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Living with persistent elbow pain can be frustrating and exhausting. Everyday actions – lifting a coffee mug, turning a doorknob, or picking up your child – can send a jolt of pain through your elbow. You might have tried rest, ice, braces, or pain medications, only to find the pain comes roaring back as soon as you return to normal activities. If this sounds familiar, you’re not alone, and it’s not all in your head. Chronic elbow pain (often from tendon injuries like tennis elbow or golfer’s elbow) has a way of lingering despite our best efforts.
Shockwave therapy is emerging as a non-surgical option that may offer hope when other treatments haven’t. In the first few paragraphs of this article, we’ll introduce what shockwave therapy is and how it might help your elbow heal when rest and conventional therapies fall short. (Disclaimer: Results may vary; always consult a healthcare provider for personalized advice.)
Shockwave therapy (also called extracorporeal shockwave therapy, or ESWT) involves sending high-energy sound waves into the injured area. It might sound high-tech, but research suggests it can stimulate the body’s natural healing processes in stubborn injuries. In this article, we’ll explore why elbow pain can become chronic, what scientific studies say about shockwave therapy for elbow conditions, and how we at Unpain Clinic use this therapy to help patients reclaim a pain-free life. By the end, you’ll understand why shockwave therapy for elbow pain is generating buzz as a game-changer – and whether it might be an option for you.
(Results are not guaranteed, and individual outcomes can vary. Always consult your healthcare provider to see if a treatment is appropriate for your specific case.)
Elbow pain can stem from various causes, but one of the most common (and stubborn) culprits is tendon damage from overuse. Tennis elbow (lateral epicondylitis) causes pain on the outer side of the elbow, while golfer’s elbow (medial epicondylitis) affects the inner side. Despite their sporty names, you don’t have to play tennis or golf to get these injuries – any repetitive arm or wrist motion (painting, typing, using tools, lifting weights) can strain the elbow tendons over time. These conditions often start with tiny micro-tears in the tendon fibers from overuse. In the early stages there may be some inflammation, but if the irritation continues for weeks and months, the tendon’s structure actually begins to degenerate (a process called tendinosis). In chronic cases, the body lays down weaker, disorganized tissue instead of healthy tendon fibers, and the tendon doesn’t tolerate stress like it used to. Over time, scar tissue or even small calcifications can build up in the tendon, and blood supply to these tissues is poor – meaning they heal very slowly.
Why does the pain persist beyond 3 months? By the time elbow pain has been around for 3+ months, it often means the tendon hasn’t fully healed and is stuck in a cycle of partial healing and re-injury. You might feel a bit better with rest, but as soon as you resume activity, the pain flares up again because the underlying tendon weakness was never truly fixed. Simply put, rest is usually not enough to reverse chronic tendon changes. Tendons also have a relatively poor blood supply, so they don’t regenerate quickly on their own. Factors like age (e.g. over 40), repetitive strain at work, or even biomechanics (shoulder or core weakness forcing your elbow to compensate) can all set the stage for a nagging elbow problem that just won’t quit.
If you’ve been dealing with elbow pain for months, chances are you’ve tried a few common approaches already. Rest and ice are usually the first steps – and while taking a short break can calm things initially, prolonged rest without active rehab can also lead to a weaker tendon. Many people try NSAID medications or get a cortisone (steroid) injection to curb pain and inflammation. These can give temporary relief. In fact, steroid shots often provide quick short-term pain reduction in tennis elbow. However, injections don’t rebuild the damaged tendon, so the pain often returns once the steroid effect wears off (sometimes with a vengeance). Over-relying on injections or pills can also have side effects. You may have tried physical therapy or eccentric exercise programs, which are actually foundational treatments – strengthening and stretching the forearm muscles can help tendons remodel over time. Many people benefit from physiotherapy, but a significant subset still have pain despite doing all the “right” exercises. Braces or elbow straps, massage, acupuncture, and other modalities can provide some relief too, but again, some cases remain stubborn.
It’s not uncommon for chronic elbow pain sufferers to feel like they’ve “tried everything.” In the past, the next step might have been considering surgery to cut out the damaged tendon tissue. Fortunately, only a small percentage of patients should ever need surgery – studies estimate maybe 4–11% of severe or persistent cases end up in the operating room. For the rest, we just need to find the right non-invasive treatment to jump-start healing. This is where shockwave therapy enters the picture as a promising option when conventional care isn’t enough.
Shockwave therapy has been studied extensively for chronic tendon injuries – especially for tennis elbow, which is one of the most common types of chronic elbow pain. The research over the past two decades has evolved, and it’s important to acknowledge that not all studies have had the same results. Early on, some high-quality reviews were skeptical. A 2005-2009 Cochrane review (considered “platinum” level evidence) concluded that, at that time, shockwave therapy provided little to no benefit over placebo for lateral elbow pain. In that era, many trials showed no significant difference in pain or function between patients who got shockwave and those who got sham treatments. So if you read older sources saying “shockwave doesn’t work for tennis elbow,” they’re reflecting those findings.
However, more recent research suggests a more positive story, possibly thanks to better treatment protocols and patient selection. A 2020 meta-analysis by Yao et al. pooled data from 13 randomized trials (over 1000 patients) and found that extracorporeal shockwave therapy can effectively relieve pain and improve grip strength in chronic tennis elbow. In that analysis, patients who received shockwave had significantly better pain scores (VAS) and stronger grip than those who received other treatments or placebo. The authors noted shockwave also appeared safe, with no serious adverse events, and they concluded that ESWT offers clinically meaningful benefit for tennis elbow – though they did call for more high-quality studies to reinforce the findings.
