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Living with Degenerative Disc Disease (DDD) can be frustrating and exhausting. The chronic back pain, stiffness, and limitations from DDD often persist despite trying rest, medications, or standard therapies. Many people with DDD have pain that lasts longer than 3 months (chronic pain) and feel like they’ve “tried everything.” If you’ve been told your spine is worn out or that surgery is the only option left, you might be searching for alternatives. Shockwave therapy – a non-surgical treatment originally used for kidney stones – is now emerging as a promising option for musculoskeletal pain. In fact, shockwave therapy for Degenerative Disc Disease is gaining attention as a way to stimulate healing in the spine and provide relief without surgery or injections. This article will explore what DDD is, why pain can persist, and how extracorporeal shockwave therapy (ESWT) may help relieve Degenerative Disc Disease pain, according to the latest scientific evidence. (As always, results may vary; consult a healthcare provider for personalized advice.)
Degenerative Disc Disease isn’t actually a “disease” in the infectious sense – it refers to wear-and-tear changes in the intervertebral discs of your spine. Discs are the cushions between your vertebrae (spinal bones). Over time or after injuries, discs can degenerate: they lose hydration, flatten, and develop small tears. This can lead to chronic low back pain or neck pain, stiffness, and sometimes nerve pain if a disc herniation or bone spur presses on spinal nerves. Common causes include aging, repetitive strain, past trauma, or genetic factors. Not everyone with disc degeneration has pain, but in some people the degenerated discs can cause inflammation or instability that generates ongoing pain.
One important thing to realize is that imaging findings don’t always match pain levels. You might have an MRI showing degenerative disc disease, disc bulges, and arthritis, yet feel little to no pain – or vice versa. Uran Berisha, Shockwave Expert and founder of Unpain Clinic, recounts a case of a client in his 70s whose scans looked terrible (multiple degenerated and herniated discs) but who was pain-free with perfect posture. Meanwhile, others have mild disc changes on MRI but debilitating pain. Pain comes from dysfunction, not just structural damage. In other words, a worn disc can contribute to pain, but often it’s the way your body is moving (or not moving) and other factors that actually generate the pain signals.
Why can DDD pain persist for months or years? Discs have very limited blood supply, so they heal slowly. The lower back also bears a lot of stress in daily life – every time you sit, bend, or lift, the pressure on those discs can prevent healing. Over time, the surrounding joints (facet joints) and muscles may also become irritated. The result is a cycle of inflammation and pain that can be hard to break. Many people start by treating the symptoms: rest, heat, or over-the-counter pain relievers. If pain continues, doctors often prescribe physiotherapy exercises, chiropractic adjustments, or massage. These can help, but if they only address the local spine without fixing underlying issues (like core weakness or hip stiffness), the relief is temporary. It’s common to escalate to stronger interventions like steroid injections – which can numb pain for a while but don’t fix the disc or alignment issues – and then, as a last resort, consider spinal surgery (such as a disc fusion or replacement). Unfortunately, even after surgery some patients continue to have pain if the true root cause of dysfunction wasn’t addressed. As Uran Berisha explains, simply fusing a spine segment or removing a disc herniation doesn’t retrain how your body moves; that’s why pain often returns if compensations elsewhere (like tight hips or old scar tissue) remain.
The frustration of DDD is that people feel stuck in a cycle: painkillers, physical therapy, injection – and repeat – with no lasting relief. Understandably, many are eager for something that actually promotes healing of the damaged area rather than just “masking” the pain. This is where shockwave therapy comes in as a potential game-changer for chronic disc-related pain.
Shockwave therapy (specifically Extracorporeal Shock Wave Therapy, ESWT) is a non-invasive treatment that uses acoustic sound waves to stimulate healing in targeted tissues. “Extracorporeal” simply means the shockwaves come from outside the body. In a shockwave therapy session, a trained clinician uses a handheld device to deliver focused high-energy sound waves to the area of pain (for example, your lower back). Originally developed to break up kidney stones, shockwave devices were adapted for orthopedic use when doctors noticed these pulses could trigger tissue repair.
Shockwave therapy works by delivering controlled micro-trauma to tissues. Don’t let the word “trauma” scare you – it’s a therapeutic micro-stress that jump-starts the body’s natural repair mechanisms. The shockwaves increase blood flow in the area and cause cells to release growth factors that lead to the formation of new blood vessels (a process called angiogenesis). More blood flow means more oxygen and nutrients to help tissues heal, including spinal structures that normally have poor circulation. Shockwaves also stimulate cells called fibroblasts to produce collagen and other components needed to repair damaged discs, ligaments, or tendons around the spine.
