Shockwave Therapy · Lambert Sports Clinic · Surbiton

Is Shockwave Therapy Painful? What to Expect at Your First Session

If you have been recommended shockwave therapy, or are considering it for a persistent tendon condition, you probably want to know what the experience is actually like. The honest answer is: it is not entirely comfortable, but it is generally well tolerated, and most patients find the discomfort manageable and worthwhile given the potential benefits.

This guide walks through exactly what to expect before, during and after your shockwave therapy session at Lambert Sports Clinic.

Before the Session

Your first appointment includes a full physiotherapy assessment before any shockwave is delivered. Your physiotherapist will take a detailed history of your symptoms, assess the affected area, confirm the diagnosis, and establish that shockwave is appropriate for your presentation. If there is any uncertainty, or if imaging is needed first, this will be discussed with you.

There is no special preparation required. Wear comfortable clothing that gives easy access to the area being treated. Avoid applying lotions or oils to the skin over the treatment area on the day.

During the Session — What Does Shockwave Feel Like?

A gel is applied to the skin over the treatment area — similar to the gel used in ultrasound scans. The shockwave probe is then held against the skin and moved over the target area while delivering rapid pulses of acoustic energy.

Most patients describe the sensation as a firm, repetitive tapping or clicking — similar in some ways to a firm deep tissue massage. Over the most sensitive area of the tendon, this can feel uncomfortable. Your physiotherapist will adjust the position and pressure of the probe based on your feedback.

The shockwave application typically takes 5 to 10 minutes per area. The total appointment, including assessment and exercise review, usually takes 20 to 30 minutes.

Is It Painful?

This varies depending on the condition, the individual, and the stage of treatment. For some patients, shockwave is mildly uncomfortable but entirely manageable. For others — particularly over acutely sensitive areas like a very reactive plantar fascia or calcific tendonitis deposit — it can be noticeably uncomfortable during application.

Importantly, the shockwave itself is applied to the symptomatic area, and some discomfort during treatment does not mean the treatment is harmful. Your physiotherapist can adjust the energy level and number of pulses based on your feedback and response.

After the Session

It is common — and expected — to experience a temporary increase in pain in the treated area in the 24 to 48 hours following the first shockwave session. This is a normal response and does not indicate that the treatment has made things worse. Most patients find this settles and is followed by progressive improvement over subsequent sessions.

You may also notice some redness or local warmth in the treated area immediately after the session — this is a normal skin response and typically resolves within a few hours. Occasionally, minor bruising can occur, particularly in thinner-skinned areas.

What to Do After Shockwave

• Continue with your prescribed exercises — rehabilitation is an essential part of the shockwave treatment programme
• Avoid heavy loading of the treated area for 24 to 48 hours if it is very sore
• Avoid anti-inflammatory medication (such as ibuprofen) in the days following shockwave — the inflammatory response shockwave initiates is part of how it works
• Continue normal daily activities as able

How Many Sessions Before It Stops Being Uncomfortable?

Most patients find that sessions 2 and 3 are more comfortable than the first, as the acute sensitivity in the target area tends to decrease with treatment. By session 3 or 4, many patients find the sensation quite manageable.

Summary — Is Shockwave Worth It?

For patients with chronic tendon conditions who have not responded to physiotherapy alone, shockwave therapy offers a meaningful additional treatment option. The temporary discomfort during and after sessions is generally well tolerated and is outweighed for most patients by the improvement in pain and function that the treatment produces. At Lambert Sports Clinic we will always discuss your expectations and answer any questions before treatment begins.