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Frequently Asked Questions

When you have chronic pain everything you do in your life is affected. Having daily pain is no way to live, especially when the pain is avoidable.

It is a pleasure to share this information about a state-of-the-art solution to a common painful problem. ESWT or Extracorporeal Shock Wave Therapy will make your life more enjoyable with one simple 18-minute procedure.

The information on these pages will answer the following questions for you:

What is ESWT?

Extracorporeal Shock Wave Therapy or ESWT is an 18-minute non-surgical procedure used to cure chronic plantar fasciitis, Achilles tendonitis, tennis elbow, shoulder tendonitis, and other chronic tendinopathies.

Lithotripsy, a similar shock wave therapy procedure, is used regularly for breaking up and dispersing kidney stones. When urologists found that patients who had the kidney stone procedure presented with increased bone density and new tissue growth, the possibilities of shock wave therapy were revisited.

ESWT is used internationally for conditions all over the body. In the United States, an FDA study was performed for patients who suffer from chronic plantar fasciitis with or without the presence of a heel spur. The results were an amazing average reduction in pain of 92% with only one treatment. (This data reflects the results of the patients who participated in a one-year follow-up study with the Dornier EPOS Ultra machine.)

ESWT benefits patients because their condition can be treated extracorporeally, meaning outside of the body. Because the treatment is non-invasive many of the expenses and risks of surgery are eliminated. Excellence Shock Wave Therapy uses the Dornier EPOS Ultra for all our orthopedic ESWT procedures.


How effective is ESWT?

Our own experience and the FDA ESWT study using our treatment protocol shows an overwhelming success rate. In the study, a group of 150 patients was asked to rate their pain level on a scale of 1 to 10. The average pain level before treatment was 7.7.

After receiving one ESWT treatment, the patients were asked one year later to rate their pain level again on a scale of 1 to 10. The patients who reported had an average pain score post-ESWT of 0.6. This is a 92% reduction in pain and a much higher rate of success than any non-surgical or surgical procedure. More importantly, ESWT is very safe.

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What is involved in the procedure?

ESWT benefits patients because their condition can be treated extracorporeally, meaning outside of the body. Since ESWT is non-invasive, there is no lengthy recovery period, virtually no time off from work or risk of causing further damage. The same cannot be said with surgery.

During the treatment, you lie back comfortably with the area to be treated resting on the machine on a soft, water-filled membrane. To ensure patient comfort, a local anesthesia is used. The technician will make sure you are comfortable throughout the procedure. The technician uses an ultrasound scan to view and target the damaged location. During the treatment, you will hear repetitive clicking sounds.

The Excellence Shock Wave Therapy Technician and your Doctor will insist upon your comfort during treatment. Our technicians have performed tens of thousands of ESWT treatments and are proficient at using the analgesic effects of certain levels of shockwaves to make the treatment comfortable. Your comfort is a priority to us.

If you are nervous or anxious about treatment talk to your doctor or treatment coordinator. Our goal is to always make sure you are comfortable and relaxed during treatment!


How long have you been providing ESWT?

Excellence Shock Wave Therapy has been providing ESWT since 2000, using the first ESWT device to enter the United States. In 2002 we upgraded and converted technologies to the Dornier EPOS Ultra. Excellence Shock Wave Therapy has provided ESWT to thousands of patients in New Jersey, Pennsylvania, Delaware, New York, Maryland and Washington D.C.


What conditions can be treated by ESWT?

ESWT can effectively treat a range of musculoskeletal conditions. Complaints involving attachment points for tendons and ligaments in major joints such as the plantar fascia, Achilles tendon, shoulder, elbow and knee are common areas for ESWT treatment. Contact us to discuss your individual condition.


What kind of recovery can I expect?

ESWT forces your body to create new tissue cells in the damaged area. Expect gradual healing to take place over days, weeks or months. Though not typical, some have mild soreness or bruising after treatment. Some people experience no more pain from day one. Most will have noticeable to significant improvement by the thirteenth week. A second treatment after sixteen weeks may be necessary in approximately 20% of patients. As it took time to create the injury, healing also takes time. Total healing of the area can take up to one year.

The best thing about ESWT is that unlike surgery, you avoid getting worse before getting better. You do not need to plan lengthy time off from work or your life for painful post-procedure recovery.


When should I consider ESWT?

If you have had your condition for more than six months and have tried three conservative therapies with no results, don’t wait. It is natural to procrastinate, but it is not a good idea for tendonosis conditions, since continuously using degenerative tendon tissue can cause further damage.

For example, every time that you feel pain when you place weight on your heel or lift something with your arm, it’s because you are pulling against the tendon fibers. When the condition progresses to a rupture, ESWT is no longer an option and you will have no treatment alternative but invasive surgery.

Additionally, if left untreated, you can experience new problems. With heel pain in your foot you may naturally compensate by walking on your toes or limping to protect yourself from pain. These abnormal movements will, in time, cause strain to your knees, hips and lower back, or even worse, may result in the same condition in the other foot. Compensation issues occur whenever you have chronic pain left untreated.

If your pain has just begun, you may be able to avoid ESWT by early intervention. Please feel free to call us and we will recommend a specialist who can help you take care of the problem today. Take care of yourself. Fix the problem, don’t delay.


I’ve tried other things but they didn’t help. How do I know ESWT will?

Tendonitis sometimes resolves by itself or with the help of treatments such as strapping, physical therapy, anti-inflammatory medications, or cortisone injections. When the condition is new (usually less than six months) it is called acute tendonitis.