Another important effect is pain reduction through biochemical and neurological mechanisms. Shockwave therapy has been shown to reduce the levels of Substance P (a pain-signaling chemical) and to trigger the release of endorphins – our natural painkillers. It may also work on the “Gate Control” principle: the intense stimulation from the shockwave pulses can essentially confuse or overwhelm pain nerve fibers, closing the nerve “gate” that would send pain signals to the brain. The overall anti-inflammatory effect is significant too – studies note decreases in inflammatory markers (like IL-1, TNF-α) in treated tissues. In summary, shockwave therapy can create a healing-friendly environment: more blood flow, controlled inflammation, and modulation of pain signals.
Types of shockwaves: There are two main types used in therapy – focused ESWT and radial ESWT. Focused shockwaves penetrate deeper (targeting specific depth within tissue), whereas radial shockwaves spread outwards more broadly. For lower back pain and DDD, practitioners may use focused shockwave to reach deeper spinal structures. In fact, shockwave pulses can penetrate roughly up to 8–12 centimeters into the body, far deeper than manual therapies like massage. This depth is crucial for targeting deep-seated issues near the spine. As Uran Berisha explains in one Unpain Clinic podcast, shockwave can reach areas other treatments can’t, breaking down scar tissue adhesions and improving blood circulation even in deep spinal muscles. Unlike a massage or surface modality, shockwave energy can get to the injured disc’s vicinity and surrounding ligaments/muscles to stimulate repair.
You might be wondering: Does shockwave therapy actually work for Degenerative Disc Disease? What does the evidence say? It’s a great question – and evidence-based care is extremely important to us at Unpain Clinic. While research specifically naming DDD is still emerging, there is a growing body of high-quality evidence showing that shockwave therapy can reduce chronic low back pain and improve function in conditions related to disc degeneration.
Clinical Trials and Reviews: The most compelling data comes from recent systematic reviews of multiple clinical trials. For example, a 2023 meta-analysis in the Journal of Orthopaedic Surgery and Research pooled results from 12 randomized controlled trials (632 patients) with chronic low back pain. Patients who received shockwave therapy had significantly greater pain relief compared to those who received sham or conventional therapy. How much more relief? At 4 weeks after treatment, pain scores in the shockwave group were on average 1.04 points lower on a 0–10 scale than controls. By 12 weeks, pain was 0.85 points lower than controls, on average. These differences may sound modest, but they were both statistically and clinically significant – meaning patients felt real improvement. Disability due to back pain also improved: that meta-analysis found shockwave therapy led to greater reduction in disability scores (Oswestry Disability Index) at 4 and 12 weeks post-treatment, by about 4–5 points more than controls. Perhaps most importantly, there were no serious adverse effects reported in any of those studies. The authors concluded that shockwave is effective and safe for treating chronic low back pain.
Another comprehensive review (2021, 10 RCTs with 455 patients) similarly found that shockwave therapy provides significant short-term pain relief and functional improvement for chronic back pain. Patients had notably less pain at 1 month follow-up (an analysis reported a standardized mean difference of -0.81 in pain scores favoring shockwave) and better function at 1 and 3 months, compared to placebo or standard care. Again, no serious side effects were observed. These findings reinforce that shockwave’s benefits aren’t just a fluke in one study – multiple trials around the world have shown consistent results.
What about specifically for degenerated discs? Direct studies on “Degenerative Disc Disease” per se are somewhat limited, but research on closely related conditions is very promising:
Lumbar Disc Herniation: Degenerative discs often go hand-in-hand with disc herniations. A 2018 randomized trial published in Journal of Orthopaedic Surgery and Research showed that shockwave therapy was effective for patients with lumbar disc herniation. Those who underwent shockwave had significant pain reduction and improved functional scores compared to those who didn’t. In practical terms, shockwave helped people with herniated disc pain get better relief and move more easily, which suggests it can address disc-generated pain.
Comparative Study in Elderly Patients: A 2023 study looked at older adults with chronic lumbar disc prolapse (herniation). Interestingly, it compared pulsed electromagnetic field therapy (PEMF) versus shockwave therapy. The result: both treatments led to similar improvements in function for these patients. Pain levels decreased in both groups, though one report noted PEMF might have a slight edge in immediate pain reduction while shockwave caught up in outcomes like mobility. The takeaway here is that shockwave therapy held its own against another non-invasive modality, and both helped patients avoid more invasive measures.
Facet Joint Pain: Degenerated discs put extra stress on facet joints (the small joints at the back of your spine). Facet pain is a common companion to DDD. Exciting new research in 2025 focused on chronic lumbar facet syndrome – which often co-occurs with disc degeneration – and the results were remarkable. In a randomized controlled trial of 128 patients with chronic facet joint pain, shockwave therapy achieved a 64% average reduction in pain scores at 12 months post-treatment. Yes, over half their pain was gone a year after treatment, on average. Those patients also saw a 42% improvement in disability (whereas a control group improved only ~12%). Some even had documented tissue healing on MRI – resolution of bone marrow inflammation in over half of the treated patients – which suggests shockwave helped calm the arthritic process. And just like other studies, no side effects were reported. While this study was about facet joint issues, it’s very relevant to DDD sufferers because facet arthritis often develops alongside disc degeneration and contributes to the pain. It’s encouraging to see that shockwave can significantly reduce pain even in these chronic spinal joint cases.