Another 2020 systematic review (Ruan et al., published in Medicine) took a deep dive into shockwave vs. placebo. Interestingly, this review found that by 12 weeks after treatment, the average pain scores weren’t dramatically different between shockwave and placebo groups – but more patients in the shockwave group achieved a significant pain reduction (at least 50% pain relief). In other words, shockwave therapy seemed to increase the likelihood of meaningful improvement even if the absolute difference in pain scale points was modest on average. That same review also confirmed shockwave patients had greater improvements in grip strength than controls at the 3-month mark. The takeaway was that shockwave might not magically erase pain for everyone, but it can tip more people into the “better” category compared to doing nothing – a hopeful sign for those who have tried standard care without success. It also highlights that results vary from person to person, and why larger sample sizes are needed to detect those benefits.
What about shockwave therapy versus other treatments? Researchers have compared it to things like ultrasound therapy and steroid injections – common alternatives for chronic elbow pain. A recent 2025 umbrella review of multiple studies concluded that shockwave therapy provides significantly better pain relief in tennis elbow than both placebo and standard physiotherapy modalities like therapeutic ultrasound. In that review, shockwave was more effective at reducing pain intensity than ultrasound (a meta-analysis found shockwave led to greater pain score improvements). However, shockwave and ultrasound had similar results on functional scores (like grip and daily function), indicating that while shockwave can reduce pain, a comprehensive rehab approach is still important for full functional recovery. As for cortisone injections, trials have shown a bit of a “tortoise and hare” scenario. Steroid shots tend to act fast – many patients feel relief within days that peaks a few weeks in. Shockwave, on the other hand, works gradually over several weeks as the tendon heals. One clinical trial illustrated this perfectly: at a 4-week check-in, the injection group had superior pain relief, but by 12 weeks, the shockwave group caught up and even surpassed the injection group in terms of good/excellent outcomes for pain and function. In other words, shockwave’s benefits may be slower to appear, but they can equal or outlast the quick fix of a steroid shot in the longer term. This makes sense, because an injection mainly masks pain and tamps down inflammation temporarily, whereas shockwave aims to actually repair the tissue. It’s also worth noting that steroid injections, when repeated, can weaken tendon tissue over time, whereas shockwave has the opposite intent (strengthening the tendon’s structure).
How does shockwave therapy work? When those sound waves pulse into your injured tendon, they create what we call micro-trauma – tiny disturbances that stimulate a healing response. This might sound counterintuitive (causing micro-injury to heal an injury?), but it’s similar to how weightlifting causes micro-tears that build stronger muscle. Shockwaves trigger the body to send blood flow and repair cells to the area. Research shows that shockwave treatment prompts a number of beneficial biological reactions: improved blood vessel formation (angiogenesis) and circulation, recruitment of stem cells and growth factors to the tendon, breakdown of calcifications or scar tissue, and even a pain-relieving effect on nerve fibers. In essence, shockwave therapy “reboots” the stalled healing process. The energy waves also have an analgesic effect – they likely disrupt pain signal pathways and over-stimulate nerve endings in a way that reduces pain perception (a principle known as hyperstimulation analgesia). Over a series of treatments, the cumulative effect can be a stronger, better-healed tendon and a reduction in pain.
Importantly, the evidence to date indicates that shockwave therapy is quite safe when applied for chronic musculoskeletal conditions like elbow tendinopathy. The most commonly reported side effects are minor and short-lived – things like temporary soreness, reddening of the skin, or slight swelling in the treated area. These typically resolve on their own within days and usually don’t require stopping the treatment. No long-term or serious complications have emerged in the literature for the doses of shockwave used in tendon therapy. In fact, one systematic review noted that shockwave had better overall safety than some other treatments for tennis elbow. (By contrast, repeated cortisone injections can sometimes cause tendon weakening or skin/light tissue changes.) So, while every intervention has some risk, shockwave’s risk profile is very low, especially when performed by qualified providers. Still, good studies always caution that more research is welcome – we’d love to pinpoint exactly which subgroups of elbow pain patients benefit the most and refine the treatment parameters further. But the bottom line from current evidence is this: shockwave therapy can help many people with chronic elbow pain (particularly lateral or medial epicondylitis) by reducing pain and improving function, and it does so with minimal risk. It’s not a guaranteed cure or a one-shot miracle, but it’s a valuable tool – especially for those who have been stuck in pain for a long time.
At Unpain Clinic, shockwave therapy has become one of our go-to modalities for tough elbow pain cases. As a clinic specializing in advanced pain therapies, we’ve seen firsthand how shockwave can succeed where conventional therapies plateau. That said, we never take a one-size-fits-all approach – every patient gets a thorough assessment to identify the underlying why of their elbow pain. (In our podcasts, we often emphasize looking beyond “Where does it hurt?” to “Why does it hurt?” – because sometimes an old shoulder injury or poor movement pattern is contributing to the elbow issue.)
Assessment and personalized plan: When you come in with chronic elbow pain, our clinicians (physiotherapists or chiropractors trained in shockwave therapy) will start with a comprehensive evaluation. We review your history – How did the pain start? What makes it worse? What have you tried already? – and then we do a physical exam not just of your elbow, but of your entire arm, shoulder, neck, and even posture. This whole-body approach often reveals contributing factors: for example, a tight forearm muscle, a weak shoulder blade stabilizer, or poor ergonomics at your workstation. We map out the pain pattern (is it right at the bony epicondyle or radiating down the forearm? any nerve involvement like tingling?) and measure things like grip strength and range of motion. By the end of the assessment, you’ll know exactly what’s going on and why it’s hurting – and we’ll have a targeted treatment game plan.
