What to Expect at a Shockwave Session
A focused shockwave session is short and needs no anesthesia or recovery time. Here is what happens before, during and after, so nothing comes as a surprise.
Updated October 30, 2026 · Educational information, not medical advice. Results vary, and not everyone is a candidate.
Before: your evaluation
Shockwave starts with an evaluation by a provider: Charles Ortega, PA-C, or Rowena Calleja, PT, a Texas-licensed physical therapist. The provider asks about your pain, how long you have had it and what you have already tried, examines the area, and checks for anything that would make shockwave a poor idea. If shockwave is appropriate, the provider sets your plan. If not, they talk through other options, such as physical therapy.
Please tell us at the evaluation if any of these apply to you:
- You take a blood thinner (anticoagulant) or have a bleeding or clotting disorder
- You are pregnant or might be
- You have a pacemaker, defibrillator or other implanted device
- You have had a steroid (cortisone) injection in the area recently
- You have cancer, an infection, or a recent injury or tear in the area
- You take anti-inflammatory medicines regularly, such as ibuprofen or naproxen
See safety and side effects for why these matter.
What to wear and bring
- Loose clothing that lets staff reach the painful area easily, such as shorts for a knee or heel, or a sleeveless top for a shoulder or elbow
- A list of your medications, including over-the-counter pain relievers and supplements
- Any imaging reports (X-ray, ultrasound or MRI) of the area, if you have them
- Your insurance card if you have an office visit with a provider; the office visit may be billable to insurance, but the shockwave sessions are self-pay
During the session
Sessions are performed by trained medical staff, following the plan your provider set. You sit or lie in a comfortable position with the area exposed.
- Gel: staff put a gel on your skin. It helps the pulses pass from the applicator into the tissue.
- Finding the spot: staff press around the area and ask where it is most tender, then aim the applicator there. This is sometimes called shockwave mapping. Clinical guidance notes that some discomfort while locating the painful spot is expected.
- The pulses: the applicator rests on your skin and delivers the pulses. Most people describe a tapping or pulsing feeling. It can be uncomfortable, especially over the sorest point.
- Adjusting intensity: staff usually start at a lower energy and increase it as you tolerate. Tell them if it is too much; they can turn it down.
- Length: a session usually takes about 15 to 30 minutes.
There are no needles, no incisions and no anesthesia. Research suggests numbing the area may make shockwave less effective, which is one reason it is not usually used.
After the session
Most people go back to their usual day, including driving and work. Mild, temporary discomfort is common. The area may be red, a little swollen or sore for a short time, and some people notice increased soreness in the days after a session. See safety and side effects for the full list.
During your course, your provider may ask you to:
- Avoid anti-inflammatory medicines such as ibuprofen, naproxen or aspirin for pain. Guidance written for clinicians advises this because inflammation may be part of the tissue's response. Ask us what you can take for soreness instead. Do not stop any medicine a doctor prescribed (including daily aspirin) without asking the prescriber first.
- Avoid high-impact activity, such as running, jumping or heavy lifting with the treated area, especially in the first days after a session. Researchers note the tendon may tolerate less load shortly after shockwave.
- Keep up gentle movement and any home exercises your provider or physical therapist gives you, without pushing harder just because the area feels better right after a session.
Over the course
Your provider sets the number and spacing of your sessions based on your evaluation. In studies, courses were commonly 3 to 5 sessions about a week apart, though protocols varied widely between studies.
Do not expect a change after one session. In clinical trials, results were usually measured weeks to months after the last session, often at about 3 months. Some people notice a difference, some notice little, and results vary. Your provider will check in on how you are doing and may adjust the plan.
Shockwave is often combined with physical therapy when your provider thinks it fits. Physical therapy at Innovare Tx is billed to insurance; shockwave is self-pay. See cost and memberships.
When to call us
Call (214) 233-3094 if, after a session, you have:
- Pain that is getting worse rather than settling over a few days
- Large or spreading bruising, or swelling that keeps increasing
- Numbness or tingling that does not go away
- A sudden pop, snap or sharp pain in the area, or trouble putting weight on a heel or ankle
- Any skin breakdown, blistering or signs of infection
For chest pain, trouble breathing or other emergencies, call 911.
Frequently asked questions
Sources
- Tenforde AS, et al. Best practices for extracorporeal shockwave therapy in musculoskeletal medicine. PM&R, 2022
- van der Worp H, et al. ESWT for tendinopathy: technology and clinical implications. Knee Surg Sports Traumatol Arthrosc, 2013
- NICE HTG200: Extracorporeal shockwave therapy for refractory plantar fasciitis (the procedure)
- Extracorporeal shock wave therapy for the treatment of musculoskeletal pain: a narrative review. Healthcare (Basel), 2023
Next in the shockwave guide
Shockwave Therapy Safety and Side Effects
Common and rare side effects, and who should not have shockwave.
ReadShockwave Therapy Cost and Memberships
Self-pay, insurance, membership credits and payment plans.
ReadYour First Shockwave Visit in Addison
What the first visit covers, who you will see and how to book.
ReadWondering 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.