Sciatica/Nerve Pain: Degenerative discs in the lower back can cause sciatica – pain shooting down the leg due to nerve compression. Shockwave therapy might help here in ways beyond just pain relief. Emerging evidence suggests shockwave can actually promote nerve healing. Lab studies have shown that low-intensity shockwaves activate biological pathways (like YAP/TAZ signaling) that spur nerve regeneration. In animal models of sciatic nerve injury, shockwave treatment stimulated Schwann cells, which support nerve repair, and led to faster nerve conduction and regrowth of nerve fibers. While these findings are pre-clinical, they hint that shockwave therapy isn’t just a temporary pain blocker – it may help nerves recover from compression injuries. Clinically, some patients with chronic sciatica report improvement in numbness or tingling after a course of shockwave, possibly thanks to these regenerative effects.
In summary, the evidence indicates that shockwave therapy can help reduce pain and improve function in chronic low back pain conditions related to disc degeneration. It’s important to note that while the research is very promising, shockwave therapy for DDD is still relatively new in the mainstream. Some clinical guidelines haven’t caught up yet and thus don’t list ESWT as a standard first-line treatment for chronic back pain. This is largely because more large-scale and long-term studies are needed specifically in disc degeneration patients. However, the trend in the data is clear and positive. Researchers call the improvements from shockwave “clinically important” – meaning patients don’t just feel a tiny change, they feel a real difference in daily life. And they feel it without major risks. This non-invasive therapy has an excellent safety profile, which we’ll discuss more below.
Finally, there’s even intriguing research in regenerative medicine circles about shockwave therapy potentially aiding disc repair. In an animal study (rat model) simulating Degenerative Disc Disease, adding shockwave therapy helped restore disc height and health. Specifically, shockwaves reduced the expression of enzymes that break down disc cartilage (like MMP-3 and MMP-13), allowing the disc matrix to regenerate better. The combination of shockwave plus gentle spinal traction had the greatest effect on regenerating the degenerating discs in those rats. While this is an early pre-clinical finding, it provides a fascinating glimpse at why shockwave might be helpful for DDD – it could be creating a more favorable environment for your discs to heal or at least not degrade further. Human studies will be needed to confirm if similar disc regeneration can happen in real patients. For now, the primary goal of shockwave therapy in DDD is pain relief and improved function, but who knows – future research may show actual structural improvements as well.
At Unpain Clinic, shockwave therapy is one of our flagship treatments, and it’s administered by experienced physiotherapists and chiropractors who specialize in this modality. Our approach to treating Degenerative Disc Disease with shockwave therapy is holistic and tailored to each individual. We don’t just ask “Where does it hurt?” – we ask “Why does it hurt?” (This whole-body diagnostic philosophy is at the core of our clinic’s method, as you’ll see in the Call-To-Action below.)
Assessment: First, we perform a thorough assessment to pinpoint all factors contributing to your back pain. This includes reviewing your history (injuries, lifestyle, past treatments) and a head-to-toe physical examination. Often, people with DDD have additional issues like hip mobility limitations, core muscle weakness, old surgical scars, or even tight hamstrings that alter their spine mechanics. For example, scar tissue from a past surgery (appendix, C-section, etc.) can create fascial restrictions that tug on your lower back. If we find something like that, we know we’ll need to address it as part of the treatment plan. Degenerated discs might be the diagnosis you’ve been given, but our assessment seeks out the underlying dysfunctions – whether it’s a tilted pelvis, a leg length imbalance, poor posture, or anything else.
Shockwave Therapy Treatment: If you’re a suitable candidate for shockwave (more on who is not a candidate in the FAQ), we incorporate it into your treatment plan as a primary modality for pain relief and tissue healing. A typical session involves using a focused shockwave handpiece on specific targets. For lumbar DDD, this usually means the clinician will apply the probe over areas such as: the paraspinal muscles adjacent to the degenerated disc level, the facet joint region corresponding to that disc, and any trigger points in the low back or gluteal muscles that are reacting to the disc pain. We also often treat around the sacroiliac (SI) joints and hip area, since those can contribute to lower back strain. By treating the muscular and fascial system around the spine, we aim to reduce the protective muscle spasm and improve flexibility, which takes pressure off the discs.
Each shockwave pulse feels like a strong tapping or thumping sensation on the skin. We adjust the intensity to your comfort – it can be a bit uncomfortable (some describe it as a 5-6/10 discomfort during treatment), but it’s generally tolerable and does not require any anesthesia. In fact, aside from some mild soreness or redness, there are virtually no side effects after a session. You can walk out and continue your normal activities without downtime. The number of pulses and energy settings are based on research-backed protocols: often 1,500–3,000 pulses per session at a moderate energy level, focusing on one region at a time. A session for back pain may last about 10-15 minutes of actual shockwave application (the assessment and other manual techniques may add to the visit length).
