Shockwave therapy can be unpleasant, and at the most painful spot it can be painful at times, but the physiotherapist adjusts the intensity so that it remains bearable. The patient feels a rhythmic, rapid tapping. On a 0–10 pain scale the discomfort should stay moderate, and it is worth mentioning any change in sensation straight away. After the treatment you can usually return to your everyday activities.
Below we describe exactly what you feel during the treatment, how to prepare for the visit, who cannot have shockwave therapy and what to do afterwards.
In brief
- The sensation is like rapid tapping; the physiotherapist sets the intensity and changes it during the treatment based on your feedback.
- The most common reactions after the treatment are temporary tenderness, redness and, rarely, a small bruise.
- Contraindications include pregnancy, clotting disorders and anticoagulant medicines, and cancer in the treatment area.
- The treatment costs 100 PLN, with manual therapy 200 PLN; there are also packages of 5, 10 and 15 visits.
- The clinic in Rydułtowy is open Mon–Fri 7:00–20:00, private visits, no referral needed.
Contents
What do you feel during shockwave therapy?
The applicator head is placed on skin covered with gel and sends a series of rapid pulses, which feel like rhythmic tapping or knocking, sometimes with slight tingling. It is most unpleasant at the spot that hurts day to day, e.g. at the tendon attachment on the heel or around the elbow. Away from that spot the sensation is usually mild.
It is typical for the tender point to react more strongly – the shockwaves act precisely where the tissues are overloaded. One difference between shockwave therapy and other treatments, e.g. TECAR, lies in the sensation: TECAR produces warmth, while shockwave therapy produces mechanical impacts. You can read more about the indications in our post shockwave therapy – what it helps with.
Can the intensity of the shockwaves be reduced?
Yes. The physiotherapist sets the strength and frequency of the pulses, usually starting with lower values and gradually increasing them as the tissues get used to them. During the treatment they ask about your sensations and can reduce the intensity, change where the head is applied or take a break at any time. Your feedback is the most important parameter here.
A simple agreement helps: say when the pain goes beyond a level you can comfortably tolerate. There is no point in “gritting your teeth” – a stimulus that is too strong will not make the treatment work better and may put you off further visits.
When should you see a doctor first?
Talk to a doctor before the treatment if you are pregnant, take anticoagulants or have a clotting disorder, are undergoing cancer treatment, have a pacemaker, a fresh injury or a skin infection in the treatment area, or have had a steroid injection in that spot in recent weeks. The physiotherapist will in any case check for contraindications during the interview before the first treatment.
After the treatment, contact a doctor if major swelling, a large haematoma, fever or pain that gets worse over the following days instead of easing appear. Shockwave therapy is usually used for chronic conditions, not for fresh injuries.
How to prepare for shockwave therapy?
Preparation is simple: bring your imaging results and a list of medicines, wear clothes that easily expose the treatment area, and do not put cream on the skin. Tell the physiotherapist about chronic illnesses, anticoagulant medicines and recent injections. Do not take painkillers “just in case” before the treatment, unless a doctor has prescribed them.
- Documents. Bring your X-ray, ultrasound or MRI report and discharge summaries, if you have them.
- List of medicines. Especially anticoagulants, anti-inflammatories and steroids.
- Clothing. Shorts for the knee or heel, a vest top for the shoulder.
- Skin. Clean, with no cream or lotion on the treatment area.
- Questions. Write down in which situations it hurts most – this helps to find the right spot.
What to do after shockwave therapy?
After the treatment you can usually return straight away to your everyday activities and drive. The area may be tender and red for a day or two, and a small bruise rarely appears. For a few days, avoid intense sport that loads the treated area. Continue the exercises recommended by the physiotherapist, as shockwave therapy is meant to support them, not replace them.
It is often recommended not to cool the area with ice for a few days and not to take anti-inflammatory medicines unnecessarily, as they may weaken the tissue response to the treatment. If a doctor has prescribed a medicine, do not stop it on your own.
How much does shockwave therapy cost in Rydułtowy?
A single shockwave treatment costs 100 PLN, and combined with manual therapy 200 PLN. Packages are also available: 5 visits for 450 PLN, 10 visits for 800 PLN and 15 visits for 1 100 PLN. A package covers shockwave therapy only, and unused visits expire after the validity period.
Shockwave therapychronic pain at tendon attachments, e.g. heel, shoulder, elbowPLN 100, with manual therapy PLN 200Packages are valid for 1, 2 and 3 months from purchase respectively. The number of visits in a package does not mean that this many treatments are needed – the physiotherapist decides on the number of treatments individually after the examination. Prices valid from 08.2026.
Good to know: with heel pain, shockwave therapy is part of a broader plan with exercises and a change of footwear – we describe this in our post heel spur – does shockwave therapy help.
Summary
Shockwave therapy can be unpleasant, especially at the most tender point, but the intensity is matched to the patient’s sensations and can be reduced at any time. Before the treatment, bring your test results and a list of medicines, and afterwards expect temporary tenderness. Pregnancy, anticoagulant medicines and cancer in the treatment area require a prior consultation.
Frequently asked questions
Can I take a painkiller before shockwave therapy?
It is not a good idea to take painkillers “just in case” before the treatment, as they make it harder to judge your sensations and choose the intensity. If you take medicines regularly on your doctor’s advice, do not stop them on your own – just tell the physiotherapist about them during the interview. Anticoagulants, anti-inflammatory medicines and recent steroid injections are particularly important.
Can a bruise appear after shockwave therapy?
Yes, sometimes a small bruise, redness or slight swelling appears at the treatment site. These usually go away on their own within a few days. This happens more often in people with delicate skin or those taking medicines that affect blood clotting. A large haematoma, major swelling or fever after the treatment is a reason to contact a doctor.
Can I go to work and drive after the treatment?
In most cases, yes. Shockwave therapy requires no anaesthesia or recovery period, so after the treatment you can go back to work and drive. For a few days, however, it is worth avoiding intense sport and heavy loads on the treated area, especially running with heel pain or lifting with shoulder or elbow pain.
Do later shockwave treatments hurt less?
For many people, yes, because the tenderness of the area decreases over time and the patient already knows what to expect. This is not a rule, however, as the physiotherapist may gradually increase the intensity. It is worth reporting your sensations at every visit, because the treatment parameters and further steps are decided on that basis.
Sources
- International Society for Medical Shockwave Treatment (ISMST), Consensus statement on indications and contraindications for ESWT, updated 2016.
- Schmitz C. et al., Efficacy and safety of extracorporeal shock wave therapy for orthopedic conditions: a systematic review on studies listed in the PEDro database, British Medical Bulletin, 2015.
- Koenig R.C. et al., Heel Pain – Plantar Fasciitis: Revision 2023, Journal of Orthopaedic & Sports Physical Therapy, 2023.
- National Institute for Health and Care Excellence (NICE), Extracorporeal shockwave therapy for refractory plantar fasciitis (IPG311), 2009.
About the author: Tatiana Grabowska, MSc – master’s degree in physiotherapy, licence to practise number PWZFz 11646 (Polish physiotherapist licence). Since 2013 she has run the “W zdrowym ciele” physiotherapy and rehabilitation clinic in Rydułtowy; she has about 12 years of professional experience.
- Consultation180 PLN
- Referralnot needed
- ReceptionMon–Fri: 7.00–20.00