Shockwave therapy treatment approach: If your elbow pain is the type we expect to respond to shockwave (which is typically the case for chronic tendinopathies), we’ll include True Shockwave™ therapy as a central part of your treatment plan. True Shockwave refers to focused shockwave therapy – a specific type of shockwave that penetrates deeper into tissue than radial pressure wave devices. (We use advanced focused shockwave equipment at Unpain Clinic, because research and our experience show it’s more effective for tendons in terms of reaching the target area.)
A typical shockwave therapy session for elbow pain is straightforward and quick. You’ll sit or lie comfortably with your arm supported. The therapist applies a handheld probe with gel on the affected tendon area (for tennis elbow, this is on the outer elbow; for golfer’s elbow, the inner side). When the machine is activated, it delivers thousands of tiny acoustic pulses over a few minutes – you’ll hear a clicking sound and feel a tapping or thumping sensation on your skin. Does it hurt? Most patients describe it as uncomfortable but tolerable – more of an intense vibration or pressure than a sharp pain. You might feel it ache in the familiar “hurt spot” as the waves penetrate, but it’s typically well within bearable limits (we adjust the intensity to your comfort). No anesthesia or needles are needed, and once the treatment stops, any discomfort usually fades quickly. The entire treatment per elbow might take around 5-10 minutes of actual shockwave application.
What’s happening during these sessions is what we described earlier – the shockwaves are stimulating your tendon’s healing. They increase local blood flow and inflammation in a therapeutic way (essentially calling the immune system’s repair crew to attention), break down old scar tissue, and provoke the tissue to regenerate. Over time, this can lead to pain reduction and improved strength. We generally schedule one session per week, because after a shockwave treatment the tendon is stimulated and needs a few days to do the repair work before we “challenge” it again. A typical course might be 3–6 sessions for chronic elbow tendinopathy. Some patients feel notable improvement after just 2 sessions, while others require all 6 to really notice the change – everyone’s healing capacity is different. We set realistic expectations: shockwave is not usually an instant fix, but rather a process. Many of our elbow pain clients start to feel a decrease in pain after the second or third treatment, and often report functional gains like a stronger grip or ability to lift objects with less pain as the sessions progress. By the end of a full shockwave course, the goal is to have significantly reduced your daily pain and improved your arm function (so you can do your usual activities without that wincing feeling). The improvements often continue even after the sessions are done, as shockwave’s effects can unfold over weeks – for instance, studies show tendon healing and new blood vessel growth can continue for up to 8+ weeks post-treatment. Unlike a temporary painkiller, shockwave’s benefits tend to last, because we’re addressing the root tissue problem. In our experience, once a tendon has healed properly, it stays better as long as you maintain good habits (and avoid the exact overload that caused the problem in the first place). One of our patients – let’s call him Charles – had elbow pain for over a year that hadn’t improved with physio or a steroid shot. He was skeptical about shockwave but gave it a try. After 3 focused shockwave sessions (spread over 3 weeks), he reported that his resting pain was gone and he could finally grip and turn door knobs without that stabbing pain. By follow-up at 2 months, he was back to golfing and doing manual work with only minor soreness after very intense activity – a huge improvement from before. This kind of outcome, while individual, shows how shockwave can genuinely help rebuild a failing tendon. (This story is an illustrative example; individual results will vary.)
Combining shockwave with other therapies: At Unpain Clinic we emphasize that shockwave is a powerful tool, but it works best in conjunction with a holistic treatment plan. During your shockwave treatment course, we’ll likely prescribe some gentle therapeutic exercises as well – typically pain-free range of motion movements, gradual eccentric strengthening (slowly lowering weight with your wrist extensors or flexors to strengthen the tendon), and stretches to keep the arm mobile. We might use manual therapy (soft tissue release) on tight forearm muscles or dry needling if there are myofascial trigger points referring pain to the elbow. The idea is to correct any contributing factors while shockwave repairs the tissue. Unpain Clinic is also one of the few centers that offers EMTT (Electromagnetic Transduction Therapy), a pulsed electromagnetic field treatment. Sometimes for very chronic elbow cases we pair EMTT with shockwave in the same visit – the shockwaves mechanically stimulate the tendon, then EMTT’s magnetic field provides a cellular “boost” to further reduce inflammation and encourage healing. This combo is painless and can accelerate recovery in our clinical observation. But we always keep shockwave as the star of the show for these tendon issues; other modalities (laser, EMTT, exercise, etc.) are supporting actors to maximize the outcome. We do not usually recommend additional cortisone injections once someone is undergoing shockwave, because steroid could actually inhibit some of the inflammatory healing response we’re trying to promote. If a patient’s pain is extremely high, we might coordinate with their physician about appropriate pain management during the early phase of treatment, but generally shockwave itself has an analgesic effect after each session that makes the pain more tolerable.
Throughout your care, we track progress – maybe your grip strength improves from 50% to 80% of your other hand, or your pain that was 8/10 is now 3/10 when lifting a pan. If something’s not improving as expected, we re-evaluate and adjust. Our clinicians are shockwave experts (our founder, Uran Berisha, BSc PT, RMT is a leading Shockwave Therapist who’s helped teach others in this field). In fact, in our podcast “Shockwave for Tennis Elbow” (Episode 9, June 10, 2020) we spoke with shockwave expert Ove Indergaard about the best practices and evidence for treating stubborn elbow tendinopathies. We take pride in staying up-to-date with the research and technology – the devices we use are top-tier (focused shockwave that can reach deep into the tendon). We also ensure patient comfort and safety every step of the way. Shockwave therapy for elbow pain is always done by a trained professional who understands how to target the treatment and adjust intensity to your tolerance. The procedure is non-invasive – no needles, no incisions – and after a session, you can walk right out and continue your day (perhaps a bit sore in the elbow, but usually nothing that stops you from your routine). We do advise you to avoid heavy strain with that arm for about 24-48 hours after a shockwave session, to let the healing processes work without interruption. But light activity is fine and even encouraged.
