Shockwave · Safety

Shockwave Therapy Safety and Side Effects

Like any procedure, focused shockwave has side effects and reasons not to have it. Here is what the published guidance lists, in plain language.

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In short

The side effects reported most often are short-lived: discomfort during the session, skin redness, soreness, swelling and bruising. Numbness or tingling, headache and migraine have also been reported. Serious problems are uncommon, though a few tendon ruptures have been reported after shockwave. It is generally not used during pregnancy, over an active infection or a cancer, over growth plates in children, over the lungs, or in people with a significant bleeding disorder, and blood thinners and pacemakers need extra care. Your provider screens for all of this at your evaluation.

Updated October 30, 2026 · Educational information, not medical advice. Results vary, and not everyone is a candidate.

How risky is shockwave?

Shockwave is non-invasive: no needles, incisions or anesthesia. In its review of shockwave for stubborn plantar fasciitis, the UK's National Institute for Health and Care Excellence (NICE) found that the evidence raised no major safety concerns. A systematic review of randomized trials reported no serious adverse events in the studies it included.

That does not mean there are no side effects, or that shockwave suits everyone. The rest of this page covers what can happen and who should not have it.

Common side effects

These are the side effects listed in clinical guidance and reported in trials. They are usually mild and temporary:

Discomfort or pain during the session, especially over the tender spot
Skin redness where the applicator was
Soreness, which for some people increases for a few days after a session
Mild swelling
Bruising, or occasionally a small collection of blood under the skin (hematoma)
Numbness or tingling from irritation of a nearby nerve
Headache or migraine, less often

Higher energy settings are linked with a greater chance of bruising, which is one reason staff start low and adjust. If soreness is bothering you, ask us what you can take; your provider may ask you to avoid anti-inflammatory medicines during your course. See what to expect.

Rare but serious

Serious complications are uncommon, but a few have been reported. Across published trials, two Achilles tendon ruptures were reported within 2 weeks of a first focused shockwave session, both in women over 60. A 2026 case report described an Achilles rupture about six months after a course of shockwave. Long-standing tendon problems can themselves weaken a tendon, and those authors cautioned that their case did not show shockwave caused the rupture.

Clinical guidance suggests that older adults and people with an existing partial tendon tear should be told about this possible risk and may be asked to limit activity during treatment. Shockwave is generally not used over a completely torn tendon.

Feeling less pain right after a session does not mean the tendon is ready for more load. Follow your provider's activity advice even when the area feels better.

Who should not have shockwave

Published guidance, including the contraindication list from the International Society for Medical Shockwave Treatment, generally advises against shockwave in these situations:

Pregnancy: shockwave is not aimed where a fetus could be in the treatment field, and many lists rule out shockwave during pregnancy
Cancer or a tumor in the treatment area
An active infection in the area, such as a bone infection
Over open growth plates, in children and teens who are still growing
Over the lungs, brain or spine, or near major nerves and large blood vessels
A significant bleeding or clotting disorder
A completely torn tendon in the area

Situations that need extra care

Some situations do not automatically rule shockwave out, but your provider needs to know about them and may change the plan or decide against it:

Blood thinners (anticoagulants), because shockwave can cause bleeding into the tissue. Do not stop a blood thinner on your own.
A cardiac pacemaker, defibrillator or other implanted device, especially if it is near the treatment area
Regular use of anti-inflammatory medicines
A recent steroid (cortisone) injection in the area
Age over 60 or a known partial tendon tear, because of the rupture reports above

Your provider screens for these

Before any session at Innovare Tx, a provider (Charles Ortega, PA-C, or Rowena Calleja, PT, a Texas-licensed physical therapist) reviews your history, medications and the area to be treated, and checks for the situations above. If shockwave is not a good fit, the provider will tell you and talk through other options, such as physical therapy. Trained medical staff then perform the sessions following the plan the provider sets.

Be open about your health at the evaluation, and tell staff before each session if anything has changed, such as a new medicine, a pregnancy or a new injury.

When to call us after a session

Call (214) 233-3094 if pain keeps getting worse instead of settling, if bruising or swelling keeps spreading, if numbness or tingling does not go away, or if you feel a sudden pop or snap or cannot put weight on the area. For emergencies, call 911.

Frequently asked questions

No procedure is risk-free. NICE found the evidence on shockwave for stubborn heel pain raised no major safety concerns, and the common side effects are mild and short-lived. A few serious problems, such as tendon ruptures, have been reported. Your provider checks whether it is appropriate for you.

Shockwave is generally not used during pregnancy. Tell us if you are pregnant or might be.

Possibly, but your provider needs to know, because blood thinners raise the chance of bleeding and bruising. Never stop a blood thinner without talking to the doctor who prescribed it.

Pacemakers and other implanted devices need extra care, especially near the treatment area. Tell your provider at the evaluation; they will decide whether shockwave is appropriate.

Redness, soreness and swelling usually settle quickly, although some people feel sorer for a few days after a session. Call us if pain is getting worse instead of better.

Sources

Keep reading

See everything in the shockwave guide

Wondering whether shockwave fits your pain?

Book a consultation at our Addison clinic. A provider examines the area, explains your options, and tells you plainly whether focused shockwave makes sense for you.

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