Treatment course: Shockwave therapy is not a one-and-done treatment; it works cumulatively. Typically, we recommend a course of about 5 to 8 sessions, done once or twice per week over 3-6 weeks. Many patients start noticing improvements after the first 2-3 sessions – for instance, better mobility or a slight pain decrease – but significant pain relief often kicks in around week 4 of the treatment plan. By 8-12 weeks after starting, research and clinical experience show maximum functional gains are achieved. It’s also at this 2-3 month mark that we evaluate if additional sessions are needed or if we transition you to a maintenance or exercise-focused program. Everyone is different: some people respond very quickly, and others need a longer course (especially if they’ve had DDD for many years). We set realistic expectations from the start – shockwave is there to stimulate your body’s healing, so gradual improvement is normal. It’s not a “magic wand” that erases degenerative changes overnight, but rather a catalyst for recovery.
Combination with Other Therapies: Although shockwave therapy is the main modality we use for DDD, we often combine it with other supportive treatments to enhance results. For example, we might do some gentle spinal mobilizations or traction to improve joint alignment, or use Class IV laser therapy on a low setting to further reduce inflammation (if available). However, we do not bombard you with endless passive treatments. Our focus is on active rehabilitation as well. We’ll likely prescribe specific exercises – e.g. core stabilization exercises, hip stretches, or neural flossing if you have sciatica – to do between shockwave sessions. These help maintain the improvements from shockwave and address the functional issues (like weak glutes or tight hip flexors) that we identified. Education is another big component: we teach you better movement patterns, posture, and even breathing techniques. Believe it or not, something as simple as learning to breathe with your diaphragm can alleviate spine pressure – chronic shallow breathing tightens your diaphragm and core, which can aggravate back pain. We incorporate these holistic elements because DDD pain often isn’t just about the disc; it’s about the whole body system coping with the disc. As Uran Berisha shares in the Unpain Clinic Podcast “How to Relieve Back Pain When Nothing Else Works” (Episode #7, 2023), addressing those hidden causes – from scar tissue to stress tension – is key to lasting relief, and shockwave therapy is one of the fastest ways to restore function at the deepest level for chronic back pain.
Monitoring Progress: Throughout your shockwave treatment course, we track your progress. We use pain scales, movement tests, and functional goals (like “sit for 30 minutes without pain” or “lift my grandchild again”) to see how you’re improving. If something isn’t progressing as expected, we re-evaluate and adjust the plan. Because Unpain Clinic practitioners are experts in shockwave, we can modulate the treatment parameters as needed – for example, increasing the energy or targeting a different tissue if we suspect an adjacent problem. This individualized care is a big reason why patients who “failed” standard physio elsewhere often succeed here. We’re not just doing a protocol to you; we’re constantly tailoring it for you.
Real Patient Experiences: While we cannot share identifiable patient testimonials in this article, we can describe a typical success story. (This composite story is for illustration only, not an actual testimonial.) Meet John: John is a 52-year-old accountant who came to us with 10 years of lower back pain. He was diagnosed with Degenerative Disc Disease at L4-L5 and L5-S1, confirmed by an MRI showing thinning discs. John had tried chiropractic adjustments, weekly massage, and had two cortisone injections. These gave only temporary reprieve – a few weeks later, the pain always crept back. He was unable to exercise and had to take frequent breaks at work to stretch. John was skeptical about yet “another treatment,” but decided to try shockwave therapy because he wanted to avoid spine surgery.
During John’s initial assessment, our therapist found that in addition to disc degeneration, John had extremely tight hip flexor muscles and an old ankle injury from basketball that altered his gait. We started a plan including focused shockwave therapy to his lower back and hips, once a week. After 3 sessions, John reported that his morning stiffness was noticeably less and he could get out of bed with less pain. After 6 sessions, he was able to sit through a 2-hour meeting without low back ache (previously unthinkable for him). By the end of the 8th session, John’s pain levels had decreased about 60%. More importantly, he felt stronger – we had gradually introduced core stability and hip strengthening exercises as his pain decreased, and now he could plank for 30 seconds and resumed light cardio at the gym. At a 3-month follow-up, John was doing maintenance exercises at home and coming for one shockwave “booster” session per month. He shared that he had been able to play nine holes of golf with minimal discomfort, something he hadn’t done in years. Results vary for each person, but stories like John’s show that even if you’ve “had Degenerative Disc Disease for years,” it’s possible to gain improvement in pain and function with a comprehensive approach. We never promise a 100% cure – DDD is a chronic condition and needs managing – but we do aim for significant, meaningful relief that improves your quality of life.
(All medical treatments have limitations and individual responses differ. The above example is for educational purposes and is not a guarantee of results.)