In summary, our approach at Unpain Clinic to elbow pain involves combining the cutting-edge healing stimulation of shockwave therapy with a comprehensive rehab strategy. We assess and treat the whole person, not just the elbow in isolation. Shockwave serves as the catalyst that kick-starts tissue repair, while we also guide you in strengthening the area, improving flexibility, and addressing any other factors (from posture to shoulder mechanics) that could affect your recovery. This whole-body, root-cause focus is why many patients who “tried everything” elsewhere finally see progress with us. If you’re interested in more insight, check out our YouTube short “Golfer’s Elbow Pain? When Rest Isn’t Enough” (Unpain Clinic, 2025) – where we explain why just resting a chronic elbow tendon often isn’t sufficient and how treatments like shockwave can make a difference. We love educating our patients through videos and podcasts, because an informed patient is an empowered patient.
Next, let’s look at a real-world example of how a typical shockwave treatment journey might unfold, and then we’ll offer some practical at-home tips to complement your in-clinic therapy.
Meet “John,” a 45-year-old active individual (name changed for privacy). John is an avid tennis player and also does handyman work on the side. About 9 months ago, he developed a sharp pain on the outside of his right elbow – classic tennis elbow. He tried the usual rest and ice, and when that didn’t help, he went for physiotherapy. The physio gave him exercises and stretches, which helped a bit, but John admits he was inconsistent with them once the supervised sessions ended. He returned to tennis too soon and felt a pop of pain again. Frustrated, he got a cortisone injection, which took the pain away in a week. He was thrilled – but two months later, as he resumed heavy use of his arm building a deck, the elbow pain came back, maybe even worse than before. By now, John has had elbow pain on and off for almost a year. It’s affecting his mood and making him avoid activities he loves. He can’t grip his racket firmly and even struggles with things like carrying groceries or using a screwdriver. John describes the pain as a constant dull ache with random spikes of sharp pain when he uses the arm.
When John comes to Unpain Clinic, he’s understandably skeptical and tired of “wasting money” on therapies. We conduct a thorough assessment and identify that he indeed has lateral epicondylitis in a chronic stage – there’s tenderness at the outer elbow, slight weakness in his grip and wrist extension, and some contributing tightness in his shoulder and forearm muscles. We explain our plan: focused shockwave therapy once a week for about 5 weeks, combined with a couple of targeted exercises and some soft tissue work. We emphasize that this is not an overnight fix, but a process to actually heal the tendon. John is game to try – “I’ll do anything if it means I don’t have to quit tennis,” he says.
During the first shockwave session, John is a bit anxious about how it will feel. The therapist applies the probe to his elbow tendon and starts the machine at a low setting. John is surprised – “It’s not too bad,” he remarks, as he feels a pounding sensation. We gradually increase the intensity to a therapeutic level. He feels some discomfort, like a deep ache, especially where his tendon is most tender, but it’s tolerable. In 10 minutes, it’s done. His elbow actually feels slightly numb (in a good way) right after, likely due to the pain signal interruption shockwave can cause. We advise him to take it easy that day and stay hydrated.
Over the next week, John notes a slight reduction in his baseline pain. On session two, we hit the same spots. This time John barely flinches – he knows what to expect. After this session, he reports that that evening his elbow felt a bit “warm and tingly” (increased blood flow can do that), but by the next morning he noticed he could lift his coffee pot without the usual stab of pain – something he hadn’t done in months. Encouraged, he diligently does the home exercises we gave (eccentric wrist curls with a light dumbbell) and avoids heavy arm strain.
By session three, John’s pain at rest is almost gone. He only feels discomfort now during heavier activities, and even that is less intense than before. He tests his grip strength with us and it’s improved significantly. We continue with shockwave pulses, focusing on a couple of adjacent tender spots as well to ensure the entire tendon and muscle unit is being treated. We also address a tight triceps trigger point that might be contributing.
After five sessions, John feels “80-90% back to normal.” He’s back to hitting practice tennis serves (with a brace on initially), and reports just mild soreness afterward instead of sharp pain. We decide to space out one more “booster” shockwave session a few weeks later. At his 3-month follow-up, John is essentially pain-free in daily life. He’s playing tennis matches again and doing his handyman projects with only the occasional minor reminder in the elbow if he really overdoes it (which he now knows how to manage and not push through). John says what made the biggest difference was that shockwave fixed the issue he couldn’t reach himself. “I did the exercises before, but it wasn’t until the shockwave treatments that something seemed to click and the pain started melting away,” he says. He also appreciated that we looked at his shoulder and gave him some upper back exercises – turns out his shoulder blade was not stabilizing well, likely putting extra strain on the elbow during tennis swings. By correcting that, we help prevent the elbow problem from returning. John’s story is one we see often: a patient goes from despair (“I thought I’d have to live with this pain or stop my hobbies”) to relief (“I have my arm back!”) after a structured plan involving shockwave therapy.
Of course, not every case is identical. Some patients respond more slowly, and a few might not get the full relief we hoped for – if that happens, we re-examine for any missed causes or consider alternative treatments. But a significant majority of our elbow tendinopathy patients do experience substantial improvement with shockwave. It’s rewarding to see someone go from being unable to pour a cup of coffee to returning to sports or work pain-free. These stories motivate us to keep offering the most advanced, evidence-based care possible. (This example is for illustration only; individual experiences will differ. We never guarantee outcomes, but we do promise to give you our best effort and a honest outlook.)