Acute tendonitis is an inflammation. All of the treatments used at this stage are meant to rest the area or deal with the inflammation. Those who do not get better in the “acute” phase have what is called chronic tendonosis. The difference between tendonosis and tendonitis is simple: Tendonitis is an inflammation. Tendonosis is degenerative or damaged tissue. You can use steroid injections repeatedly with no result if the problem has gone beyond inflammation. Surgery used to be the only option for tendonosis. ESWT treats tendonosis because ESWT forces the damaged tendon to heal


What ESWT equipment is used by Excellence Shock Wave Therapy?

We use the Dornier EPOS Ultra. The EPOS is FDA Class 3 approved for the treatment of chronic plantar fasciitis. In our opinion, the Dornier EPOS is the highest quality, state-of-the-art device on the market.

There are three main reasons why Excellence Shock Wave Therapy chose the Dornier EPOS Ultra as our ESWT equipment:

1.The Dornier EPOS uses ultrasound during the treatment process. This means the doctor can locate, view, and target the specific area or damage/injury with pinpoint accuracy. Shock waves are directed exactly where they are needed, and only where they are needed, to ensure a successful treatment.

2.The Dornier EPOS treats plantar fasciitis by sending the shock waves in through the tendon from the side of the heel. Other equipment sends the shock wave in from the bottom of the heel directing the shock waves up and into the heel bone. This bone impact is painful. Because we do not impact bone, we do not need to use unnecessary general anesthesia or IV sedation.

3.The Dornier is a high-energy ESWT machine with a wide range of settings and penetration depths. This allows the doctor and the technician to fine-tune the procedure to your individual diagnosis. The Dornier treatment is not one-size-fits-all.


What are the differences between the Dornier equipment used by Excellence Shock Wave Therapy and other ESWT equipment?

Excellence Shock Wave Therapy has selected the Dornier EPOS Ultra as our equipment of choice because it offers the highest, yet most variable, energy output. It also incorporates ultrasound to view the damaged tissue and target the shock waves directly at, and only to, the damaged tissue.

The Dornier is capable of performing both low energy and high energy treatments. Excellence Shock Wave Therapy does not perform low energy shock wave therapy for plantar fasciitis. Only high energy is FDA tested and approved for plantar fasciitis. High energy ESWT causes cavitation or microtrauma to the tissue. This forces the body to lay down new fibroblast tissue and actually repair the tendon while also affecting pain receptors.

Low energy shock wave therapy affects only the pain receptors. Low energy shock wave therapy cannot be performed with a local anesthetic because a local injection has been shown to nullify the results of low energy treatments on pain receptors. This means the patient must be able to tolerate the pain of the treatment. Once tolerance has been reached, the energy level cannot be increased. Multiple treatments are required to affect the pain receptors with low energy shock wave therapy.

Lately there have been some manufacturers of devices that are unfocused pressure waves machines trying to position their machines as ESWT. Pressure wave devices are used for relaxing muscles and trigger point pain. They are not ESWT, and do not produce the same results or function in the body. Insist on high energy ESWT with the Dornier Epos Ultra.

Discover more details about the differences


How do I know ESWT is right for me?

Your certified Excellence Shock Wave Therapy practitioner will perform a thorough examination and order any necessary diagnostic tests to determine the best course of treatment for your condition. Though this website focuses on ESWT, it is the goal of every doctor in the Excellence Shock Wave Therapy group to provide the best possible treatment for your pain. We will refer you to a physician who will make a complete diagnosis and treatment plan. The doctor may recommend ESWT or another course of treatment. You will not have to guess if ESWT is right for you. The doctor can help you make your treatment decisions based on your individual condition.

If ESWT is right for you, we do not need to delay treatment. We know you are in pain and will make every effort to schedule your treatment quickly and at a time convenient to your schedule. The sooner you receive treatment, the sooner you are enjoying your hobbies and active lifestyle again


Why doesn’t my orthopedic surgeon or podiatrist do this procedure?

The physicians certified by Excellence Shock Wave Therapy in ESWT are truly state-of-the-art practitioners, and they are also dedicated to reducing the need for surgery. There are some surgically oriented practices that do not look to offer non-surgical treatments. You may find many physicians are not even familiar with this treatment. We encourage you to share this information with your physician and have him or her contact us for physician-oriented information.

Additionally, ESWT technology costs more than a half million dollars to offer in a practice. This investment is simply not possible within a doctor's practice. Excellence Shock Wave Therapy owns the equipment and trains physicians in the technology and practice of ESWT. Doctors who offer this treatment are committed to avoiding unnecessary surgery and hospitalization for their patients.


I have had this problem for a long time. Is it too late for me?

No! The chronic sufferer has new hope with ESWT. Long-term sufferers finally have a non-surgical treatment option. If you have “tried everything” don’t be discouraged, this is a new weapon against your pain!


Is ESWT covered by my insurance?

We are happy to contact your insurance company to find out if there is coverage for ESWT for you. Please call us for an informational packet and to discuss your condition and insurance coverage.


How does this treatment vary from laser therapy or other multiple treatment devices?

Recently we have seen some manufacturers of physical therapy devices that are unfocused pressure waves trying to position their product as ESWT.  Lasers, and pressure wave devices are used for relaxing muscles and trigger point pain.  They are not ESWT, and do not product the same results or function in the body.  Insist on high energy ESWT with the Dornier Epos Ultra for a curative procedure.  High Energy ESWT with the Dornier is the only procedure that is FDA approved, and proven effective to repair tissue without surgery.