Musculoskeletal medicine · UK
Shockwave therapy - a non-surgical route through stubborn tendinopathy.
Extracorporeal shockwave therapy (ESWT) delivers acoustic pressure waves through the skin into stubborn tendon and bone conditions - plantar fasciitis, Achilles and patellar tendinopathy, tennis elbow, greater trochanteric pain, calcific shoulder. Recommended by NICE for several MSK indications, and delivered without needles or downtime.
Why patients choose us
- 01
Focused and radial under one roof
The right device for the tissue, chosen by the clinician performing the procedure - not by whichever machine the clinic happens to own.
- 02
Loading physiotherapy included
A structured progressive loading programme runs alongside the shockwave course - the combination is the evidence-based unit.
- 03
Independent, and free
We are paid by no clinic, so the recommendation - including whether shockwave is the wrong route for you - is impartial and costs you nothing.
Indicative pricing
What private Shockwave Therapy (MSK / Extracorporeal) costs in the UK.
Ranges across our MSK network. Focused shockwave with ultrasound guidance sits at the top; radial shockwave in a physiotherapy clinic at the base.
In short
A private shockwave course (3–6 sessions): £450–£1,200.
| Procedure | Indicative range | Typical duration | Stay / turnaround |
|---|---|---|---|
| MSK consultation with ultrasound | £220–£380 | 30–45 min | Same visit |
| MRI (targeted, one region) | £350–£550 | 30 min | Report in 2–5 days |
| Radial shockwave - single session | £90–£180 | 10–20 min | Same visit |
| Focused shockwave - single session | £150–£280 | 15–25 min | Same visit |
| Course of 3 sessions (radial) | £300–£500 | Over 3–4 weeks | Same-day sessions |
| Course of 5 sessions (focused, US-guided) | £700–£1,200 | Over 5–6 weeks | Same-day sessions |
| Combined shockwave + loading physio bundle | £850–£1,600 | Over 6–8 weeks | Two visits/week |
Prices vary by hospital, by consultant, and by the complexity of your case. We come back with a firm quote within one working day.
The problem
A middle route between injection cortisone and surgery.
Chronic tendinopathy is a huge gap in UK MSK care - too far along for physio alone, too early for surgery. Shockwave sits in the middle when it is used properly.
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Cortisone weakens tendons
Repeated cortisone injections into tendons weaken them and increase rupture risk. Shockwave offers a non-injection route for stubborn tendinopathy.
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Loading physio does most of the work
The evidence for shockwave is strongest when combined with a proper loading programme. Passive shockwave alone underperforms.
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The right device for the tissue
Focused shockwave for calcific rotator cuff, deep tendinopathy and bone. Radial for superficial tendon and enthesis. We match the device to the pathology.
The journey
From enquiry to recovery - what happens, in order.
One team from first message through follow-up.
Phase 1 · Before
Assessment, imaging and planning
Phase 2 · On the day
Procedure and recovery
Phase 3 · After
Results, follow-up and review
- 01
Before
You tell us what is going on
A short, confidential form. Where the pain is, how long, imaging done so far, previous physiotherapy and injections.
- 02
Before
We come back with a route
Within one working day: whether shockwave is right, which device, and whether an MRI is needed first.
- 03
Before
MSK consultation and imaging
Assessment, ultrasound of the target tissue and MRI where indicated. Loading physio prescribed to start immediately.
- 04
Before
Course planned and NSAIDs stopped
3–6 sessions over 3–6 weeks. NSAIDs stopped 3 days before to protect the healing response.
- 05
On the day
Each session
Clinic room, no anaesthetic, 10–20 minutes on the target tissue. Home and back to normal activity the same day.
- 06
After
Loading physio through the course
Structured progressive loading physiotherapy alongside and after the course - where most of the recovery is made.
- 07
After
Six-week and three-month reviews
The 6-week review is the honest check-in. The 3-month review is when full benefit is judged and a second course considered if needed.
