What Is Extracorporeal Shock Wave Therapy (ESWT)?

1. What Is It Actually?

Extracorporeal shock wave therapy is a procedure in which a device generates strong, short waves. These waves are transmitted from outside through the skin into the body. Extracorporeal means 'outside the body'. The waves feel like small, rapid taps. They can be used, for example, on the heel, knee or shoulder. Researchers are investigating whether these waves help when tendons or joints hurt. Some studies also examine whether the waves support healing after surgery. The treatment usually lasts only a few minutes. You lie comfortably while the doctor guides the device over the area. It is not an invasive procedure involving a scalpel. That is why it is also called non-surgical. In the studies we found, the therapy was tested in adults, for example for knee pain or after prostate surgery. The researchers want to know: Does it really help, and if so, how well?

2. Where Does It Come From?

The idea of shock waves originally comes from medicine. Doctors used strong waves to break up kidney stones without cutting the skin. Later, researchers wondered: Can gentler waves also help with tendons and muscles? This is how extracorporeal shock wave therapy was developed. Today, it is used in many clinics and practices. In the studies provided, different body regions are examined. For example, the Achilles tendon, knee or penis after surgery. The studies investigate whether the waves reduce pain and improve function. Some studies compare shock wave therapy with other treatments, such as injections. Others examine how well it works on its own. The researchers use different strengths of waves. Some are gentle, others stronger. This is referred to as low-dose or high-energy. What works best is not yet fully clear.

3. What Are the Researchers Investigating?

Researchers have already conducted many studies in adults. In the studies provided, for example, knee pain in osteoarthritis is examined. A large review summarised several studies. It shows that extracorporeal shock wave therapy can improve pain and function. However, not every study finds a clear advantage. For the Achilles tendon in the foot, there are also indications of help. After prostate surgery, researchers are investigating whether the waves support healing. There are also initial studies on erectile dysfunction. Some compare extracorporeal shock wave therapy with cortisone injections in the shoulder. The results are not always the same. Sometimes the shock wave seems better, sometimes the injection. Researchers ask: For whom is which treatment best? How often should the waves be applied? And how strong should they be? These questions remain open. What is clear: The therapy is well tolerated. Severe side effects are rare. However, we do not yet know for sure in all conditions whether it really helps.

4. An Experiment to Think About

You can try something at home that is similar to a gentle shock wave. Take an empty plastic bottle and fill it with water. Then tap the bottle lightly with the palm of your hand. You can feel how the waves spread through the water. Researchers imagine that shock waves work in a similar way in the body. They bring movement to the tissue without injuring it. But be careful: this is only a model. In the body, everything is much more complicated. That is why doctors and researchers test the real therapy in studies with many people. They carefully examine whether it helps and whether it is safe. If you want to learn more about such studies, you can become a researcher yourself later.

For adults and professionals: the detailed page on Extracorporeal Shock Wave Therapy (ESWT)