Chronic foot pain has a frustrating secret: after months of hurting, your body often stops treating the injury as an injury. The repair crews go home, inflammation smolders, and nothing improves. Radial shockwave therapy — also called EPAT — is an FDA-cleared way of calling the repair crews back.
How it works
A handheld applicator, similar to an ultrasound wand, delivers focused acoustic pulses deep into the injured tissue. Those pulses create a controlled micro-stimulus that the body reads as a fresh signal: this tissue needs attention. The response is very real — increased blood flow, the growth of new microscopic blood vessels, and the release of the biochemical signals that drive tissue repair.
In other words, shockwave doesn’t mask pain. It restarts the healing your body abandoned.
What it treats
- Plantar fasciitis and chronic heel pain
- Achilles tendonitis and tendonosis, including insertional Achilles pain
- Tendonosis elsewhere in the foot and ankle
- Acute and chronic muscle pain
What the evidence says
Shockwave has been studied for more than fifteen years, and here’s the honest version rather than the sales version.
In the largest placebo-controlled trial for stubborn heel pain, 61% of patients got better after twelve weeks, compared with 42% of the people who got a fake treatment. Pain scores dropped by about 72%. That’s a real effect, and it’s why we offer it. It also means it doesn’t work for everyone, and we’d rather you know that up front.
The evidence is strongest for plantar fasciitis that has dragged on for months. For Achilles tendon pain it’s weaker, so if that’s what you have, we’ll tell you before you spend money on it.
It does all of this with no incision, no infection risk, no scar tissue, and no downtime.
What a course looks like
- Per session: about 5 minutes, in the office, no anesthesia.
- Course: typically 4–5 sessions, one week apart.
- During: a strong rhythmic tapping; tender spots briefly ache — usefully marking the true injury.
- After: walk out, drive, work, live normally the same day. Mild bruise-like soreness for a day or two is common and is a sign the biology is responding.
- Side effects: rare — occasional skin bruising or short-lived soreness.
Where it fits in how we work
Shockwave sits on the first rung: nothing breaks the skin. At our practice it’s often the step that spares a chronic heel or Achilles from needing anything more invasive, and we pair it with custom orthotics so the mechanical cause doesn’t simply rebuild the injury.
One honest note: most insurance plans don’t cover shockwave. True to how we work, you’ll get the exact price and our honest read on whether it’s the right tool for your foot before you commit to anything.
Sources
- Gerdesmeyer L, Frey C, Vester J, et al. Radial extracorporeal shock wave therapy is safe and effective in the treatment of chronic recalcitrant plantar fasciitis: results of a confirmatory randomized placebo-controlled multicenter study. Am J Sports Med. 2008;36(11):2100-9. PubMed
- Sun J, Gao F, Wang Y, et al. Extracorporeal shock wave therapy is effective in treating chronic plantar fasciitis: a meta-analysis of RCTs. Medicine (Baltimore). 2017;96(15):e6621. PubMed Central