Typical end-to-end: 6–8 weeks for a full course. Symptom benefit peaks: 3 months after the last session.
When it helps
When Shockwave Therapy (MSK / Extracorporeal) is the right step.
The situations where shockwave is a NICE-endorsed option, and the flags that mean a different route.
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Plantar fasciopathy
Chronic heel pain over 3 months despite orthoses, calf stretching and loading - one of the strongest indications for shockwave.
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Achilles tendinopathy
Mid-portion and insertional Achilles pain after failed loading physio. Focused shockwave with continued eccentric loading.
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Patellar tendinopathy (jumper’s knee)
Anterior knee pain at the inferior pole of the patella in loading athletes. Radial or focused shockwave alongside slow heavy resistance training.
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Calcific rotator-cuff tendinopathy
A defined calcium deposit in the supraspinatus tendon with pain - focused shockwave is a NICE-recommended non-surgical option.
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Greater trochanteric pain (gluteal tendinopathy)
Chronic lateral hip pain from gluteus medius or minimus tendinopathy - radial shockwave with hip strengthening.
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Tennis and golfer’s elbow
Lateral or medial elbow enthesopathy after failed physio. Radial shockwave sessions weekly.
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Selected bone applications
Delayed union and non-union of long-bone fractures, and selected stress fractures - under orthopaedic supervision.
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Red flag: full-thickness tear or infection
Shockwave is contraindicated over an acute full-thickness tendon tear, active infection, tumour, or over children’s growth plates. Imaging first.
Device options
Focused, radial, and how they compare.
What each option involves, and when we recommend it.
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Focused ESWT (fESWT)
Higher-energy focused pulses delivered to a defined depth. Best for deep tissue targets - calcific rotator cuff, insertional Achilles, deep hip tendinopathy - and bone applications.
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Radial ESWT (RSWT)
Lower-energy radial pulses that spread from the applicator. Best for superficial tendinopathy and enthesopathy - plantar fascia, tennis elbow, patellar tendon, gluteal tendons.
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Ultrasound-guided delivery
Real-time ultrasound to locate the pathology accurately. Standard for deep and calcific targets, and where anatomy makes surface landmarks unreliable.
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Combined with loading physiotherapy
A structured, progressive loading programme in parallel with the shockwave course. The combination is the evidence-based unit.
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Shockwave for delayed union
Focused shockwave through a fracture site with delayed healing - an orthopaedic indication with a growing evidence base.
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Shockwave for calcaneal spurs
A NICE-recommended option for chronic plantar heel pain with a calcaneal spur - the shockwave targets the fasciopathy, not the spur itself.
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Repeat courses
A second course is offered if the first delivered partial benefit but not full resolution. A third is uncommon.
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Not for erectile dysfunction
Li-ESWT for ED is a separate application with a different evidence base and delivery - see the dedicated ED shockwave page.
Our vetted UK network
A small panel of specialists, we picked them.
Consultants across London and the major UK cities. Introductions are made privately, once we understand your case.
Selection criteria
How we choose every specialist in our network.
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MSK doctors and extended-scope physiotherapists trained in ESWT
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Focused and radial devices under one roof - matched to the pathology
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Ultrasound imaging for diagnosis and, where needed, delivery guidance
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Structured loading physiotherapy programme running alongside the shockwave course
Safety and recovery
What to expect afterwards - honestly.
Shockwave is a well-tolerated clinic procedure. The risks worth planning are selecting the right pathology, the right device, and combining with a proper loading programme.
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A clinic-based, non-invasive procedure
No injections, no anaesthetic, no downtime. Sessions are 10–20 minutes; you can drive home and go back to work.
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Discomfort during and after
Sessions are uncomfortable - the machine can be dialled down for tolerance. Mild soreness for 24–72 hours after each session is normal.
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Bruising and skin reaction
Small bruises and skin redness are common. Larger haematomas are uncommon and settle in 1–2 weeks.
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Symptoms can flare before they settle
Some patients feel worse for 1–2 weeks before the healing response builds - the reason we book the review at 6 weeks, not before.
