Chronic Pain That Won't Quit: Shockwave Therapy and Other Next Steps

When Pain Outlasts the Usual Fixes

Long-lasting pain can make life feel smaller. You rested. You did the exercises. You took the pills. The ache came back anyway. After a while it is easy to believe you will just have to live with it.

You have plenty of company. CDC data show that about one in four American adults lives with chronic pain. Many of them have not run out of options. They have simply not heard about the next ones yet. Sometimes relief comes from adding a different kind of tool, not from pushing harder with the same ones.

How Shockwave Therapy Works

One option worth knowing about is extracorporeal shockwave therapy, usually called ESWT or shockwave therapy. The name sounds dramatic, but it is a non-surgical treatment done in an office. A handheld device sends strong sound pulses through the skin into a painful tendon or tissue. Sessions are usually short, and most people need three to five of them.

The pulses seem to increase blood flow in the area and trigger a fresh healing response in tissue that has stalled. They can also help break up calcium deposits in some shoulder tendons. Doctors first used shockwaves to break kidney stones, and the method was later adapted for muscles, tendons and bones.

It can be uncomfortable during treatment, and you may feel sore for a day or two. It is not right for everyone, including people who are pregnant, take blood thinners or have certain other conditions, so a proper exam comes first.

What the Evidence Shows

Shockwave therapy has the best support for a few specific problems. The FDA has approved shockwave devices for chronic heel pain from plantar fasciitis that has not improved with other care, and reviews of randomized trials have found it reduces pain and improves walking for many of those patients. There is also good evidence for calcium deposits in the shoulder. Results for tennis elbow, Achilles pain and other tendon problems are more mixed, though some people do well.

It is not a cure-all, and it will not help every kind of pain. Back pain from a disc problem or nerve pain, for example, need a different approach.

Combining Treatments for Better Results

New treatments tend to work best as part of a larger plan. Shockwave therapy does not replace physical therapy. It often makes it work better, by calming irritated tissue so you can do the strengthening exercises that keep pain from returning.

Other pieces can help too. Acupuncture and massage ease pain for some people. Pain psychology, including cognitive behavioral therapy for pain, helps people manage how pain affects sleep, mood and activity, and it has solid research behind it. Gradual strength work with a trainer or a physical therapist builds the support your joints and tendons need. Gentle classes at a yoga or pilates studio can keep you moving between sessions.

Next Steps

If you feel stuck, these steps can help you move forward without giving up what already works:

• See the right specialist. Look for a sports medicine doctor, orthopedic specialist or physical therapist who offers shockwave therapy and treats your specific problem. Ask for a clear diagnosis first.
• Ask direct questions. How many sessions? What does it cost, and does insurance cover it? What results do your patients usually see, and how will we measure progress?
• Keep the team talking. Tell your physical therapist and doctor about any new treatment so they can adjust your plan together.

Living with stubborn pain is exhausting, especially after a long search for answers. Search Live Well Map to find sports medicine and pain specialists near you.

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