JEFFREY PENG MD
SPORTS MEDICINE & FAMILY MEDICINE
Shockwave Therapy
Shockwave Therapy For Orthopedic
Pain Relief & Tissue Healing
Extracorporeal shockwave therapy (ESWT) is a non-invasive, FDA-approved treatment that uses high-energy acoustic waves to treat chronic musculoskeletal conditions, reduce pain, and promote tissue regeneration — without surgery or downtime.
What Is Extracorporeal Shockwave Therapy?
Extracorporeal shockwave therapy (ESWT) is a non-invasive treatment that delivers high-energy acoustic waves — called shockwaves — to injured or painful areas of the body. Originally developed for breaking up kidney stones, this technology has been used in orthopedics for over two decades to treat tendon, ligament, muscle, and bone conditions.
Unlike surgery or injections, shockwave therapy works from outside the body. It activates your body's natural healing processes through several key mechanisms:
New Blood Vessel Formation
Promotes angiogenesis — the growth of new blood vessels — delivering more oxygen and nutrients to damaged tissue to accelerate repair.
Cellular Repair Activation
Stimulates fibroblasts for tendon and muscle repair, and osteoblasts for bone healing, along with the release of natural growth factors.
Scar Tissue Breakdown
Breaks down calcifications, fibrosis, and scar tissue that restrict movement, helping restore normal mobility and range of motion.
Pain Signal Disruption
Desensitizes nerve endings and disrupts chronic pain signals, providing both immediate and long-term pain relief.
Orthopedic Conditions Treated with Shockwave Therapy
ESWT is effective for a wide range of musculoskeletal conditions, particularly chronic injuries that have not responded to conservative treatments like physical therapy, rest, or medication. Common conditions treated include:
Plantar Fasciitis
Achilles
Tendinopathy
Rotator Cuff
Tendinopathy
Calcific Tendonitis of
the Shoulder
Tennis Elbow (Lateral
Epicondylitis)
Golfer's Elbow (Medial
Epicondylitis)
Patellar Tendinopathy (Jumper's Knee)
Knee Osteoarthritis
Frozen Shoulder
(Adhesive Capsulitis)
Myofascial Pain
Syndrome
Muscular Trigger
Points
Hip Bursitis (Greater
Trochanteric Pain)
Hamstring
Tendinopathy
Stress Fractures &
Bone Healing
What Does the Research Say?
Clinical Evidence for ESWT
Dr. Peng's approach to shockwave therapy is rooted in the latest clinical trial evidence. Here is what the research shows for specific conditions:
Tendinopathies (Rotator Cuff, Achilles, Plantar Fasciitis, Tennis Elbow)
A systematic review and meta-analysis of 45 clinical trials examined shockwave therapy's effects on chronic tendinopathies. The strongest results were seen in rotator cuff tendinopathy, with significant pain reduction. Achilles tendinopathy showed marked improvements in both pain and function. Plantar fasciitis demonstrated substantial pain relief, and tennis elbow showed moderate but meaningful benefits. The review concluded that ESWT is a highly effective option for relieving tendinopathy pain.
Knee Osteoarthritis
A study comparing physical therapy alone to physical therapy combined with shockwave therapy found impressive results: the group receiving ESWT showed an 82% improvement in functional ability, compared to just 48% in the physical therapy-only group.
Frozen Shoulder
A systematic review and meta-analysis assessing various nonsurgical treatments found that shockwave therapy ranked among the top options for reducing pain and improving shoulder function, performing comparably to established treatments like ultrasound-guided capsular distension.
Myofascial Pain Syndrome
A review of 27 clinical trials found that shockwave therapy significantly reduced pain, improved function, and increased pain tolerance compared to other treatments — particularly for neck and shoulder pain.
ESWT vs. Cortisone Injections: A meta-analysis of over 1,100 participants across 16 studies found that shockwave therapy was more effective than corticosteroid injections for plantar fasciitis at both 3 and 6 months. Cortisone effects were short-lived, often fading after 12 weeks, while ESWT provided lasting improvement in pain, plantar fascia thickness, and foot function.
