Shockwave Therapy for Foot & Ankle Pain

What Is Shockwave Therapy?

Shockwave therapy (also known as Extracorporeal Shock Wave Therapy, or ESWT) is a non-invasive, medication-free pain relief treatment. Despite the name, there’s no electric shock – instead, a small handheld device delivers high-energy sound waves (pressure waves) through the skin to the injured area. You’ll feel a series of rapid tapping or pulsating sensations on your foot, but treatment is generally not painful. Most patients only experience mild discomfort, and we adjust the intensity to keep you comfortable. No anesthesia or injections are needed, and the procedure typically takes about 10-20 minutes.

Those targeted sound waves boost blood flow and metabolism in the damaged tissue, which jump-starts the healing process. Shockwave therapy causes the body to form new blood vessels (neovascularization) and release natural growth factors that help repair plantar fascia, tendons, and bones. It can even partially break down some calcifications (like heel spurs) over time, helping to reduce irritation. The result is a reduction in inflammation, accelerated tissue regeneration, and lasting pain relief. Many patients notice their muscles relaxing and some pain easing immediately after a session, with continued improvement in the weeks that follow as the tissue heals.

Why Choose Shockwave Therapy for Foot & Ankle Pain?

Shockwave therapy is an innovative option for treating chronic foot and ankle conditions that haven’t improved with standard care. If you’ve tried rest, ice, stretching, orthotics, or medications without success, shockwave can provide long-lasting relief without surgery. In fact, this therapy is often recommended by foot and ankle specialists for stubborn plantar fasciitis heel pain that persists beyond a few months. It’s proven effective: clinical studies show shockwave therapy has a 70–80% success rate in significantly reducing plantar fasciitis pain and inflammation. The American College of Foot and Ankle Surgeons even lists ESWT as a preferred treatment for chronic plantar fasciitis, meaning it’s a well-established, evidence-based solution.

How does it help? Shockwave not only reduces pain, but actually stimulates healing of the underlying issue. For example, in chronic plantar fasciitis (heel pain), the repetitive sound waves cause controlled micro-trauma that triggers the plantar fascia ligament to repair itself stronger and healthier. It also “overstimulates” nerves to reduce pain signals (providing an analgesic effect). Shockwave therapy aims to fix the root cause by regenerating tissues. This leads to more durable, long-term relief. Many of our patients are able to avoid surgery or more invasive procedures thanks to shockwave therapy, getting back to their normal activities with minimal downtime.

Another big advantage is that shockwave therapy is safe and quick to recover from. There are no incisions, no need for anesthesia, and virtually no risk of serious complications. After a treatment session, you can walk out of the office and continue your day normally – no casting or prolonged rest needed. The most common post-treatment effects are just mild soreness or redness in the area, which resolve within a day or two. This makes shockwave an excellent option for active individuals or athletes who can’t afford long recovery periods.

When to consider shockwave? We typically recommend shockwave therapy for chronic conditions (lasting more than 3 months) or when other treatments haven’t provided relief. That said, it can also help acute injuries heal faster in certain cases. Dr. Patish will evaluate your specific situation to determine if shockwave is right for you. We’ll ensure you have a proper diagnosis (for instance, ruling out a stress fracture or nerve entrapment that might be causing pain) and that you don’t have any contraindications (like circulation problems or an active infection in the area) before starting therapy. Patients of all ages can benefit from shockwave – we have treated everyone from young athletes with sports injuries to seniors with long-term heel pain. (Note: We generally avoid using shockwave on children’s growth plates or in pregnant patients, out of caution.) Overall, if you’re in good health and dealing with a foot or ankle pain that just isn’t getting better, shockwave therapy might be the game-changer you need.