Managing elbow pain isn’t just about what happens in the clinic – what you do at home and between sessions plays a big role in recovery. Here are some simple, safe tips to help you support your healing (whether you’re receiving shockwave therapy or not). Remember, these are general suggestions – always follow the specific advice your therapist or doctor gives, and consult a professional before starting new exercises if you’re unsure.
Activity Modification: You don’t need to completely stop using your arm (in fact, complete immobilization can be counterproductive), but you do want to avoid the specific movements that aggravate your pain. Identify the triggers – for example, lifting palm-down, gripping a heavy tool, or doing a backhand swing in tennis. Whenever possible, give those high-strain activities a break or find a different way to do them. Use the other arm for carrying groceries, or two hands for lifting something, etc. If typing or mousing all day flares your elbow, set up an ergonomic workstation (wrist support, proper chair height) and take mini-breaks to stretch your forearm. Temporarily reducing stress on the tendon helps calm the pain and prevents further damage while you heal.
Therapeutic Exercise: Gentle exercises can help an elbow tendinopathy by improving blood flow and gradually strengthening the tendon. One proven approach is eccentric strengthening – this means lengthening the muscle under load. A classic example is a wrist extensor eccentric exercise: hold a light weight (or soup can) in your hand, palm down, support your forearm on a table, then use your other hand to help curl your wrist up. Finally, slowly lower the weight with the affected wrist alone (so the extensor muscles are working as they lengthen). Do 10-15 reps if it’s pain-free or only mildly uncomfortable. Over time, eccentrics can stimulate tendon remodeling. Stretching is helpful too: gently extend your arm and use the opposite hand to pull your fingers down (stretching the top of your forearm for tennis elbow) or to pull the fingers up (stretching the underside for golfer’s elbow). Hold 20–30 seconds, no bouncing. These stretches should create a pulling feeling but not sharp pain. Also, don’t forget the shoulder and postural muscles – row exercises or scapular squeezes can improve upper body mechanics and offload the elbow. Always exercise within tolerable pain limits; a mild discomfort during rehab exercises is OK, but stop if you get a sharp or severe pain. Consistency is key – doing a little bit every day or every other day is better than a marathon session once a week.
Home Modalities for Pain: For pain flare-ups, you can use ice or heat depending on what feels better for you. Ice packs (10-15 minutes) can numb pain and reduce any reactive swelling after activity – for example, if your elbow aches after a long day, icing in the evening may help. Heat (via warm towel or heat pack) can relax tight muscles and increase circulation – it might be nice before doing your rehab exercises to warm up the area. Some people alternate heat and ice. Topical gels (like anti-inflammatory creams or tiger balm) can provide temporary relief as well, though they mainly soothe muscles around and may have placebo benefits for the tendon. If your doctor is okay with it, over-the-counter anti-inflammatories (like ibuprofen) can be used sparingly on bad days, but remember they may relieve pain without actually fixing the tendon – so don’t rely on painkillers to push through major pain, or you might overdo it.
Bracing (Optional): An elbow strap (counterforce brace) can be worn during activities to reduce tendon strain. This is a band that wraps around your forearm just below the elbow. It can dampen the force transmitted to the painful tendon when you grip or lift. It’s not a cure, but a crutch to make activities more tolerable while you heal. If it helps your pain during tasks like typing or yardwork, use it, but avoid wearing it 24/7 (you don’t want the muscles to get too dependent or lose circulation from a too-tight strap). And ensure it’s properly placed – a physical therapist can show you the sweet spot.
Listen to Your Body: Pain is your guide. Some mild soreness during the healing process is normal – your tendon might protest as you start using it more correctly or after a shockwave session (which intentionally triggers some inflammation for healing). But sharp pain or significant swelling is a red flag to scale back. If you experience sudden severe pain in the elbow, inability to move it, or notice things like significant swelling, redness, or heat in the joint, those could indicate something beyond “just tendonitis” (like an acute tear, infection, or arthritis flare). In such cases, pause what you’re doing and seek medical evaluation to rule out more serious issues. Also, if your elbow pain is ever accompanied by numbness/tingling in the hand or weakness in the arm that is rapidly worsening, get medical advice – sometimes nerve compression (like radial tunnel syndrome or cubital tunnel for inner elbow) can mimic tendon pain and needs a different approach.
Lifestyle & Whole-Body Health: Chronic tendon problems can be influenced by your overall health. Prioritize good nutrition – adequate protein, Vitamin C, and minerals like magnesium/zinc can support tissue repair. Stay hydrated, as tissues heal better when well-hydrated. Get quality sleep, since that’s when a lot of healing and growth hormone release happens. If you smoke, consider cutting down or quitting; smoking has been linked to poorer tendon healing due to reduced blood flow. Managing stress is also beneficial (high stress can alter pain perception and slow recovery). Think of this as an opportunity to not just fix your elbow, but to get healthier overall – your body will thank you, and you may reduce the risk of other injuries too.
Finally, patience is vital. Tendon injuries take time to turn around – you might be looking at several weeks to a few months for full healing, depending on how long the issue has been present. The good news is that with treatments like shockwave and a dedicated rehab plan, you can get there. Many people who suffered for a year or more are able to recover function and become pain-free – but it won’t happen overnight. Celebrate small improvements (like a little less pain brushing your teeth, or an extra 5 pounds of grip strength gained). These are signs you’re on the right track. If you have a setback (e.g., you helped a friend move furniture and now your elbow flared up), don’t panic – use your tools (rest, ice, brace) for a few days and it will likely settle; then gradually resume your exercises. Recovery is seldom a straight line, but overall you should trend upward.
(Disclaimer: The above advice is general and educational. It is not a substitute for professional medical guidance. Always consult your physiotherapist or physician about the appropriate care for your specific situation.)
