Shockwave Therapy Success Rate: What the Evidence Shows
Published success rates for shockwave therapy (extracorporeal shockwave therapy, or ESWT) range from roughly 34% to 91%, depending on the condition treated and how “success” is defined. For chronic tendon and heel problems that have not settled with other care, a course of treatment gives many people meaningful pain relief. Results are strongest when the right condition is matched to a properly delivered course. At Parks Therapy Centre, shockwave therapy starts with a £60 assessment, so the diagnosis comes before the treatment.
This guide explains what the figures mean, what the research reports for plantar fasciitis, tennis elbow, Achilles and shoulder tendon problems, how many sessions a course involves, and who should not have treatment.
TL;DR
Reported success rates vary widely (about 34% to 91%) because studies define success, choose patients and set energy levels differently.
A 2024 meta-analysis of 45 clinical studies found significant pain reduction in plantar fasciitis, tennis elbow, chronic Achilles tendinopathy and rotator cuff tendinopathy.
A typical NHS course is one session a week for 3 weeks, with a review 4 to 6 weeks after the last session.
ESWT is usually considered for symptoms lasting 3 to 6 months or more that have not responded to other conservative care.
Some people should not have shockwave therapy, including during pregnancy and with a pacemaker, so an assessment comes first.
Table of Contents
What “success rate” actually means
A single percentage for shockwave therapy does not exist, and any page that quotes one is simplifying. A success rate depends on three things: the condition, the outcome measure and the protocol.
One trial may count a patient as a success if pain falls by at least 50% on a scale. Another may use a clinician-graded score, and a third may ask whether the patient has no heel pain at all. The same treatment can look very different under each definition.
NICE, the body that assesses procedures for the NHS, notes that its committee found the data difficult to interpret because of varied treatment protocols, comparators, end points and energy types. A review by Wang puts the wide spread of results down to differences in study methods, patient selection, devices, energy levels and outcome measures.
So the useful question is: what is the likely benefit for my condition, at my stage, with a correctly delivered course?
Success rates by condition
Condition | What the research reports | Source |
Plantar fasciitis (heel pain) | 34% to 88% success across studies; 47% successful at 3 months in a 293-patient trial | |
Tennis elbow (lateral epicondylitis) | 68% to 91% success across studies; 89% at 52 weeks in one review | |
Greater trochanteric pain syndrome (outer hip) | 74% recovered or improved at 15 months | |
Rotator cuff tendinopathy | Significant pain reduction in pooled analysis | |
Chronic Achilles tendinopathy | Significant pain reduction in pooled analysis |
The ranges are wide because they combine very different studies. They are not a promise for any one patient.
Plantar fasciitis
Heel pain is the condition most people ask about. In a randomised trial of 293 patients with refractory plantar fasciitis, reported by NICE, 47% of the shockwave group had a successful outcome at 3 months, compared with 30% of the sham group.
Longer follow-up is encouraging. In a trial of 149 patients, 69% of those treated with ESWT had an excellent result, meaning no heel pain, at a mean of 64 months.
The 2024 meta-analysis found a pooled pain reduction effect size of -1.63 for plantar fasciitis. In plain terms, across the pooled studies pain fell by a large amount. If you are also working on stretches and loading at home, our guide to plantar fasciitis exercises covers the programme that sits alongside shockwave treatment.
Tennis elbow
Across several studies, the success rate for shockwave in tennis elbow ranged from 68% to 91%. A 2023 narrative review reported that at 52 weeks the greatest effect for epicondylitis was achieved with shock waves (89%). The 2024 meta-analysis also found a significant pain reduction for lateral epicondylitis.
If your elbow pain comes from a repetitive sport, load management matters as much as the treatment itself. Racket-sport players often look at pickleball paddles for tennis elbow when they want to reduce strain on the forearm tendons while they recover.
Achilles and shoulder tendons
The 2024 meta-analysis reported significant pain reductions for chronic Achilles tendinopathy (SMD -1.38) and rotator cuff tendinopathy (SMD -2.37). A 2026 network meta-analysis of 65 publications and 3,921 cases found that ESWT improved pain and tendinopathy severity in lateral epicondylitis, Achilles tendinopathy, rotator cuff tendinopathy and greater trochanteric pain syndrome.
For knee tendon problems, a 2018 meta-analysis of 19 randomised trials found significant effects on treatment success rate (odds ratio 3.36), pain and range of motion.
The pattern matters. Shockwave suits chronic, localised tendon and fascia problems, which is why a proper assessment of the painful area comes first.
Who shockwave therapy is usually offered to
NHS trusts generally offer ESWT for chronic problems. One NHS trust states that it is usually offered when symptoms have persisted for at least 3 to 6 months and have not responded to conservative treatment such as physiotherapy, activity changes, ice, orthotics, painkillers or steroid injection.
In practice, you are a likely candidate if you have:
heel pain that has lasted months despite stretching and supportive footwear;
tendon pain at the elbow, shoulder, hip or Achilles that flares with activity and has not settled;
a clear diagnosis from a clinician, rather than a guess from the symptoms.