Managing Degenerative Disc Disease is not just about in-clinic treatments – what you do at home can make a big difference in your outcomes. Here are some general at-home tips to complement your shockwave therapy and professional care (always personalize these with guidance from your provider):
Stay Active, But Smart: Total bed rest is not recommended for DDD beyond a day or two of severe flare-up. Gentle movement helps keep blood flowing to the discs and prevents stiffness. Try low-impact activities like walking or swimming, as tolerated. Movement is medicine for the spine. However, avoid heavy lifting or extreme bending/twisting during flare-ups. Listen to your body – if a certain movement sharply increases pain, modify or stop it.
Core Engagement: Work on your core muscle endurance with light exercises (approved by your therapist). This doesn’t mean intense sit-ups; often, it’s gentle exercises like pelvic tilts, dead bugs, or planks (starting with modified planks). A stronger core can offload stress from your discs by supporting your spine better. Even 5-10 minutes a day of core activation can be beneficial. Remember to breathe during exercises – exhale during effort to avoid tensing up incorrectly.
Posture & Ergonomics: Be mindful of your posture, especially if you have a desk job. Poor sitting posture (slouched or hunched) can increase disc pressure. Ensure your workstation is spine-friendly: your monitor at eye level, lower back supported, and feet flat on the floor. Take micro-breaks every 30-60 minutes to stand up, stretch your hip flexors, and gently arch your back or do a “standing back bend” if comfortable. These “motion breaks” prevent continuous pressure on the discs.
Heat Therapy for Muscle Relief: Use a warm pack or take a warm shower to loosen tight lower back muscles. Heat will not “heal” a degenerated disc, but it can ease muscle tension and improve circulation around the spine, which may reduce pain. Apply heat for 15-20 minutes at a time. Some people find alternating heat and cold (contrast therapy) helpful: for example, a warm pack followed by a brief cold pack. If inflammation is acute, ice can numb pain, but for chronic DDD stiffness, many prefer heat.
Healthy Lifestyle: Your disc health is part of your overall health. Stay hydrated – discs are about 70% water, and while drinking more water won’t magically rehydrate a degenerated disc, dehydration certainly doesn’t help. Nutrition matters too; eat a balanced diet rich in proteins (for tissue repair) and anti-inflammatory foods (like fruits, vegetables, omega-3 fatty acids). If you smoke, consider quitting, as smoking decreases blood flow to discs and accelerates degeneration. Maintaining a healthy weight will reduce excessive load on the spine – every extra pound is additional strain on those discs.
Sleep Smart: Sleep is when your body recovers. Use a mattress with adequate support (medium-firm tends to be recommended for back pain, but individual preference varies). Sleeping position: many DDD patients find relief sleeping on their side with a pillow between the knees, which keeps the spine aligned. If you’re a back-sleeper, try a pillow under your knees. Avoid stomach-sleeping as it twists the neck and can strain the back.
Pain Management: If you have a pain spike, you can use short-term aids responsibly. Over-the-counter NSAIDs (like ibuprofen) may reduce inflammation, but use them sparingly and follow dosing guidelines – they are a temporary crutch, not a long-term solution. Topical creams (menthol, capsaicin, or CBD balms) can provide localized relief without systemic side effects; feel free to use these on sore back muscles. Always consult with your doctor if you find yourself needing pain pills regularly.
Watch for Red Flags: Know when to seek urgent medical care. If you ever experience severe new symptoms like loss of bowel or bladder control, numbness in the groin, or rapidly worsening weakness in your legs, this could indicate cauda equina syndrome or a serious nerve compression – seek emergency care immediately. These situations are rare, but important to catch. Also, if your back pain is accompanied by unexplained weight loss, fever, or is not mechanical (i.e., it doesn’t change with movement/rest), let your doctor know, as it could signal a different issue.
By following these at-home guidelines and staying proactive, you can support your spine’s health and enhance the effects of treatments like shockwave therapy. Remember, these tips are general educational information – always tailor them to your personal condition and check with your healthcare provider for specific advice.
(Disclaimer: This advice is not a substitute for professional medical evaluation. Always consult with a qualified healthcare provider before starting any new exercise or self-care routine.)
Yes – shockwave therapy is considered very safe when applied by a trained professional. One of the big advantages of shockwave for DDD is that it’s non-invasive (no incisions, no anesthesia). Studies encompassing hundreds of back pain patients have reported no serious adverse events related to shockwave therapy. The most common thing people feel is some mild discomfort during the treatment and sometimes temporary soreness or redness in the area afterward – similar to how you might feel after a deep tissue massage. This mild soreness usually resolves within a day or two. Unlike surgery or injections, there’s no risk of infection, no scars, and no significant downtime. Important: There are certain situations where shockwave should not be used. It’s contraindicated to apply shockwave directly over the spine (bone) or over vital organs like the lungs, heart, or brain. We also avoid using it over any area with an active infection or tumor. If a patient is pregnant, we would not do shockwave over the low back or abdomen (to be extra safe for the fetus). These precautions are well-established. Overall, for the typical DDD patient, shockwave therapy is a low-risk treatment. Our therapists will screen you for any contraindications before starting. If you have specific health conditions (like a bleeding disorder or a pacemaker), we will evaluate those on a case-by-case basis. Always inform your provider of your full medical history before treatment.
