Shockwave therapy (SWT) is a non-invasive medical procedure that uses acoustic waves to stimulate healing in various musculoskeletal tissues. It is a common treatment for chronic conditions like plantar fasciitis and Achilles tendinopathy. This process works by causing a controlled, temporary inflammatory response to kickstart the body’s natural repair mechanisms. The primary concern for most people considering this treatment is the physical experience felt during and immediately following the session.
Understanding the Two Main Types of Shockwave Therapy
The physical feeling of the treatment varies significantly based on the technology used, which falls into two primary categories: Radial Shockwave Therapy (RSWT) and Focused Shockwave Therapy (FSWT). Radial devices generate waves created by pneumatic pressure, causing the energy to disperse widely and shallowly, reaching a depth of about three to four centimeters. This type of shockwave is strongest at the skin’s surface, resulting in a sensation often described as a strong, rapid hammering or vibration.
Focused Shockwave Therapy (FSWT), in contrast, uses electromagnetic or piezoelectric elements to create waves precisely targeted to a specific, deeper point within the tissue. Because the energy is concentrated at a focal point deeper below the skin, this method bypasses most surface sensory nerves. FSWT can penetrate up to six inches, delivering a higher energy density that feels more like a deep, intense pulse or a sharp, internal click at the site of the injury.
Describing the Sensation During Treatment
Regardless of the type, the session begins with the application of a coupling gel, followed by the practitioner placing the handheld applicator against the skin. The machine itself is quite loud, producing a rapid, audible ticking or clicking sound, sometimes likened to a small jackhammer or a machine gun. The actual feeling on the body is a series of intense, rhythmic pulses that penetrate the tissue.
Patients often describe the sensation as intensely irritating or uncomfortable rather than a sharp, cutting pain. When the acoustic waves pass over healthy tissue, the feeling is usually a strong vibration or a deep thumping. The intensity increases noticeably when the device is positioned directly over a painful spot, which is a sign that the therapeutic energy is correctly targeting the damaged tissue.
Managing Discomfort and Pain Tolerance
The level of discomfort during the procedure is managed collaboratively between the patient and the practitioner. Therapists are trained to work within a patient’s pain tolerance, often aiming for a level around six or seven out of ten on a pain scale. The energy settings can be adjusted instantaneously by the operator to ensure the treatment remains tolerable for the few minutes it takes to deliver the required number of pulses.
Sessions are brief, typically lasting only five to ten minutes per treatment area. Although some clinics may use a topical numbing cream, the treatment is generally tolerated well enough that this is often unnecessary. Starting at a lower intensity and gradually increasing it allows the body to acclimate to the unique sensation.
Immediate Sensations After the Session
Immediately after the shockwave application ceases, the treated area often feels temporarily numb or dull, attributed to the acoustic energy briefly overwhelming local pain nerves. Patients frequently experience an immediate, temporary reduction in chronic pain, which allows for improved range of motion.
As the session concludes, mild, visible skin changes may be apparent, including temporary redness or minor swelling at the contact site. A few hours later, a residual deep ache or throbbing sensation may set in as the short-term nerve desensitization wears off. This feeling is similar to the soreness experienced after an intense workout and indicates that the body’s controlled inflammatory healing response has been successfully initiated.