Shockwave Therapy: A Solution for Pain and Overuse Injuries in Active Older Adults

Physical activity is linked to increased longevity, and the number of active older adults is rising. However, aging also brings a higher risk of pain and overuse injuries such as plantar fasciitis (heel pain), Achilles tendinopathy, and tennis elbow. Standard treatments include rest, over-the-counter medication, and physical therapy. When these methods prove insufficient, shockwave therapy offers an alternative.

Understanding Shockwave Therapy

Extracorporeal shockwave therapy (ESWT) involves a device that applies high-intensity pressure pulses, generated by sound waves, to the affected area. It is FDA-approved for treating plantar fasciitis and tennis elbow, and also effective for Achilles tendinopathy. Results for shoulder tendinitis and hamstring injuries are mixed.

The therapy is typically administered in a doctor's office or clinic, usually in three weekly sessions. Patients describe the sensation as "uncomfortable but manageable," comparable to tapping with a rubber hammer, with adjustable intensity.

How Shockwave Therapy Works

The precise mechanisms are still being studied, but shockwave therapy is believed to:

• Increase blood flow to the injured region.
• Stimulate the body's repair processes for damaged tissue.
• Potentially promote new blood vessel growth.
• Interrupt or destroy pain signals by affecting nerve endings in the injured area.

Patient Experience and Outcomes

Jonathan Segal, a retired physician in his early 70s, experienced severe heel pain consistent with plantar fasciitis. Having successfully undergone ESWT for Achilles tendinopathy previously, he sought the treatment for his heel. After three sessions, Segal reported significant improvement within weeks, with symptoms disappearing completely after the full course of treatment.

While not all patients achieve complete relief, research indicates that most experience substantial pain reduction, lasting effects, and a low recurrence rate. The treatment allows patients to maintain an active lifestyle with minimal restrictions, unlike surgery or injections.

Types and Coverage

There are two main types: radial shockwave therapy, which spreads pressure over a wider, shallower area, and focused shockwave therapy, which targets a precise point. Providers select the appropriate option based on the patient's condition.

A notable drawback is that most insurance plans do not cover shockwave therapy, leading to out-of-pocket costs ranging from approximately $100 to several hundred dollars per session.

Despite the cost, Segal considered the treatment "definitely worth it" given its effectiveness in allowing him to resume his active routines.

Research into a broader range of musculoskeletal conditions treatable with shockwave therapy is ongoing.