Yes – research and clinical experience show that shockwave therapy is considered very safe for chronic elbow pain (tendinopathies) when applied by trained professionals. The side effects are typically minor and short-lived. You might experience some discomfort during the treatment (a tapping sensation on the skin and in the deeper tissues) and the area can be a bit sore or reddened afterward, similar to how a deep massage might feel. However, these effects usually resolve within 24-48 hours. No long-term or serious complications have been documented in studies for musculoskeletal use. Shockwave is non-invasive – it doesn’t involve any injections or incisions – so there’s no risk of infection or tendon rupture from the treatment itself. It’s a tool that stimulates your body’s healing, and your body does the rest. Of course, safety also depends on proper patient selection. At Unpain Clinic, we always screen patients to make sure shockwave is appropriate (for example, we wouldn’t use it over an area with an active tumor, infection, or near a pacemaker, etc.). But for the typical elbow tendinitis case, shockwave therapy has an excellent safety profile. Many patients actually find that, after the first few minutes, the shockwave treatment isn’t bad at all and are reassured by how quick and relatively easy it is.
The number of sessions can vary based on the severity and chronicity of your elbow condition, but generally a course of shockwave therapy for chronic elbow pain involves about 3 to 6 sessions, usually spaced one week apart. In our clinic, we often start with a protocol of 3 sessions and then re-assess your progress. If you’re improving steadily but not quite where we want you, we’ll add a few more sessions (up to 5 or 6 total). Each session builds on the previous one – shockwave has a cumulative effect of stimulating tissue healing. Some patients experience significant relief after just 2-3 sessions, especially if the elbow pain wasn’t too longstanding. More chronic or severe cases (say, pain persisting for over a year or tendon with a lot of degeneration) might need the full 6 sessions, or occasionally a few more. It’s also common to do follow-up booster sessions: for example, we might do 6 weekly sessions, then have you come back 6-8 weeks later for one more maintenance treatment to ensure the healing response is sustained. The good news is that because shockwave triggers biological changes that continue over time, you typically don’t need endless treatments. It’s not like some therapies where you’re going twice a week indefinitely. Once the tendon’s healing response is rebooted and you’ve strengthened it with rehab, you’re done – with the caveat of listening to your body and maybe coming in for a touch-up if you start to feel the problem creeping back down the road. We tailor the plan to each individual. Your therapist will discuss how many sessions they anticipate for you specifically, and we always monitor improvement each visit to make sure we’re on the right track.
This is a common concern, and understandably so – nobody likes more pain on top of pain! The sensation of shockwave therapy can be a bit uncomfortable, but it’s usually tolerable for the vast majority of people. Patients describe it as a rapid tapping or thudding feeling on the skin and deeper in the tissue. At lower settings, it’s often quite easy – just a vibration. At higher settings (which may be needed to effectively treat a thick tendon), it can cause an aching or pressure sensation. The level of discomfort can also depend on how sensitive your elbow is at baseline; if your tendon is extremely tender, you’ll feel the pulses more. Our approach is to start at a low intensity and gradually increase to a therapeutic level as you accommodate to the feeling. We check in with you frequently during the treatment. Most people find that while it’s an odd feeling, it’s not a sharp or intolerable pain. In fact, the treatment typically numbs the area a bit as it progresses, due to its pain-modulating effect. A session only lasts a few minutes, and if needed we can pause or reduce the intensity momentarily. After the session, you might have some soreness in the region (often described like the mild muscle soreness after exercise or a deep tissue massage). This can last a few hours or a day. An easy remedy is to ice the area afterward if it’s sore, or just allow it to settle – it generally does so quickly. We do not require any anesthesia for elbow shockwave treatments – it’s nowhere near the pain level of something like a surgery. To put it in perspective: many patients with elbow pain say the pain of their condition (like the sharp jab when lifting something) is worse than the discomfort of the shockwave pulses, and they’re willing to accept a few minutes of mild pain in the clinic to get relief from the daily chronic pain. If you’re very pain sensitive, talk to your therapist – sometimes taking Tylenol or using a bit of numbing cream beforehand can take the edge off (though most people don’t need it). Rest assured, we strive to make the experience as comfortable as possible and will work within your tolerance.
Yes, absolutely. In fact, shockwave therapy is often most indicated for chronic cases that haven’t healed with time. Chronic elbow pain (lasting many months or years) usually means the tendon is stuck in a degenerative state and the body has kind of given up trying to repair it. Shockwave is designed to jolt that tendon back into healing mode by stimulating blood flow, cell activity, and new tissue growth. We’ve treated patients who suffered for 2, 5, even 10 years with off-and-on elbow tendinopathy, and many have experienced significant relief with shockwave therapy. Research supports this as well – studies often focus on chronic lateral epicondylitis (pain > 6 months) and find that shockwave can achieve improvements even in these stubborn, long-term cases. In fact, we particularly recommend shockwave for cases lasting longer than 6 months or those that haven’t responded to standard treatments. The reason is simple: if your elbow was going to heal on its own, it likely would have by that point. Shockwave offers a fresh stimulus that can break the cycle of degeneration. Now, it’s important to have the correct diagnosis – if your “elbow pain for years” isn’t actually tendon-related (for example, if it’s arthritis in the joint or a nerve issue), shockwave might not be the right tool. That’s why a proper evaluation is key. But if it is a tendon issue (tennis elbow, golfer’s elbow, etc.), whether it’s 3 months old or 3 years old, shockwave is worth considering. Chronic pain sufferers often come in a bit skeptical because they’ve been let down by other treatments. We like to be realistic yet optimistic: shockwave therapy can often help even long-standing elbow pain, but it may require a full course of treatment and some patience as the old tissue gradually transforms. When it works, though – it’s incredibly rewarding to finally be rid of a pain you thought you’d have forever.
