March 26, 2026 Author : Filipa Vilabril (physical medicine and rehabilitation ) Shockwave therapy is a treatment modality within the field of Physical Medicine and Rehabilitation. In many situations of pain and musculoskeletal injuries, it is an effective alternative to longer, more repetitive, or invasive treatment approaches. It is a short duration and non-invasive treatment. It does not require prior preparation, nor does it imply significant restrictions after its completion. It is compatible with most daily and work routines. What is shockwave therapy? Shockwave therapy consists of the localized application of high-energy acoustic waves to the surface of the body area to be treated , using specific medical equipment. These waves can be of two types and the choice is determined by the pathology and the structure to be treated: Focal shockwaves , which act more deeply and precisely; Radial shockwaves , with a more superficial and dispersed action. Shockwave therapy is a personalized medical act and cannot be applied automatically or in a standardized way. It is always performed by a physiatrist, as it involves in each case: Detailed clinical evaluation; Correct diagnosis and indication; Definition of the type of wave, intensity, and number of sessions; Coordination with other rehabilitation therapies whenever necessary. Several treatment sessions are usually necessary, between three and five, with an average duration of 15 to 20 minutes each. Anesthesia, prior preparation, or recovery period are not required, making it a treatment that allows for an immediate return to usual activities, including daily and work routines. What are the main physiological effects and benefits of shockwave therapy? The action of shockwave therapy is based on the stimulation of natural biological mechanisms of tissue regeneration and pain modulation . Among the main effects are: Increased local vascularization; Stimulation of angiogenesis, i.e., the formation of new blood vessels; Fragmentation of calcifications; Reduction of muscle tension and trigger points; Modulation of pain at the neurological level; Activation of cellular regeneration processes; Tissue remodeling. The most frequently observed clinical benefits include: Significant and sustained pain reduction; Improved function and mobility; Reduced need for analgesic medication; Faster recovery; In many cases, it avoids the need for more invasive procedures. What are the main clinical indications for shockwave therapy? The effectiveness of shockwave therapy is well documented in the scientific literature, especially in the treatment of chronic tendon pathologies and persistent pain syndromes, particularly when there has been no satisfactory response to conventional conservative treatments. The main indications include: Tendinopathies and enthesopathies: Plantar fasciitis / heel spur; Achilles tendon tendinopathy; Lateral epicondylitis ("tennis elbow"); Patellar tendinopathy; Shoulder tendinopathies (rotator cuff). Painful calcifications : Calcific tendinitis of the shoulder. Myofascial syndrome : Persistent muscle trigger points; Localized or referred muscle pain. Chronic bursitis Specific bone consolidation delays Some situations of resistant chronic musculoskeletal pain In what situations can referral for shockwave therapy be considered? There are several situations associated with pain and musculoskeletal injuries that may motivate referral for evaluation by a physiatrist, with a view to possible shockwave therapy, for example: Persistent pain for more than three months; Lack of satisfactory response to conventional physiotherapy alone; Significant functional limitation; Frequent need for analgesics and/or anti-inflammatories; Presence of calcifications or documented chronic tendinopathy. Meet the physical medicine and rehabilitation clinical team from Hospital da Luz network.. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