The exact number of sessions can vary, but most people need a series of treatments rather than a single session. At Unpain Clinic, we often start with a protocol of about 5 to 6 sessions, then reassess. Research suggests that a typical course might range from 3 to 6 weeks of treatment, with about 1-2 sessions per week. In practice, many patients with chronic back pain do ~6 sessions and experience significant improvement, but some may benefit from extending to 8-10 sessions especially if their condition is severe or longstanding. Remember, degeneration accumulated over years won’t reverse overnight – it takes time for the body to repair and adapt. The good news is that the pain relief from shockwave tends to be cumulative and long-lasting. Studies with follow-ups show continued improvement even 3-6 months after completing a course of shockwave therapy. After your initial sessions, depending on your progress, we might suggest maintenance sessions (for example, one session every 4-6 weeks) to sustain the benefits. We tailor the plan to you: someone in their 30s with mild DDD might bounce back faster, whereas someone in their 60s with multiple degenerated levels may need a longer plan. Your therapist will give you an estimated timeline during your assessment.
Shockwave therapy can cause some discomfort, but it is generally tolerable. Patients often describe the feeling as tiny rapid pulses or thuds against the skin. The level of intensity is adjustable – we start at a moderate setting and check in with you. You might rate the discomfort as, say, 4–5 out of 10 at first, but interestingly, the area often numbs slightly as we continue, or you acclimate to the sensation. If it’s too intense, we can dial it down. The goal is to deliver a therapeutic intensity without causing you to tense up or feel severe pain. After the session, it’s common to feel that the treated area was “worked on.” You might have mild soreness akin to post-workout muscle soreness, or in some cases a bit of bruising if you are sensitive (though bruising is more common in areas like the heel for plantar fasciitis than in the back). There is no lingering pain beyond that. In fact, many patients feel a reduction in their typical pain in the hours or days after a session – sometimes immediately, sometimes after 24-48 hours as the body responds. To put it in perspective, shockwave discomfort is much less than the pain of, say, a steroid injection or the post-op pain from surgery. Most people find it very worth it given the potential relief. If you are very pain-sensitive or anxious, let us know; we have techniques to make it easier (like starting with radial shockwave which is gentler, or using cooling gels, etc.). Rest assured, we’ve treated patients of all pain tolerance levels successfully.
Absolutely, yes. In fact, shockwave therapy is specifically aimed at chronic conditions that haven’t healed with time. Many of the clinical studies on shockwave for back pain involved patients who had pain for many months or even years. The chronic nature of DDD pain often means the body’s natural healing processes have stalled or been unable to complete repair. Shockwave aims to re-ignite those healing processes. So even if you’ve had DDD for a long time, you may still respond well. At Unpain Clinic we have seen plenty of “old injuries” or degenerative issues make improvements with shockwave therapy – for example, a patient with 10+ years of back pain who finally notices a change after shockwave was introduced. Research suggests that chronic low back pain cases (pain > 3 months) actually derive significant benefit from shockwave. That said, every individual is unique. Factors like your overall health, activity level, and the extent of degeneration play a role in outcomes. We set realistic goals – our aim is often to reduce your pain to a manageable level (or even pain-free periods) and improve your daily function, not necessarily to “cure” decades of wear-and-tear. Degenerative Disc Disease can be thought of like aging – we can’t stop the clock, but we can definitely improve how you feel and move with the condition. One encouraging aspect: shockwave’s effects on tissue regeneration and blood flow might be just what long-dormant tissues need. Even years-old scar tissue can soften under shockwave; even chronically tight muscles can relax. So, if you’ve suffered for years, don’t lose hope – shockwave therapy may offer relief when other things haven’t.
Shockwave therapy is safe for most people, but there are a few contraindications and precautions. You should not have shockwave therapy if:
You are pregnant (we avoid treating the back or pelvic area in pregnancy as a precaution).
You have an active infection or open wound in the treatment area.
You have a known tumor or cancer in the treatment area (we do not want to stimulate blood flow to a tumor).
The treatment area is directly over the lungs or intestines. (For example, we wouldn’t do shockwave over the mid-back where the ribs and lungs are directly underneath, because the air-filled lung can be injured by shockwaves. This isn’t a concern for low back since there’s no lung tissue there, but it’s a general rule).
Over major nerves or blood vessels without adequate training – however, in the hands of a skilled provider, we avoid nerve bundles.
Relative contraindications (caution advised):
If you are on blood-thinning medication or have a bleeding disorder, we’d use lower settings to avoid excessive bruising.
If you recently had a steroid injection in the area (within the last 4-6 weeks), we usually wait, as cortisone can weaken tissue and we don’t want to stress recently injected tissues.
Severe osteoporosis or other metabolic bone conditions in the spine – shockwave might be adjusted or avoided in these cases.