ESWT vs. PRP Injections: A meta-analysis comparing PRP to ESWT for plantar fasciitis found PRP provided a slightly greater reduction in pain at 3–6 months — but the differences were not substantial. ESWT's major advantage is that it's non-invasive, requires no downtime, and avoids injection-related complications. For the best outcomes, combining both treatments is often recommended.
Watch: The Science Behind
Shockwave Therapy
In this video, Dr. Peng reviews the clinical evidence behind shockwave therapy, compares it to cortisone injections and PRP, and explains what to expect during treatment.
Focused vs. Radial Shockwave Therapy
There are two types of shockwave therapy devices, each suited to different conditions and tissue depths. Dr. Peng's clinic offers both for comprehensive treatment.
Focused Shockwave
Radial Shockwave
Penetration Depth
Deep tissue (up to 12 cm)
Superficial (up to 3.5 cm)
Energy Type
Precise, concentrated electromagnetic waves
Broader, pneumatic pressure waves
Best For
Bone conditions, deep tendons, calcifications, specific targeted areas
Superficial tendons, fascia, trigger points, broad muscle areas
Common Uses
Non-union fractures, avascular necrosis, calcific tendinitis, deep rotator cuff
Plantar fasciitis, tennis elbow, myofascial pain, Achilles tendinopathy
For many conditions, a combination of both focused and radial shockwave provides the best results — focused waves to directly address the injured area, and radial waves to treat surrounding soft tissue.
What to Expect During Shockwave Treatment
Shockwave therapy is performed in the clinic and requires no anesthesia. Here is what a typical session looks like:
Initial consultation: Dr. Peng will assess your condition using diagnostic musculoskeletal ultrasound to identify the precise area to be treated and confirm your diagnosis.
During treatment: A coupling gel is applied to the skin, and a handheld shockwave device is moved in a circular motion over the targeted area. Treatment takes approximately 15 minutes per area. The intensity starts low and is gradually increased to a therapeutic level. You may feel mild to moderate discomfort — the intensity is always adjusted for comfort. Higher energy levels tend to produce quicker improvements.
After treatment: There is no downtime. You can return to normal activities immediately. Mild soreness, swelling, or redness may occur but typically resolve within 48 hours. You may take acetaminophen if needed, but it is important to avoid NSAIDs (ibuprofen, naproxen, aspirin) as they can interfere with the body's healing response.
Treatment course: Most conditions require 3 to 5 sessions, scheduled once or twice per week. Many patients notice improvement after just 1 to 2 sessions, with optimal results appearing a few weeks after completing the full course. Outcomes are enhanced when ESWT is combined with a targeted exercise program or platelet-rich plasma therapy.
Shockwave Therapy Cost
& Insurance Coverage
The cost per shockwave therapy session typically ranges from $150 to $300. A full treatment course of 3 to 5 sessions may cost between $450 and $1,500, depending on the condition being treated and the number of sessions required.
It is important to note that most insurance plans do not currently cover extracorporeal shockwave therapy, and it is generally considered a self-pay procedure. Contact our office to discuss pricing and payment options for your specific condition.
Dr. Jeffrey Peng MD offers shockwave therapy (ESWT) in Campbell, CA — proudly serving patients from San Jose, Santa Clara, Los Gatos, Cupertino, Sunnyvale, Saratoga, Mountain View, Milpitas, and the greater Silicon Valley area.
Frequently Asked Questions
Frequently asked questions
About Dr. Jeffrey Peng — Your Shockwave Therapy Specialist
Dr. Jeffrey Peng is a board-certified sports medicine and family medicine physician specializing in non-surgical treatments for sports injuries and orthopedic conditions. He completed his residency with the Stanford Family Medicine Residency Program and his sports medicine fellowship with the Stanford Primary Care Sports Medicine Fellowship in San Jose.
Dr. Peng's practice focuses on evidence-based, minimally invasive treatments including diagnostic musculoskeletal ultrasound, ultrasound-guided procedures, platelet-rich plasma (PRP) therapy, and extracorporeal shockwave therapy. He is an active faculty member training the next generation of physicians and runs a popular YouTube channel with over 400,000 subscribers dedicated to evidence-based sports medicine education.
His sports medicine clinic is located in Campbell, California, serving the greater San Jose and Silicon Valley area.