While shockwave therapy is safe for most people, there are a few contraindications and precautions. We will screen you for these before starting. You should not have shockwave therapy directly over an area where there is an active infection or open wound – we’d wait for that to heal first. It’s also contraindicated over any malignant tumor (cancer) or if you have a known bone tumor in the area. If you have a bleeding disorder (like hemophilia) or are on strong blood thinners, we have to be cautious because shockwaves could theoretically cause a bit of internal bleeding/bruising; we might avoid or modify treatment in such cases. Shockwave is generally not used over growth plates in children (so we typically wouldn’t treat a very young patient’s elbow with shockwave, though tennis elbow is very rare in kids). If you are pregnant, we wouldn’t use shockwave over regions near the uterus or low back, etc., but treating an elbow is usually considered fine – still, as a precaution, some providers avoid any shockwave during pregnancy just to be extra safe. Other relative contraindications include: if you have a pacemaker or other implanted electronic device, we avoid using shockwave in that area to prevent interference (again, treating an elbow when you have a pacemaker in your chest is generally okay, but we stay away from chest areas with shockwave). We also don’t do shockwave directly over major nerves or blood vessels – but around the elbow, the therapist knows to target the tendon and avoid zapping a nerve bundle. Lastly, if you have had a cortisone injection recently in that elbow, we usually wait a number of weeks (at least 4-6 weeks) before doing shockwave on the same spot, because the steroid can weaken tissue temporarily and we want that to dissipate first. During your consult, we’ll go through your medical history. Conditions like diabetes or rheumatoid arthritis don’t prevent shockwave (in fact, some diabetics benefit from shockwave for tendinopathies), but we factor in that healing might be slower. To sum up: shockwave isn’t for open wounds, active cancer, certain vascular or bleeding conditions, or over implanted devices, but for most people with chronic elbow pain it’s a suitable and low-risk therapy. If you’re unsure, ask a provider – there might be alternative treatments if shockwave is not advised in your case.
Coverage for shockwave therapy can vary quite a bit depending on your location and insurance plan. In many cases, shockwave therapy performed by a registered physiotherapist or chiropractor is billed under standard treatment codes (such as physiotherapy) and thus may be covered by extended health benefit plans or insurance, just like any other physio treatment. For example, if you have coverage for physiotherapy, the shockwave can be part of your physio session – you’d want to verify that the clinic doesn’t charge an extra fee for it. At Unpain Clinic, we are transparent about any additional costs. Some clinics consider shockwave a specialized service and charge an out-of-pocket fee per session that insurance may not reimburse. It really depends on the clinic’s billing practices and the insurer. Government health plans (like Alberta Health, etc.) typically do not cover shockwave therapy specifically, so it falls to private insurance or self-pay. We encourage patients to check with their insurance provider. You can ask: “Is extracorporeal shockwave therapy for chronic tendinopathy covered under my plan?” If they don’t recognize “shockwave therapy,” ask if they cover physiotherapy or chiropractic – as long as the provider is licensed and it’s part of that treatment, it might be covered. Some insurance plans have special provisions or limits for “advanced therapies.” If you find out it’s not covered, don’t despair – many clinics (including ours) offer package pricing or payment plans to make it affordable, because we don’t want cost to be a barrier to getting effective treatment. Also, consider that shockwave often helps resolve conditions faster, potentially reducing the need for ongoing therapy visits – which can save money in the long run. We will work with you to explore your insurance and provide any documentation needed (like receipts with the treatment code) so you can submit for reimbursement. If you have no coverage, some health spending accounts or wellness accounts (if your employer offers those) might be used for shockwave therapy. The bottom line: coverage isn’t universal – check your plan details, and feel free to contact us or your insurer for clarification. We’ve had many patients successfully claim shockwave treatment, but others have paid out of pocket. Our admin team at Unpain Clinic is happy to assist in figuring this out so you can focus on getting better.
The side effects of shockwave therapy are generally mild and temporary. The most common ones include: pain during treatment – as discussed, there can be some discomfort while the shockwaves are being delivered, but this stops when the treatment stops. After a session, you may have transient pain or aching in the treated area – sort of like post-exercise soreness. This typically lasts a few hours to a day or two at most. You can also experience a bit of redness or swelling on the skin where the probe was – this is due to increased blood flow and the mechanical impact, but it should fade within hours. Sometimes patients develop a small bruise on the area, especially if a higher energy setting was used or if they tend to bruise easily. This isn’t dangerous and will resolve like any other bruise. In rare cases, some people have reported tingling or numbness in the area afterward – this is usually short-lived and might be due to a temporary nerve irritation or just the shockwave’s analgesic effect wearing off. One side effect noted in studies is that shockwave can cause a temporary local inflammatory response – but this is actually part of how it works (by triggering inflammation to restart healing). So if your elbow feels a bit warm or more sore the next day, it could be the body’s healing response kicking in. Importantly, studies have found no significant adverse events like tissue damage from therapeutic shockwave. It doesn’t seem to harm healthy tendon or muscle; it just stimulates repair. We do avoid certain areas (for example, we wouldn’t accidentally aim it at a nerve trunk or the lungs), which is why trained application is important. But the doses and devices we use for elbow pain are very focused and safe. There is also no ionizing radiation or anything like that involved – it’s purely mechanical sound waves. To be thorough: extremely rare complications could theoretically include things like a tendon tear if someone way overdid exercise immediately after shockwave on a fragile tendon – but that’s why we give post-treatment guidelines. Another “side effect” could be that it simply doesn’t work for a small percentage of patients – we don’t consider that a side effect, just a possible outcome, but it’s something to be aware of (no treatment has a 100% success rate). Rest assured, when you come in for shockwave, we will inform you of all these expected mild effects. Most patients tolerate shockwave very well and leave the clinic feeling fine, with maybe just a bit of tenderness that day. By the next visit, they often report feeling better than before. If you have any concerns during a course of shockwave therapy, we encourage you to share them – we can modify treatment intensity or address any issues. Overall, side effects are minimal and the risk-benefit balance strongly favors giving shockwave a try for persistent elbow pain.