If you have a pacemaker or other electronic implant near the area, we typically avoid focused shockwave directly over it (though shockwave isn’t electromagnetic, it’s mechanical pressure waves, so it’s generally okay – but we err on side of caution).
During your initial assessment, the therapist will review your medical history to ensure none of these apply. If they do, we’ll discuss alternate treatment options. For the vast majority of patients with Degenerative Disc Disease, shockwave is a suitable and safe therapy.
Coverage can vary depending on your insurance plan and where you live. Shockwave therapy is a relatively new treatment in North America, and it’s often provided by physiotherapists or chiropractors. In many cases, insurance companies don’t have a specific billing code for “shockwave therapy” as a separate entity. However, they may cover the treatment under the umbrella of the practitioner’s services. For example, if a licensed physiotherapist performs shockwave therapy as part of a treatment session, that session might be billed as regular physiotherapy – and thus covered if you have physio coverage. In Canada, provincial health care (like Alberta Health) does not typically cover shockwave therapy. But extended health benefit plans (through your employer or private insurance) often do, especially if administered by a registered professional. We advise patients to check with their insurance provider. Ask: “Is physiotherapy or chiropractic treatment that includes shockwave therapy covered under my plan?” Some insurance might require a doctor’s referral for physiotherapy to be reimbursed, so make sure you have one if needed. At Unpain Clinic, we provide detailed invoices with the practitioner’s credentials and treatment details, which you can submit to your insurer. Additionally, some clinics offer package pricing or payment plans for shockwave therapy if you’re paying out-of-pocket. While cost is a consideration, many patients find the investment worthwhile given the relief and potential to avoid more costly procedures down the line. Always call your insurance or check your policy manual to get the most accurate information for your specific plan.
The side effect profile of shockwave therapy is very minimal, especially compared to medications or surgery. The most commonly reported side effects are: mild pain or discomfort during treatment, transient soreness, redness, or swelling in the treated area, and occasionally small bruises. These effects are generally short-lived (resolving in 1-2 days) and not severe. Many patients actually experience an immediate pain reduction after treatment, but a few might feel a bit achy later that day – this is a normal reaction as the body’s healing processes kick in. Over-the-counter pain relievers can be taken if needed, though most people don’t require them. There is no sedation or anesthesia needed, so there are no risks like those associated with anesthesia. There’s also no risk of infection since nothing is injected or cut. In terms of internal effects, shockwaves are mechanical waves – they don’t introduce radiation or anything chemical into your body. They simply stimulate your tissues. That said, if used improperly (wrong location or too high intensity), there could be risks – for instance, if someone applied very high power shockwaves over a lung, it could theoretically cause a lung injury (this is why trained providers know where not to treat). But in experienced hands, those risks are essentially zero. There have been rare reports of temporary nerve irritation (if a superficial sensory nerve gets irritated, leading to a numb patch of skin or mild tingling that resolves). Again, this is rare and avoidable with proper technique. Overall, shockwave therapy is low-risk. Contrast this with common DDD treatments like NSAID drugs (which can cause ulcers or kidney issues) or steroid injections (which carry infection and tissue damage risks), and you can see why many people prefer to try shockwave. After treatment, we advise you to avoid any new strenuous activity with that body part for 48 hours (don’t go deadlift 300 lbs the day after, for example) just to allow the stimulated healing to proceed without disruption. But normal daily activities are encouraged.
Degenerative Disc Disease may be a chronic, wear-and-tear condition, but it does not have to sentence you to a life of pain. We’ve explored how DDD involves more than just aging discs – it’s about how your body functions as a whole and how it responds to those degenerative changes. Traditional approaches often fall short because they only address symptoms or isolated structures. Shockwave therapy offers a fresh approach by targeting the root causes of pain in Degenerative Disc Disease: it can reduce inflammation, improve blood flow, break up restrictive scar tissue, and stimulate the body’s natural healing responses in and around the degenerated discs. Importantly, it does this non-surgically and safely, with research-backed results in chronic back pain cases. While more studies focusing specifically on “DDD” are needed, the evidence so far – from meta-analyses on chronic low back pain to trials on herniated discs and facet joint pain – suggests that shockwave therapy may provide significant relief for those struggling with long-term discogenic back pain. It’s not a miracle cure or a one-size solution, but it’s a powerful tool in the hands of skilled clinicians.
If you are someone who has been frustrated by ongoing back pain from Degenerative Disc Disease, and you’re wary of invasive procedures, shockwave therapy is worth considering. Candidates who tend to do well are those with chronic mechanical back pain (worsened by activity, improved with rest), who have tried conservative treatments without lasting success, and who are looking for a way to jump-start healing rather than just mask pain. Always have a thorough evaluation – at Unpain Clinic, we ensure that shockwave therapy is appropriate for you and we integrate it into a comprehensive plan tailored to your needs.