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Rare tendon rupture
A very rare complication when applied to an already-damaged tendon at high energy. Selection and imaging first mitigate the risk.
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Not for full-thickness tears, infection or tumour
Shockwave is contraindicated over these - imaging first is the reason.
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Not for children over growth plates
The evidence in skeletally immature patients is limited; shockwave over open physes is avoided.
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Avoid NSAIDs during the course
Anti-inflammatories dampen the healing response shockwave induces. Stop 3 days before and for the course; use paracetamol for symptom control.
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Red flags after a session
Sudden severe pain, an audible pop or loss of function suggests tendon injury - same-day MSK or A&E, not a routine follow-up.
Reading your report
Your shockwave record in four parts. Read the last one first.
Every shockwave session is logged with device settings and delivered pulses. The record you receive after the course keeps to the same shape.
A quiet reminder
Medical language is precise and can read coldly - we translate it for you.
If you would like us to talk you through the report before your review, just ask.
- 01 Header
Diagnosis and imaging basis
Which tendon or bone was treated, what the ultrasound or MRI showed, and the clinical selection reasoning.
- 02 Technique
Device, energy and delivered pulses
Focused or radial, energy flux density, frequency, number of pulses per session, guidance method.
- 03 Findings
Response across the course
Session-by-session tolerance, pain scores and functional measures - the objective record of how you responded.
- 04 Plan
Loading physio and 3-month endpoint
Read this first: the continuing physiotherapy programme, the review dates, and when to consider a repeat course or a different route.
Recognised by major UK insurers
Several UK insurers cover shockwave therapy for NICE-recommended MSK indications when medically indicated and delivered by a recognised MSK clinic. Cover varies - we confirm in writing before the first session.
Frequently asked
Everything we get asked about Shockwave Therapy (MSK / Extracorporeal).
Quick answers on evidence, cost, painfulness and NHS access.
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What does the evidence say?
NICE has issued interventional procedures guidance supporting shockwave for plantar fasciopathy, calcific rotator-cuff tendinopathy and refractory Achilles and patellar tendinopathy. Guidance is more cautious for tennis elbow and gluteal tendinopathy. Systematic reviews consistently favour shockwave over sham for these indications when combined with loading.
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How many sessions will I need?
A standard course is three to six sessions at weekly intervals, delivered over 3–6 weeks. Benefit builds and peaks around three months after the last session. A second course is offered to responders who did not reach full resolution.
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Does it hurt?
The session is uncomfortable - energy is dialled to the highest tolerable level for the pathology. Most people describe it as bearable rather than painful, and mild soreness for 24–72 hours afterwards is expected. The machine settings are adjustable if you cannot tolerate the standard energy.
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Is it available on the NHS?
Yes, but variably. Some NHS musculoskeletal services offer shockwave for NICE-approved indications; others do not commission it and refer to physiotherapy or steroid injection first. Private access is faster and more predictable for a properly structured course.
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How much does shockwave cost privately in the UK?
A full course of 3–6 sessions runs roughly £450–£1,200 depending on the device (focused vs radial), the operator (MSK doctor vs physiotherapist) and imaging guidance. Insurance covers it in selected cases; we confirm cover before the first session.
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Can shockwave replace surgery?
For calcific rotator-cuff, plantar fasciopathy and mid-portion Achilles tendinopathy it very often does. For structural failure - full-thickness tears, advanced insertional Achilles change with bone spurs - surgery is still the answer, and shockwave is not.
Related treatments
Looking for something else?
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Shockwave for erectile dysfunction
A separate application with a different evidence base.
Learn more -
PRP and autologous blood injections
A related non-surgical route for tendinopathy.
Learn more -
Cortisone shots
The traditional injection route.
Learn more -
Hyaluronic acid injections
Joint-focused injection option.
Learn more -
Physiotherapy for muscular aches and pains
Loading physiotherapy alongside shockwave.
Learn more -
All tests & procedures
Every treatment we arrange.
Learn more