Conditions Treated with Shockwave Therapy

• Plantar Fasciitis (Heel Pain): This is the #1 reason patients seek shockwave treatment. We target the shockwaves at the inflamed plantar fascia ligament in your heel, stimulating blood flow and tissue repair. This approach significantly reduces heel pain and inflammation – especially if your plantar fasciitis hasn’t responded to rest, orthotics, or other therapies. Many plantar fasciitis sufferers experience major relief after a series of shockwave sessions.
• Achilles Tendinitis: Shockwave therapy helps heal an injured or degenerated Achilles tendon (whether it’s insertional Achilles pain at the back of your heel or mid-tendon tendinosis). The focused waves promote circulation and new collagen formation in the tendon. We often combine Achilles tendon treatments with plantar fascia treatments if you have pain in both areas, since the calf and heel are biomechanically linked. Clinical studies have shown shockwave can markedly improve chronic Achilles tendinopathy, getting you back to activities without Achilles pain.
• Tendonitis and Chronic Tendon Injuries: Beyond the Achilles, shockwave can treat other foot and ankle tendon issues – for example, posterior tibial tendonitis (inside ankle pain), peroneal tendonitis (outer ankle), or shin splints (tibial stress syndrome). By delivering healing pulses to the affected tendon or shin, shockwave reduces inflammation and triggers repair of microscopic tendon tears. It’s often used when rest and physical therapy haven’t fully resolved a tendon injury.
• Heel Spurs: A heel spur is a bony growth on the calcaneus (heel bone) often associated with long-term plantar fasciitis. Shockwave therapy can be directed at the heel spur area to help break up calcification and ease the surrounding tissue irritation. Over time, the body may reabsorb some of the spur. Even if the spur remains, patients usually feel significant pain relief because shockwave addressed the inflamed fascia around it. This treatment is a non-invasive alternative to heel spur surgery, so you can avoid an operation.
• Morton’s Neuroma: This condition is a painful thickening of the nerve between the toes (often between the 3rd and 4th toes). Shockwave therapy is emerging as a treatment to reduce nerve inflammation and pain in Morton’s neuroma. The pulses likely help by increasing blood flow and disrupting the pain signals in the nerve. For someone with persistent ball-of-foot pain from a neuroma, shockwave offers a potential relief option when orthotics, injections, or other measures haven’t helped enough.
• Stress Fractures and Bone Healing: While rest is the primary treatment for stress fractures in the foot or leg, sometimes the bone needs an extra healing boost. Focused shockwave (in combination with H-Wave and laser treatment) can stimulate bone growth and repair by increasing local blood circulation and cellular activity at the fracture site. We occasionally use shockwave for stubborn metatarsal stress fractures or shinbone stress injuries that are slow to heal. It’s a way to encourage bone union without surgery. (Of course, any stress fracture must be properly evaluated and typically immobilized; shockwave is an adjunct to help speed up recovery in select cases.)
• Chronic Ligament Sprains: If you have an old ankle sprain or ligament injury that never fully healed, shockwave therapy may help by promoting tissue regeneration and reducing scar tissue adhesions. For example, in a chronically unstable ankle with ligament pain, a few shockwave sessions can stimulate repair of the stretched/irritated ligaments and improve your comfort. It’s not a first-line treatment for a fresh sprain (rest and bracing are), but it’s available if a sprain becomes a lingering issue.
• Plantar Plate Injuries & Sesamoiditis: These are painful conditions in the ball of the foot (forefoot) involving small ligaments and bones. Shockwave can be applied to the forefoot area to encourage healing of a plantar plate tear or sesamoid bone inflammation, potentially avoiding the need for injections or surgery.
• Shin Splints (Medial Tibial Stress Syndrome): Runners and active individuals with chronic shin splints have found relief with shockwave therapy. The focused pulses along the shin can reduce inflammation in the periosteum (bone lining) and muscle attachments, helping to resolve that stubborn shin pain so you can return to running.
• Bursitis and Other Soft Tissue Pain: Shockwave is sometimes used for heel bursitis (inflammation of the bursa at the back of the heel) or other soft tissue inflammations in the foot/ankle. By increasing circulation, it can help flush out inflammatory mediators and ease pain when anti-inflammatories alone weren’t enough.

Focused vs. Radial Shockwave: Why Our Clinic Uses Focused Shockwave

You may have heard of different types of shockwave therapy, namely focused shockwave versus radial shockwave. Both use pressure waves to stimulate healing, but there are important differences in how they deliver energy into the tissue. We want our patients to be informed about these distinctions – and to know why we’ve chosen a focused shockwave device for treating foot and ankle conditions at our clinic.

