Shockwave Therapy in St. Louis

The mechanism is mechanotransduction — cells turning a physical push into a biological response. A controlled pressure pulse on worn-down tissue does several things at once.

Local blood flow goes up. Over a course of treatment, new small vessels form in tissue that had a poor blood supply. Blood flow is often the reason a chronic tendon problem is not healing. Tendon has a thin blood supply even at the best of times.

It also has a measurable effect on pain signals. Repeated pulses appear to lower substance P. That is one of the nerve chemicals that carries pain and keeps it going in the area. This is part of why the pain relief can outlast the treatment course.

Where calcium deposits are present — most often in the shoulder — the energy can also help break them up. Then the body can absorb them.

Shockwave is most useful when a soft-tissue problem has become chronic and has not responded to rest, activity changes or rehab:

• Plantar fasciitis and heel pain, including cases that have lasted many months — see also serious foot pain
• Tendinopathy at the elbow, patellar tendon, and Achilles
• Calcific tendinitis of the shoulder
• Greater trochanteric pain at the outer hip
• Chronic muscle pain (myofascial pain) where trigger point injection has helped but not lasted

The evidence is strongest for plantar fasciitis and for calcific shoulder tendinitis. For other uses it is reasonable but less proven. We will tell you which group yours falls into. We will not pretend they are all equal.

We apply ultrasound gel and place the handpiece over the target area. Treatment takes a few minutes per site. You will feel the pulses. Most patients call it a deep tapping or thumping. It is uncomfortable at higher strength but bearable. We adjust the strength to what you can handle.

We use no anesthesia, and that is on purpose. Telling us where the discomfort is strongest helps us find the target. You drive yourself home and go back to normal activity the same day.

A course is usually three to five sessions, about a week apart. Improvement usually comes slowly over the weeks after the course. It is not instant, because we are sparking a repair process, not numbing the area.

It does not repair a complete tear. A torn-through tendon is a structural problem. It needs a structural fix. Sparking repair in tissue that is no longer connected does not work.

It is also not a first-line treatment. For a new soft-tissue injury, the right order is relative rest, load management and rehab. Shockwave is for the problem that has already failed those steps.

We generally avoid it over an active infection or a known cancer. We avoid it with a serious bleeding disorder, or on blood thinners without talking first. We also avoid it over growth plates in patients whose bones are still growing. Tell us your full history.