Understanding Acoustic Wave Therapy

Chronic tendon, ligament, and muscle injuries can be stubborn. Many people do the right things first, including rest, stretching, activity modification, and conservative care, yet the pain keeps returning or refuses to resolve fully. Acoustic Wave Therapy, also known as Extracorporeal Shockwave Therapy (ESWT), is a noninvasive option that helps stimulate the body’s natural repair process rather than simply masking symptoms.

Acoustic Wave Therapy (AWT) and Extracorporeal Shockwave Therapy (ESWT) are often used interchangeably for similar treatments, both involving high-energy sound/pressure waves to stimulate healing in damaged tissues. Still, there are crucial technical differences:

ESWT (Focused) uses very high-energy, precisely targeted waves for deep-seated issues. In contrast, Radial Pressure Wave Therapy (RPWT) uses lower-energy, ballistic waves spreading out, often called AWT, for broader, superficial areas, making them distinct but related terms.

ESWT uses targeted acoustic pressure waves to support circulation, collagen remodeling, and tissue recovery in areas that often heal slowly, especially tendons and their attachment points. Clinical teams commonly use ESWT to help patients pursue relief while avoiding more invasive options when appropriate.

How They Work (Both)

• Stimulate blood flow (angiogenesis).
• Promote collagen synthesis and cellular repair.
• Reduce inflammation and pain.
• Break down calcifications or scar tissue.

Main Differences Summarized

• Energy & Focus: Focused ESWT has extremely high pressure (MPa) and precision; Radial waves have lower energy and spread out.
• Mechanism: F-SW is a true shockwave; RPWT is a pressure wave (not a true shockwave) created by a projectile.
• Application: F-SW for deep, calcified issues (e.g., deep tendon); RPWT for superficial, broader areas (e.g., plantar fasciitis, muscle strains).

In short, think of ESWT (Focused) as a high-intensity, precise, deep-penetrating laser, while Acoustic/Radial Wave Therapy (RPWT) is like a powerful, broad-coverage sonic massage – both use waves but deliver them differently for different needs.

What Is ESWT

ESWT is an advanced therapy that delivers acoustic energy into injured soft tissue and certain bone-related conditions. The goal is to trigger a regenerative response, which may include improved local blood flow, enhanced cellular signaling involved in healing, and a gradual reduction in pain sensitivity in the treated region. It is widely used in musculoskeletal care and has FDA-cleared indications for certain conditions, including chronic plantar fasciitis and lateral epicondylitis (tennis elbow).

Treatment sessions are typically brief, and most patients return to normal daily activities right away, with individualized guidance from the clinician overseeing care.

How ESWT Works

During care, a handheld applicator is placed over the painful or dysfunctional area. Acoustic waves are delivered into the tissue to create controlled mechanical stimulation. Research has associated ESWT with biologic effects that can support healing, including neovascularization and other signaling that help injured tendon and connective tissue remodel over time.

For patients with chronic conditions, this matters because tendons and fascia can have limited blood supply and may heal slowly. ESWT is often used to “restart” the repair cycle in tissues that have plateaued.

Conditions Helped By ESWT

Acoustic Wave Therapy is commonly used for stubborn, activity-limiting musculoskeletal conditions, including:

• Plantar fasciitis and heel pain

• Tennis elbow and golfer’s elbow

• Achilles tendinopathy and other foot and ankle tendon pain

• Patellar tendinopathy and overuse knee pain

• Hip tendinopathy and bursitis-like pain patterns

• Rotator cuff tendinopathy and shoulder pain patterns

• Strained calves and hamstrings

• Chronic tendinopathy with reduced tolerance for work, sports, or daily activity

If you have been limited by pain during walking, driving, climbing stairs, exercising, or even prolonged sitting or standing, ESWT may be worth considering as part of a conservative, results-driven plan.

The Benefits of Acoustic Wave Therapy

Supports circulation and tissue metabolism

ESWT is associated with changes that can improve local circulation and support the healing environment in connective tissues that are otherwise slow to recover.

Encourages collagen remodeling

Collagen is a key structural component of tendons and ligaments. ESWT is commonly described as supporting collagen-related repair and remodeling processes as tissue recovers.

Helps address chronic pain patterns

Some clinical explanations describe ESWT’s pain relief as involving both local tissue effects and neurologic mechanisms that can reduce pain sensitivity over time.

Noninvasive care with minimal interruption

For many patients, ESWT is appealing because it is performed without injections or incisions, and most people resume normal activities immediately with practical, clinician-guided recommendations.

What to Expect During an ESWT Session

Your visit begins with an evaluation to identify the true pain generator and confirm whether ESWT is appropriate for your condition. If ESWT is a fit, the treatment area is positioned for comfort and accessibility. A conductive gel may be applied, and the handheld applicator is then used to deliver acoustic waves to the targeted tissues.

Most patients describe the sensation as uncomfortable but tolerable, and intensity is typically adjusted to your tolerance while still reaching a therapeutic level. Mild soreness or localized tenderness may occur afterward. In many protocols, treatment is delivered in a short session and repeated over a series to build results as tissue remodeling progresses.

How Many Sessions Do Patients Typically Need

Many patients start noticing improvement early and continue building results over a short series. A typical range is 3 to 6 sessions, depending on the condition, chronicity, and how your body responds. Your plan should be individualized based on the area treated and your functional goals.

Who Should Not Receive ESWT

ESWT is not appropriate for everyone. A clinical evaluation is essential, especially if you are pregnant, have a suspected tumor or active infection in the area, have a known tendon rupture, or have other medical factors that may change candidacy. Dr. Derek Rice will review your history and help determine whether ESWT is appropriate for you.

Why Choose Rice Chiropractic and Wellness in San Diego

At Rice Chiropractic and Wellness, Dr. Derek Rice focuses on identifying the underlying cause of pain and guiding patients toward practical, durable outcomes. ESWT is offered as part of a broader, results-driven approach that may include chiropractic care, mobility and stability strategies, and a plan to restore function progressively. The goal is not only symptom relief, but also improving how you move, train, and perform daily activities with confidence.

Acoustic Wave Therapy (ESWT) in San Diego, California

Acoustic Wave Therapy is a powerful, noninvasive option that may help reduce pain, stimulate circulation, and promote healing in stubborn soft tissue conditions. If you are dealing with chronic tendon or fascia pain that has not responded to more conservative strategies, ESWT may be a nonsurgical option worth exploring.