Focused Shockwave Therapy: As the name suggests, focused shockwave concentrates the energy into a specific focal point deep in the tissue. It uses higher-energy waves that can penetrate up to about 12 cm (several inches) deep, reaching structures that lie near bone or under thick muscle/fat layers. The energy is delivered precisely where it’s needed, without losing intensity at depth. Focused shockwave is ideal for deep, chronic problems and precise targeting – for example, the origin of the plantar fascia on the heel bone, or the center of an Achilles tendon. It’s also effective on hard or calcified tissues (like bone spurs or long-standing tendon calcifications) because of the higher energy levels. In practical terms, focused shockwave treats the root of the issue rather than just the surface. Conditions like chronic plantar fasciitis, Achilles tendinopathy, bone non-unions, and deep trigger points respond especially well to focused shockwave.

Radial Shockwave Therapy: Radial shockwave (sometimes called radial pressure wave) disperses energy more broadly and superficially. The waves spread outwards from the applicator head, covering a larger area but with lower energy and only about 3–4 cm of penetration. This makes radial shockwave better suited for more superficial soft-tissue problems or general muscle massage effects. It can work nicely for treating muscle tightness, shallow tendon injuries, or larger surface areas. However, for deep foot conditions like plantar fasciitis, a radial device may not deliver enough energy to the exact spot of injury (down near the bone). Think of radial shockwave as a shotgun approach – covering a broad area with gentler pressure – whereas focused shockwave is more like a precise laser targeting the deep pain source.

Why we use focused shockwave: In our podiatry practice, we see many patients with chronic heel pain, arch pain, and Achilles issues – problems that originate in deep tissue or at bone attachments. Focused shockwave allows us to reach those painful spots more effectively and with adequate energy to trigger healing. Research has shown that for conditions like chronic plantar fasciitis, focused shockwave yields superior results compared to radial therapy. One clinical meta-analysis found focused ESWT provided better long-term relief for heel pain than radial waves. The bottom line: if your condition is deep, longstanding, or involves a localized injury, focused shockwave is usually the more effective choice. It can penetrate to the injured plantar fascia or Achilles tendon and stimulate repair in ways radial therapy might not. We’ve invested in a modern focused shockwave machine so that our patients receive the highest standard of care and the best possible outcomes.

Shockwave Therapy FAQs

Q: Does shockwave therapy hurt?
A: Despite the intimidating sound of the name, shockwave therapy is generally not painful. No electrical shocks are involved. Most patients feel a tapping or thumping sensation during the treatment. The intensity of the pulses is adjusted to your comfort level – we start at a low setting and can increase gradually if tolerated. You might feel some mild discomfort, especially over very tender areas, but it’s usually quite tolerable. In fact, many patients say it’s less painful than a deep tissue massage! We do not routinely use numbing injections or anesthesia, because the treatment is brief and well-tolerated without it (plus avoiding anesthesia actually helps ensure the therapy works to its full effect). Our doctor will check in with you throughout the session to make sure you’re okay. After the treatment, your foot may feel a bit sore or achy (like you overused it), but this typically fades within 24-48 hours. You can ice the area afterwards if needed, and take Tylenol for any discomfort. We advise avoiding anti-inflammatory meds right around the treatment days, since a little inflammation is part of the healing process. Overall, most patients handle shockwave therapy just fine and find the temporary discomfort well worth the long-term relief!

