Evidence

What Does the Research Actually Say?

Short answer

The shockwave evidence base is strongest for plantar heel pain, supportive for Achilles tendinopathy when added to a loading program, and supportive for chronic calcific tendinitis of the shoulder with higher-energy focused treatment. Elbow results are mixed. Every study below is listed with its limitations and a link to the citation.

Plantar Fasciitis · Radial pressure wave

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

Gerdesmeyer L, Frey C, Vester J, et al. · The American Journal of Sports Medicine, 2008

In plain English

In a placebo-controlled multicenter randomized trial of adults with long-standing plantar heel pain, the treated group reported greater reduction in heel pain and improved function at 12 weeks than the sham group, with no serious device-related adverse events reported.

Limitations

Follow-up was relatively short, the device studied was a radial pressure-wave unit rather than SoftWave, and results reported for a study population do not predict any individual patient's response.

View the citation on PubMed

Plantar Fasciitis · Focused ESWT

Shock wave application for chronic plantar fasciitis in running athletes: a prospective, randomized, placebo-controlled trial

Rompe JD, Decking J, Schoellner C, Nafe B · The American Journal of Sports Medicine, 2003

In plain English

Running athletes with chronic plantar fasciitis who received low-energy focused shockwave reported greater improvement in pain scores than those who received sham treatment, with differences maintained at follow-up.

Limitations

Small sample restricted to running athletes; the protocol and device differ from current systems, and athletes may respond differently than the general population.

View the citation on PubMed

Achilles / Tendinopathy · Focused ESWT

Eccentric loading versus eccentric loading plus shock-wave treatment for midportion Achilles tendinopathy: a randomized controlled trial

Rompe JD, Furia J, Maffulli N · The American Journal of Sports Medicine, 2009

In plain English

Patients with midportion Achilles tendinopathy who combined an eccentric loading program with shockwave treatment reported better outcomes at four months than those who performed eccentric loading alone — a finding often read as shockwave being an addition to rehabilitation rather than a replacement for it.

Limitations

Single-center trial with short follow-up; findings apply to midportion tendinopathy and not to insertional Achilles problems or to every activity level.

View the citation on PubMed

Achilles / Tendinopathy · Radial pressure wave

Shockwave therapy for chronic Achilles tendinopathy: a double-blind, randomized clinical trial of efficacy

Rasmussen S, Christensen M, Mathiesen I, Simonson O · Acta Orthopaedica, 2008

In plain English

Adding shockwave therapy to conventional care for chronic Achilles tendinopathy produced greater functional improvement than conventional care alone over a 12-week period.

Limitations

Small sample, short duration, and conventional care was not fully standardized between groups.

View the citation on PubMed

Elbow Tendinopathy · Focused ESWT

Extracorporeal shock wave therapy for lateral epicondylitis

Rompe JD, Hopf C, Küllmer K, Heine J, Bürger R · The Journal of Bone and Joint Surgery (British), 1996

In plain English

One of the earliest controlled reports on shockwave for lateral epicondylitis (tennis elbow) described improvement in pain and grip-related function in treated patients compared with a lower-dose control group.

Limitations

Early-generation device and protocol, modest sample, and later trials on tennis elbow have produced mixed results — the overall evidence base here is less consistent than for plantar fasciitis.

View the citation on PubMed

Shoulder Conditions · Focused ESWT

High-energy extracorporeal shock-wave therapy for treating chronic calcific tendinitis of the shoulder: a systematic review

Bannuru RR, Flavin NE, Vaysbrot E, Harvey W, McAlindon T · Annals of Internal Medicine, 2014

In plain English

This systematic review found that higher-energy focused shockwave was associated with improved pain and function, and with resorption of calcium deposits, in chronic calcific tendinitis of the shoulder more often than lower-energy or sham treatment.

Limitations

Applies specifically to calcific tendinitis rather than shoulder pain generally; included trials varied in quality, energy level and outcome measures.

View the citation on PubMed

Sports Medicine · Review of multiple types

The effectiveness of extracorporeal shockwave therapy in common lower limb conditions: a systematic review including quantification of patient-rated pain reduction

Korakakis V, Whiteley R, Tzavara A, Malliaropoulos N · British Journal of Sports Medicine, 2018

In plain English

A systematic review across common lower-limb conditions reported meaningful patient-rated pain reduction for several diagnoses, with the strongest signal for plantar heel pain and greater trochanteric pain, and weaker or less certain evidence elsewhere.

Limitations

Study quality and protocols varied widely; the review pools different devices and energy settings, so conclusions cannot be transferred to one specific device.

View the citation on PubMed

Shockwave Technology · Review of multiple types

Efficacy and safety of extracorporeal shock wave therapy for orthopedic conditions: a systematic review on studies listed in the PEDro database

Schmitz C, Császár NBM, Milz S, et al. · British Medical Bulletin, 2015

In plain English

A broad review of orthopedic shockwave trials concluded that shockwave is generally well tolerated with a low rate of serious adverse events, while noting that reported effectiveness depends heavily on diagnosis, device type and treatment protocol.

Limitations

A review of heterogeneous studies rather than a trial; it does not establish effectiveness for any individual condition or device.

View the citation on PubMed

Shockwave Technology · Review of multiple types

A systematic review of shockwave therapies in soft tissue conditions: focusing on the evidence

Speed C · British Journal of Sports Medicine, 2014

In plain English

This review distinguished focused shockwave from radial pressure waves and emphasized that the two are physically different treatments whose evidence should not be pooled uncritically, with the clearest support in specific tendon and plantar conditions.

Limitations

Narrative synthesis; the author notes inconsistent reporting of energy parameters across trials, which limits direct comparison.

View the citation on PubMed

Knee / Musculoskeletal · Focused ESWT

Shockwave therapy for the treatment of chronic proximal hamstring tendinopathy in professional athletes

Cacchio A, Rompe JD, Furia JP, Susi P, Santilli V, De Paulis F · The American Journal of Sports Medicine, 2011

In plain English

Professional athletes with chronic proximal hamstring tendinopathy reported greater pain reduction and earlier return to sport after shockwave treatment than a comparison group receiving conventional conservative care.

Limitations

Highly selected athletic population, unblinded comparison group, and results in professional athletes may not generalize to recreational activity.

View the citation on PubMed

How to read shockwave research without getting misled

  • Check the device class. Focused shockwave and radial pressure waves are physically different treatments, and reviews warn against pooling them.
  • Check the diagnosis. Results for chronic plantar heel pain say nothing about a knee, and results in professional athletes may not transfer to recreational activity.
  • Check what else the patients did. In several positive tendon trials, shockwave was added to an exercise program — the comparison was loading versus loading plus shockwave.
  • Check the follow-up length. Many trials report 12 weeks to four months, which tells you little about a year later.
  • Be wary of device-specific claims without device-specific sources. Those belong to the manufacturer's documentation, not to a clinic's marketing page.

What we exclude from this library

  • Fabricated or unverifiable citations
  • Marketing material presented as research
  • Studies summarized without their limitations
  • Claims about specific devices that we cannot source

Categories are distinguished deliberately: published research, manufacturer information, FDA and regulatory documentation, clinic information, verified ChiropracticResults outcomes, and general educational content are not the same thing and are not presented as such.

Medical disclaimer

This page is general educational information and is not medical advice, diagnosis or treatment. It does not establish a doctor-patient relationship. Whether SoftWave® or any shockwave therapy is appropriate for you can only be determined through an in-person clinical evaluation.

Reviewed by clinical staff at Total Health Chiropractic · Last reviewed 2026-09-08 · Editorial policy

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