Extracorporeal Shock Wave Therapy (ESWT) is a non-invasive procedure for the treatment of acute and chronic pain of the musculoskeletal system.

Acoustic shock waves are characterized by a pressure surge with an extremely short rise time, which is then followed by an exponential drop in pressure and a brief phase of negative pressure. The shock waves used in ESWT focus or develop in the target tissue at the point where the pain is originating from. They cause an improved local blood circulation and metabolism. The primary means by which extracorporeal shock waves affect living tissue is based on the transformation of mechanical stimuli into biochemical or biomolecular signals. The science behind ESWT is analogous to that of lithotripsy, a technology that makes use of acoustic shockwaves to break up kidney stones without surgery. The technique of using shockwaves to break up kidney stones has been around for nearly a quarter of a century. In the process of treating hundreds of thousands of patients, specialized machines were developed specifically with the idea of using the generated shockwaves in other parts of the body, e.g. to treat musculoskeletal conditions.


Extracorporeal shockwaves can be seen as a mechanical stressor that is able to induce biochemical changes in living tissue that can ultimately influence gene expression in cells at the molecular level. Consequently, when used selectively, they can produce a specific tissue reaction. This process is referred to as mechanotransduction. Mechanical stimuli affect almost all cellular functions of living tissue such as growth, cell differentiation, cell migration, protein synthesis, physiological apoptosis and tissue necrosis. Mechanical forces have a direct influence on the form, and thereby on the function, of tissue. Furthermore, new studies show that ESWT is able to stimulate endogenous lubricin production in tendons and septa. Scientific studies and publications, using the highly accurate piezo-shockwave technology, have confirmed the effectiveness of focused shockwaves for ESWT, as well as trigger point diagnosis and treatment. ESWT is one of the very few medical technologies that is effective at treating chronic injuries. It is suggested that ESWT can “jump start” the healing process in chronic, non-healing injuries and reintroduce the acute phase of healing.