Q: How many shockwave treatments will I need?
A: The number of sessions can vary, but most foot and ankle conditions respond best to a series of treatments rather than a single session. A typical treatment plan is about 3 to 5 sessions, scheduled about one week apart. We’ve found that spreading the therapy out over several weeks allows the tissue to recover and regenerate between sessions, leading to better results. Some patients get significant relief after just 1 or 2 sessions, but still benefit from completing the full series to solidify the healing. In tougher, longstanding cases (for example, severe chronic plantar fasciitis or Achilles tendinosis), we might extend the plan to up to 6 sessions. We will tailor the regimen to your progress – if you’re improving quickly, fewer sessions may be needed; if pain is very stubborn, a couple extra sessions might be added. Each session builds on the previous one, stimulating more healing until the condition is resolved. Patience is key: because we are inducing your own body to repair the tissue, it can take a little time, but the results are more natural and lasting. Most patients start to notice improvement after the second or third treatment, with maximum benefits felt about 4-8 weeks after the final session as the tissues finish rebuilding. We will monitor your pain and abilities throughout, and make sure you’re on track to meet your relief goals.

Q: What is the treatment session like?
A: A shockwave therapy session is straightforward and quick. You’ll be taken to a comfortable treatment room and can either lie face-down (with your feet up) or sit in a position that allows easy access to the affected foot. The doctor will locate the tender spot on your foot by examination. We apply a generous amount of gel to your skin (this helps transmit the shockwaves into the body). Then we place the shockwave handpiece against your skin and start the treatment. The machine generates rapid pulses – you’ll hear a ticking or popping sound and feel that percussive sensation. We’ll move the applicator around the area, focusing on the most painful points (for example, around your heel and arch for plantar fasciitis). The session typically lasts about 10-15 minutes of actual treatment time, though it could be a bit longer if we treat multiple areas (say, your heel and your Achilles tendon in one visit). After the set number of pulses are delivered, we’ll wipe off the gel and you’re done! There’s no special recovery protocol needed – you can walk normally. We do ask that on the day of treatment, you take it a little easy: no high-impact sports or intense foot workouts for about 48 hours. This gives your body time to process the inflammation and start healing. Many patients comment on how easy the whole procedure is – it’s done before you know it, and since there’s no anesthesia, you can drive yourself home and continue with your day.

Q: Are there any side effects or risks?
A: Side effects are uncommon and generally minor. Because shockwave therapy is non-invasive (nothing is injected or cut), the risks are much lower than surgery. You might have some redness, mild swelling, or bruising on the treated area afterward. This happens because of the increased blood flow and tiny capillary changes, but it usually goes away within a couple of days. A transient increase in pain can occur in some cases – basically a short-lived “flare-up” of symptoms as the body’s healing response kicks in. This is normal and should subside, leading to improvement in pain shortly after. Very rarely, if higher energies are used, a patient could develop a small hematoma (bruise) or feel some tingling/numbness if a nerve gets irritated, but these effects are temporary. We screen patients for any contraindications to keep things safe: for example, we do not perform shockwave if you have an active infection in the area, a bone tumor, or a deep vein thrombosis in your leg. We also avoid treating over any open wounds. If you have significant peripheral neuropathy (nerve damage causing loss of sensation), we’d use caution or possibly avoid shockwave, because feedback on pain is important during treatment. Also, as a precaution, we don’t do this therapy on pregnant patients. Rest assured, these situations are rare, and for the average person with foot pain, shockwave therapy is a very safe treatment. We will discuss your medical history in detail to ensure it’s appropriate for you. Overall, the benefit-to-risk ratio is excellent – the chance of serious harm is extremely low, while the chance of pain relief is quite high.

Q: How soon will I feel better?
A: Many patients are pleasantly surprised that they feel a bit of relief even after the first session. You may notice that your foot is more relaxed and that sharp pain is dulled within a day or two after treatment. However, healing is a gradual and individual process, so the noticeable improvements typically become apparent after the third or fourth session. Shockwave’s effects are cumulative – pain often continues to decrease over the course of weeks as your tissues rebuild. Peak improvement from a full shockwave course often occurs around 1-3 months after starting the treatments. This timeline can vary: if your condition was very chronic, it might take closer to the longer end (a couple of months) to fully appreciate the results. On the other hand, some patients with more acute injuries might feel back to normal just a few weeks after finishing therapy. We will schedule follow-ups to track your progress. It’s important to continue any stretching or exercises we’ve recommended during this period, as they work hand-in-hand with shockwave to maximize healing. Keep in mind that because we’re aiming for true healing (not a quick cover-up), it’s normal that it takes a few weeks to notice big changes – but those changes can be life-changing as pain fades away for the long term!