If you are unsure what is causing your pain, an assessment is the right first step. Parks Therapy Centre also offers an image assessment (£76), an image referral letter (£10) and an image results review (£67), so a scan can be arranged and reviewed when the diagnosis needs confirming. For a wider view of what helps persistent pain, see our guide to musculoskeletal pain treatment in 2026.
How many sessions, and when you notice a difference
An NHS trust describes a standard course as one session a week for 3 consecutive weeks, with sessions no more than 2 weeks apart. A follow-up 4 to 6 weeks after the last session checks the response. If symptoms have improved but not resolved, 3 further sessions may be offered. Some people improve almost immediately, and others take several weeks.
This timing explains why success rates are measured at 3 months or longer. Judging the result after the first session misses most of the effect.
Shockwave works best alongside a rehabilitation plan. Tendons respond to progressive loading, and shockwave is typically used to reduce pain so that you can do that work. Our overview of shockwave therapy: benefits, science and recovery explains what happens in the room, and our article on shockwave therapy for sports injuries covers the athlete’s view.
How long the benefit lasts
The longer-term data are some of the most encouraging. In the 64-month heel pain trial above, 69% of treated patients had no heel pain. In the outer hip study, 74% had recovered completely or improved at 15 months.
What shapes your own result:
Duration of the problem. The longer a tendon has been painful, the more a structured course and rehabilitation matter.
Diagnosis. Shockwave suits some conditions better than others, as the table shows.
Loading afterwards. Returning to the activity that caused the problem too fast can bring symptoms back.
Following the course. Gaps of more than 2 weeks between sessions are not recommended.
Safety: who should not have shockwave therapy
Shockwave therapy is not suitable for everyone, and this is checked at assessment. An NHS trust lists these as absolute contraindications:
pregnancy;
being under 18;
a steroid injection into the treatment area in the last 12 weeks;
haemophilia or a clotting disorder;
a cardiac pacemaker or unstable heart condition;
cancer or a tumour at the treatment site;
infection or acute inflammation at the treatment site;
current thrombosis;
epilepsy;
taking fluoroquinolone antibiotics;
osteogenesis imperfecta;
powered implants.
The same source lists possible side effects: bruising, pain, local swelling, skin reddening, numbness or altered sensation, skin break, and tendon or fascia rupture. In trials, effects were usually mild. NICE reports that transient skin reddening occurred in 31% of ESWT patients in a 272-patient trial, and pain during treatment in 5% and 1% of patients in two plantar fasciitis trials.
Tell your clinician before treatment if any of the above applies. If you take fluoroquinolone antibiotics, are pregnant or have a pacemaker, speak to your GP or the clinician treating that condition before booking.
Perspective: why assessment comes before the machine
Patients often ask us for a percentage. We understand why, but the figure that matters is the one for your tendon, at your stage, after a proper diagnosis. That is why we start with a shockwave assessment (£60) and treat from there. The treatment is offered as a 20-minute session (£60) or a 30-minute session (£70). Our physiotherapists work alongside acupuncture, sports massage and Pilates at our clinics across Bedfordshire and Buckinghamshire, so shockwave sits inside a wider rehabilitation plan rather than standing alone. We have been treating local patients since 1986. Our view is simple: the best results come from the right diagnosis, a completed course and a sensible return to activity. Ivan
Book a shockwave assessment
If you have had heel, elbow, shoulder, hip or Achilles pain for several months, a shockwave assessment shows whether the treatment fits your condition. Parks Therapy Centre accepts private payment and health insurance, and you can check every current price on our prices page.
Published prices: shockwave assessment £60, shockwave treatment (20 minutes) £60, shockwave treatment (30 minutes) £70.
FAQ
What is the success rate of shockwave therapy?
There is no single rate. Studies report anywhere from about 34% to 88% for plantar fasciitis and 68% to 91% for tennis elbow, depending on methods and definitions of success. A 2024 meta-analysis of 45 studies found significant pain reduction across four common tendon conditions.
How many sessions of shockwave therapy do I need?
A standard NHS course is one session a week for 3 weeks, with a review 4 to 6 weeks after the last session. Further sessions may be offered if you have improved but not fully recovered. Your clinician will set the plan at assessment.
How soon will I feel a difference?
Some people notice relief almost straight away, while others take several weeks. Because the full response builds over time, results are usually reviewed at 4 to 6 weeks and again at around 3 months.
Is shockwave therapy painful?
You can feel discomfort during treatment over the sore area. In trials, pain during treatment was reported by a small proportion of patients (1% to 5%). Temporary skin reddening and bruising are the more common effects.
Who should avoid shockwave therapy?
Pregnancy, being under 18, a pacemaker, a clotting disorder, epilepsy, a recent steroid injection in the area and taking fluoroquinolone antibiotics are among the listed contraindications. Your clinician checks these at assessment.
Sources
NICE HTG201: Extracorporeal shockwave therapy for refractory tennis elbow
NICE HTG200: Extracorporeal shockwave therapy for refractory plantar fasciitis, the procedure
NICE HTG248: Extracorporeal shockwave therapy for greater trochanteric pain syndrome
Wang (2012): Extracorporeal shockwave therapy in musculoskeletal disorders
Majidi et al. (2024): Effect of ESWT on pain in tendinopathies
Guo et al. (2026): Network meta-analysis of ESWT in tendinopathy
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