TECAR or shockwave therapy — which to choose?

TECAR is more often chosen for widespread pain and stiffness in the muscles, joints and spine, when deep heating of the tissues is helpful. Shockwave therapy is chosen for chronic, localised pain at tendon attachments, e.g. in the heel, a shoulder with calcification or the elbow. At the clinic in Rydułtowy, TECAR costs PLN 150 and shockwave therapy PLN 100. Both treatments complement exercise, and the final choice is made after an examination.

Below we compare both treatments using the same criteria: how they work, indications, contraindications, sensations, combining them with manual therapy, and price. We also describe situations in which neither of them is appropriate.

How does TECAR differ from shockwave therapy?

TECAR and shockwave therapy differ in the type of energy they use. TECAR passes radiofrequency current through the tissues, where it turns into heat and acts on a larger area. Shockwave therapy sends short acoustic pulses into one, usually small, spot, e.g. a tendon attachment. TECAR feels like warmth, while shockwave therapy feels like rhythmic tapping, which is often unpleasant.

Prices valid from 08.2026. Both treatments are described in detail in our posts TECAR therapy – what is it and shockwave therapy – what does it help with.

When is TECAR the better choice?

TECAR is considered more often when pain covers a larger area, e.g. the muscles along the spine, the neck or the thigh, when stiffness and increased muscle tension dominate, for chronic joint problems and during the healing period after sprains and strains. It is also sometimes chosen for people who do not tolerate unpleasant treatments well. However, it is not used in people with a pacemaker.

The advantage of TECAR is comfort – most patients find the warmth pleasant, and warming the tissues can make manual therapy easier for the physiotherapist. The limitation is the small number of good-quality studies, which is why the effect of the treatment is assessed on an ongoing basis and it is not treated as the only method of treatment.

When is shockwave therapy the better choice?

Shockwave therapy is usually chosen for chronic, localised pain at a tendon or fascia attachment, when exercise and changes in loading have not brought enough improvement. The best-documented indications are heel pain related to the plantar fascia and calcification in the shoulder tendons. For tennis elbow, the Achilles tendon and jumper’s knee, the research results are less clear-cut.

Shockwave therapy can be unpleasant, but the intensity is adjusted to the patient’s tolerance. It is not a method for fresh injuries, swelling or widespread muscle pain. Examples of its use are described in our posts on heel spurs and tennis elbow.

When is neither treatment appropriate?

Neither TECAR nor shockwave therapy is used during pregnancy, with cancer in the treatment area, with fever and acute infection, with inflammation or wounds on the skin in the treatment area, or with venous thrombosis. Neither of them replaces medical diagnosis when there are warning symptoms, such as pain after an injury with swelling, night pain or loss of strength.

Each treatment also has its own contraindications: for TECAR these are mainly a pacemaker and other implanted electronic devices and impaired sensation, and for shockwave therapy – clotting disorders, anticoagulants and growth plates in children. A full overview can be found in our post contraindications to physical therapy modalities.

See a doctor first, rather than booking a treatment, if:

• the pain started after a fall or injury and is accompanied by swelling or an inability to put weight on the limb;
• the joint is hot and red, and you have a fever;
• the pain wakes you at night and is accompanied by unintentional weight loss;
• you develop numbness, loss of strength or problems passing urine.

Can TECAR and shockwave therapy be combined with manual therapy?

Yes, both treatments are often combined with manual therapy and exercise, because physical treatments alone are rarely enough. At the “W zdrowym ciele” clinic, manual therapy with TECAR costs PLN 210, and manual therapy with shockwave therapy PLN 200. Sometimes the physiotherapist uses both treatments in the course of one treatment plan, e.g. shockwaves on the tendon attachment and TECAR on the tense muscles.

The order and combination of treatments depend on the problem and how the patient responds. The key is that a treatment should not replace exercise, which has the best-documented effect in tendon overload conditions.

Who decides which treatment to choose?

The physiotherapist decides on the treatment after taking a history and examining you, taking into account the type of problem, how long it has lasted, contraindications, imaging results and the doctor’s recommendations. A physiotherapy consultation in Rydułtowy costs PLN 180. The physiotherapist decides on the number of treatments individually and assesses the effect at subsequent visits, changing the treatment plan if there is no improvement.

It is worth coming to the first visit with ultrasound, X-ray or MRI results, a list of medicines (especially anticoagulants) and information about any implants. The patient can say which treatment they would prefer to try, but the physiotherapist will explain whether it makes sense in their situation.

Summary

TECAR is more often chosen for widespread pain and stiffness of the muscles and joints (PLN 150), and shockwave therapy for chronic, localised pain at tendon attachments (PLN 100). Both treatments can be combined with manual therapy (PLN 210 and PLN 200), and the choice is made by the physiotherapist after a consultation costing PLN 180.

Frequently asked questions

Sources

• Beltrame R. et al., Capacitive and resistive electric transfer therapy in rehabilitation: a systematic review, International Journal of Rehabilitation Research, 2020.
• 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.
• Koc T.A. et al., Heel Pain – Plantar Fasciitis: Revision 2023. Clinical Practice Guidelines, Journal of Orthopaedic & Sports Physical Therapy, 2023.