soreness.
Understanding Expected Post-Treatment Soreness
A mild, temporary increase in soreness is a common and expected outcome following shockwave therapy. This discomfort signals that the treatment has successfully activated the body’s natural regenerative mechanisms. The acoustic waves trigger controlled microtrauma, which is a localized mechanical stress on the tissue.
This deliberate micro-injury stimulates neovascularization (the formation of new blood vessels) and triggers a localized inflammatory healing response. The temporary soreness is the body’s reaction to this therapeutic cascade, initiating tissue remodeling. This discomfort typically peaks within the first 24 to 48 hours after the session. The soreness indicates that the intended biological process of repair has been initiated.
Identifying Abnormal Pain and Complications
While mild soreness is normal, pain that is severe, sharp, sudden, or rapidly worsening beyond the first 48 hours is not typical. Discomfort lasting longer than 72 hours should also be discussed with a healthcare provider.
Normal, minor side effects include localized bruising, skin redness, mild swelling, or transient numbness or tingling. Excessive swelling or bruising that does not improve with standard care can signal a potential issue. Rare but serious complications, such as a significant hematoma or signs of infection (like warmth and discharge), must be reported immediately.
Managing Discomfort and Recovery Timeline
Steps can be taken to manage the expected mild soreness following a session. It is recommended to avoid non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, because they can interfere with the beneficial inflammatory response the treatment creates. Acetaminophen is generally considered a safe alternative for pain management.
Gentle movement, such as light walking, is encouraged to promote circulation, but high-impact activities should be avoided for the first 48 hours. Applying ice is sometimes discouraged immediately afterward, as it can blunt the desired inflammatory reaction, though a provider may recommend it for persistent swelling. The typical recovery timeline involves three to five sessions, usually spaced about one week apart, with initial post-treatment discomfort subsiding within one to three days.