Don’t let the term “degenerative” scare you into hopelessness. Your body has an amazing capacity to adapt and heal, even later in life. With therapies like shockwave, we can tap into that capacity. Our goal at Unpain Clinic is to help you move better, hurt less, and get back to living life on your terms. Many people are turning to shockwave therapy for relief – and experiencing improvements in pain and function that they never thought possible. You could be one of them. If you’re ready to address not just where it hurts but why it hurts, we’re here to help.
(Results may vary from person to person; this article is for informational purposes and is not medical advice. Always consult your healthcare provider to determine the best treatment for your condition.)
Book Your Initial Assessment NowAt Unpain Clinic, we don’t just ask “Where does it hurt?” — we uncover “Why does it hurt?”
If you’ve been frustrated by the cycle of “try everything, feel nothing,” this assessment is for you. We take a whole-body approach so you leave with clarity, not more questions.
✅ What’s Included
Comprehensive history & goal setting
Orthopedic & muscle testing (head-to-toe)
Motion analysis
Imaging decisions (if needed)
Pain pattern mapping
Personalized treatment roadmap
Benefit guidance
🕑 Important Details
60 minutes, assessment only
No treatment in this visit
👩⚕️ Who You’ll See
A licensed Registered Physiotherapist or Chiropractor
🔜 What Happens Next
If you’re a fit, we schedule your first treatment and start executing your plan.
🌟 Why Choose Unpain Clinic
Whole-body assessment, not symptom-chasing
Root-cause focus, not temporary relief
Non-invasive where possible
No long-term upsells — just honest, effective care
🎯 Outcome
You’ll walk out knowing:
What’s wrong
Why it hurts
The fastest path to fix it
Author: Uran Berisha, BSc PT, RMT, Shockwave Expert
1. Liu K., Zhang Q., Chen L., et al. (2023). Efficacy and safety of extracorporeal shockwave therapy in chronic low back pain: a systematic review and meta-analysis of 632 patients. J. Orthop. Surg. Res. 18, 455. DOI: 10.1186/s13018-023-03943-x link.springer.comlink.springer.com
2. Notarnicola A., Paoli A., Mangone M., et al. (2019). Effectiveness of Shock-Wave Therapy for the Treatment of Chronic Low Back Pain: A Systematic Review and Meta-Analysis. Eur J Orthop Surg Traumatol. 29(2): 447-456. (Findings summarized in text: shockwave significantly reduced pain and improved function in chronic back pain patients)unpainclinic.com
3. Rompe J.D., Furia J., Maffulli N. (2018). Shockwave Therapy for Patients With Lumbosacral Radicular Syndrome: A Prospective, Randomized, Double-Blind, Placebo-Controlled Trial. J. Orthop. Surg. Res. 13(1): 204. (Study demonstrating shockwave therapy improved pain and function in lumbar disc herniation/radiculopathy patients)unpainclinic.com
4. Mokhtar M.M., et al. (2023). Comparative Study Between Shock Wave Therapy and Electromagnetic Field Therapy in Elderly Patients with Lumbar Disc Prolapse. Egyptian Journal of Medical Sciences. (Reported that both pulsed electromagnetic field and shockwave therapy led to similar functional improvements in lumbar disc herniation for older patients)unpainclinic.com
5. Nedelka T., et al. (2025). Focused Extracorporeal Shockwave Therapy for Chronic Lumbar Facet Joint Syndrome: A Randomized Controlled Trial. (Results: ~64% pain reduction at 12 months, improved disability scores, MRI showed healing in many patients, no adverse effects)unpainclinic.com
6. Chen Y., Zhang X., Li J., et al. (2020). Low-energy Extracorporeal Shock Wave Therapy combined with low tension traction can better reshape the microenvironment in degenerated intervertebral disc regeneration and repair (Animal study). Spine Journal. 20(12): 1921-1933. (In a rat model, shockwave + traction restored disc height and reduced degenerative enzymes, promoting disc matrix regeneration)pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov
7. Unpain Clinic (2025). Evidence‑Based Relief: Shockwave Therapy for Lower Back Pain (Blog article, Aug 22, 2025). – Unpain Clinic Blog. (Provides an overview of scientific research on shockwave therapy for lower back conditions, including DDD-related issues, and reports significant pain and disability improvements from meta-analyses)link.springer.comunpainclinic.com
8. Unpain Clinic Podcast – “How to Relieve Back Pain When Nothing Else Works” (Episode #7, 2023). Hosted by Uran Berisha. (Discusses the holistic approach to chronic lower back pain; notes that imaging findings like degenerative disc disease don’t always correlate with pain, and highlights shockwave therapy’s role in treating deep-seated causes of back pain)unpainclinic.comunpainclinic.com
9. Unpain Clinic YouTube Video – “Back Pain and The Unconventional Fixes” (2023). Featuring Uran Berisha. (Video explaining root causes of back pain and demonstrating how shockwave therapy penetrates deep to break down scar tissue and stimulate healing for chronic back issues)unpainclinic.comunpainclinic.com