Chronic elbow pain – whether it’s the classic tennis elbow, golfer’s elbow, or another stubborn tendinopathy – can be a real drain on your quality of life. It lingers, frustrates, and resists the quick fixes that help acute injuries. Understanding elbow pain means recognizing that these conditions are often due to tendon degeneration and poor healing, rather than just inflammation, which is why they become chronic. Traditional approaches like rest, medications, or even injections might provide temporary relief, but they often don’t solve the underlying problem of a weakened, non-healing tendon. Shockwave therapy offers a promising solution by directly stimulating the biology of healing in your elbow. As we’ve discussed, it’s a non-surgical treatment that uses sound waves to spur tissue repair, improve blood flow, and reduce pain signal sensitivity. The latest research and our clinical results indicate that shockwave therapy may help many people break out of the cycle of pain – even those who have had elbow pain for years. It’s not magic, and it’s not instant, but with a proper treatment course, shockwave can lead to a stronger tendon and lasting relief.
If you’re a good candidate – typically someone with chronic elbow tendon pain (lateral or medial epicondylitis) that hasn’t fully responded to rest or therapy – shockwave is well worth considering. It shines particularly in cases of chronic pain (> 3-6 months) and in individuals looking to avoid more invasive measures. Keep in mind, shockwave therapy is most effective when combined with a holistic plan: addressing strength deficits, flexibility, and movement patterns in addition to the targeted shockwave treatments. That’s why at Unpain Clinic we pair shockwave with a whole-body assessment and personalized rehab program. We don’t just chase symptoms; we find and treat the root causes. Our motto is that we want you to leave each session with more clarity about your condition, not more questions.
In summary, shockwave therapy is changing elbow pain treatment by providing a non-invasive, evidence-backed option that can jump-start healing in tendons once thought “stuck” in chronic pain. It offers hope to those who’ve been cycling through therapies without lasting success. Whether you’re a tennis player with a stubborn backhand injury or a tradesperson who’s had elbow aches for ages, shockwave therapy might be the modality that finally gets you over the hump. Of course, results vary – some patients experience dramatic improvement, while others may see moderate changes – but the overall success rates and research trends are encouraging. And with its low risk profile, it’s a sensible step to try before considering more drastic measures like surgery.
If elbow pain has been holding you back, you don’t have to just grin and bear it or mask it with temporary fixes. There are effective, regenerative treatments available, and shockwave therapy is leading the charge among them. Many patients have regained pain-free function in their arms thanks to this technology and a comprehensive treatment approach. You could be next.
Ready to take the next step? At Unpain Clinic, we’re here to help you finally break free from elbow pain with a customized plan built around shockwave therapy and our expertise in pain management. We invite you to experience a different approach – one focused on why you’re in pain and how to fix that, rather than just band-aids. It starts with a thorough initial assessment, and from there, if you’re a candidate, we’ll map out your road to recovery.
Now, as you finish this article, imagine yourself six weeks or a couple of months from now: You’re lifting that heavy pan, swinging that golf club, or typing a long email without that familiar twinge in your elbow. That’s the potential outcome when we treat the root cause and promote true healing. We’d love to help you get there. The first step is up to you – and it could be just a click away.
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. Yao G. et al. (2020). Efficacy of Extracorporeal Shock Wave Therapy for Lateral Epicondylitis: A Systematic Review and Meta-Analysis. Biomed Res Int, 2020:2064781. PMID: 32309425
2. Ruan Z. et al. (2020). Effectiveness of extracorporeal shock wave therapy in patients with tennis elbow: A meta-analysis of RCTs. Medicine (Baltimore), 99(30):e21220. PMID: 32791694
3. Coombes BK et al. (2009). Shock wave therapy for lateral elbow pain (Cochrane Review). Cochrane Database Syst Rev, (4):CD003524.
4. Beyazal MS et al. (2015). Comparison of the effectiveness of local corticosteroid injection and shockwave therapy in lateral epicondylitis. J Phys Ther Sci, 27(12):3755-3758. PMID: 26834345
5. Simplicio CL et al. (2020). Extracorporeal shock wave therapy mechanisms in musculoskeletal regenerative medicine. J Clin Orthop Trauma, 11(Suppl 1):S309-S318. PMID: 32523286
6. Alharbi M. (2025). Comparative efficacy of shockwave therapy vs. ultrasound in lateral epicondylitis: a meta-analysis. Eur J Orthop Surg Traumatol, 35(1):307. PMID: 40668449
7. Podcast – “Episode 9: Shockwave for Tennis Elbow with Ove Indergaard” (June 10, 2020)
8. Unpain Clinic (2025). Golfer’s Elbow Pain: When Rest Isn’t Enough and What to Do Next. (Blog post, Dec 24, 2025)
9. Unpain Clinic – YouTube Shorts: “Golfers Elbow Pain? When Rest Isn’t Enough” (2025)
10. Unpain Clinic (2026). Understanding Tennis Elbow: Causes, Symptoms, and Treatments. (Blog post, Jan 8, 2026)
11. Unpain Clinic – Shockwave Therapy Edmonton (Service Page). “What is Shockwave Therapy?” (Accessed 2026)