Q: Will shockwave therapy fix my problem permanently?
A: Shockwave therapy is designed to address the root cause of your foot or ankle pain by repairing tissue, so in many cases the results are long-lasting or even permanent. Clinical outcomes have shown that pain relief from shockwave can last many months to several years for chronic plantar fasciitis and tendinitis sufferers. That said, the durability of relief also depends on maintaining good foot care and addressing any underlying causes of your condition. For example, if you have plantar fasciitis and shockwave heals it, it’s wise to continue wearing supportive shoes with custom orthotics that we can make for you, and doing your stretches to prevent recurrence. If you go back to the same behaviors that caused the issue (like abrupt over-training in sports or poor footwear), the condition could potentially return over time. Think of shockwave as opening a window of opportunity – it heals the injured tissue and reduces pain, giving you a fresh start. From there, we’ll guide you on prevention strategies to make the results last. In our experience, the majority of patients treated with shockwave for things like heel pain are still doing great at their 6- or 12-month follow-ups. Some studies even report that patients remain pain-free a year or more after therapy. In tough cases, if symptoms ever slowly creep back, a maintenance booster session or two of shockwave down the line can help keep the pain at bay. But for most, once the injury is healed and the tissue is healthy, you’re able to return to your normal lifestyle without chronic pain – which is our ultimate goal!

Q: Is shockwave therapy covered by insurance?
A: In general, most insurance companies do not cover shockwave therapy for musculoskeletal conditions (like plantar fasciitis or tendonitis) because they consider it an out-of-pocket elective treatment. We understand cost is an important consideration for our patients. The good news is that we keep our shockwave therapy, laser and an H-Wave therapy affordable. Our office will explain the pricing clearly up front. Many patients find that shockwave therapy is far less expensive (and less risky) than surgery – and if it helps you avoid an invasive procedure or long-term medications, it’s a worthwhile investment in your health. We also offer payment options and scheduling flexibility to make it as easy as possible. Think of it this way: shockwave is a cutting-edge treatment using advanced medical equipment, yet our fees are a fraction of what surgical intervention would cost. We never want cost to be the reason someone lives in pain, so talk to us and we’ll do our best to accommodate your needs. And because it often eliminates the need for ongoing therapies or doctor visits once your pain is resolved, many patients actually save money in the long run. Always feel free to discuss any financial concerns with our staff – we’re here to help.

Q: What should I do before and after the treatment?
A: There’s not too much you need to do to prepare – that’s the beauty of this simple therapy. On the day of your appointment, we recommend you wear comfortable clothing where you can easily expose the treatment area (for example, shorts or pants you can roll up if we’re treating your Achilles or shin). If we’re focusing on your foot, any attire is fine as we’ll just remove your shoe and sock. We might ask you not to take certain pain relievers (particularly NSAIDs like ibuprofen) for a day or two beforehand, so that you can accurately feel the pain during treatment and because we want to encourage the natural inflammatory healing response. Eating and drinking normally is okay; there’s no need to fast. After the session, we advise taking it easy for the rest of the day – you can do your normal daily activities, but avoid heavy exercise or anything that puts a lot of strain on the treated foot for 48 hours. Keep doing any stretching exercises or foot-strengthening exercises that have been recommended, as these will complement the shockwave therapy. It’s also a good idea to stay hydrated and maintain a healthy diet to support tissue healing. If you experience some soreness, you can ice the area for 10-15 minutes at a time. We usually say no NSAID anti-inflammatories for about 2 days after treatment (to let that pro-healing inflammation do its job). Acetaminophen (Tylenol) is fine if you need pain control, as it works differently. Lastly, listen to your body – if your foot feels a bit tender, give it rest. Typically, by the second day after treatment, you can resume light to moderate activities as tolerated, and then progress back to full activities in the coming week(s) as you feel better. We will give you any specific instructions tailored to your condition, but in general, there’s very little you need to do differently – shockwave doesn’t disrupt your life like surgery would.