Having ESWT
Extracorporeal shockwave therapy for Achilles tendinopathy and plantar fasciitis
Preparation before ESWT
You will need to make sure that you are available for the full course of 3 treatments. If you miss 2 consecutive treatments, you will need to start the course again.
2 weeks before your first procedure and throughout your treatment, you should not take NSAIDs (non-steroidal anti-inflammatory medicines). Examples are ibuprofen, aspirin or medicine that contains aspirin (such as flu or cold remedies).
However, if a doctor has prescribed you aspirin 75mg for a specific medical condition, you should continue to take this.
Wear comfortable clothing as you will be lying on your front for the treatment.
You can eat and drink normally before and after your treatment.
Having ESWT
The treatment will be given in the orthopaedic outpatient department. The ESWT will be done by a trained clinician.
You will be asked to lie on your front with your legs supported by a pillow.
The clinician will put some gel on the injured area and then place the hand piece of the machine on the gel.
The ESWT is given using the hand piece. It delivers compressed air impulses through the gel.
Each treatment takes about 5 minutes but you should allow about 15 to 20 minutes for your appointment.
Pain
You will be asked how much pain you are experiencing during the treatment, and we will attempt to adjust the treatment to help manage this. The pain will stop at the end of your procedure.
After ESWT
You will be able to get up and walk away immediately after the treatment.
If you do have any discomfort after the shockwave treatment, you can take painkillers (such as paracetamol).
Returning to usual activities
You will be able to return to your usual activities straight away and can return to work immediately.
We advise you not to undertake any strenuous, pain-provoking activity or high impact exercise for 48 hours after the procedure.
Contact a GP or go to your nearest emergency department (A&E) if:
- you experience a sudden onset of pain to the area or any loss of function
Follow-up appointment
You will have a phone appointment about 8 weeks after your final treatment. You will also receive a questionnaire at 3 and 12 months after your treatment, to assess the effectiveness of ESWT.
Further information
National Institute for Health and Care Excellence (NICE) has produced recommendations for patients on ESWT for Achilles tendinopathy and plantar fasciitis.
Resource number: 3914/VER5
Publish date: October 2026
Review date: October 2029