New to shockwave or in pain for more than 3 months? Book a Telehealth to see if we can help you!
Living with sacroiliac (SI) joint dysfunction can be frustrating and exhausting. The persistent low back and buttock pain, stiffness, and instability make even simple movements daunting. Many people with SI joint issues feel trapped in a cycle of rest, pain medications, and treatments that offer only temporary relief. If you’ve been struggling with chronic SI joint pain for months, you’re not alone – studies estimate that SI joint dysfunction may be the underlying cause in up to 15–30% of chronic low back pain cases.
Shockwave therapy has emerged as a promising non-surgical treatment for stubborn SI joint dysfunction. In the first few paragraphs of this post, we’ll introduce how shockwave therapy (also called Extracorporeal Shockwave Therapy, or ESWT) offers a new approach to chronic SI joint pain. This therapy uses acoustic sound waves to stimulate the body’s healing processes in targeted areas. Patients and clinicians alike are excited because shockwave therapy may help reduce inflammation, break up scar tissue, improve blood flow, and modulate pain in the SI joint area – all without surgery.
If SI joint pain has you at your wit’s end, take heart. Below, we’ll explain what SI joint dysfunction really is, why it can become chronic, and how shockwave therapy is giving many patients a path to lasting relief. You’ll see what the latest research says about shockwave therapy for SI joint issues, how we at Unpain Clinic apply this innovative treatment, and what you can realistically expect. Results vary from person to person, and it’s important to consult a healthcare provider for individualized advice – but research suggests shockwave therapy can be a game-changer for many with chronic SI joint pain.
Let’s dive in and explore why shockwave therapy is helping SI joint dysfunction patients move again.
The sacroiliac joints connect the base of your spine (the sacrum) to the hip bones (ilium) on each side. These joints are crucial for weight-bearing and stability in your pelvis. Sacroiliac Joint Dysfunction (SIJD) happens when one or both SI joints become irritated, inflamed, or misaligned. Common causes include ligament injury (from falls or lifting), arthritis or degeneration of the joint, pregnancy-related pelvic changes, or even muscle imbalances that put uneven stress on the SI region. The result is often deep, aching pain near the waistline or buttocks, sometimes radiating to the groin or down the leg, which can mimic other problems like sciatica or herniated discs.
One reason SI joint pain can persist beyond 3 months (becoming chronic) is that the underlying issues aren’t always addressed. People with SIJD often try rest, heat/ice, anti-inflammatory medications, or even SI joint belts to stabilize the area. While these can provide short-term relief, the pain frequently returns as soon as normal activities resume. Traditional physical therapy exercises can help strengthen core and gluteal muscles for SI support, but if key muscles are “shut off” due to pain or old injuries (like abdominal surgery scars), exercise alone might not stick. Some patients resort to cortisone injections into the SI joint or radiofrequency ablation (burning the nerve), which may dull pain temporarily but don’t always fix the root cause of joint dysfunction. It’s no wonder many SI joint sufferers describe feeling like they’ve “tried everything” – only to still hurt.
To make matters worse, SI joint dysfunction is often underdiagnosed. Its symptoms overlap with general low back pain, so it can take months or years for patients to get a clear diagnosis. All this leads to understandable frustration. In fact, fewer than half of people with chronic low back pain (of which SIJD is a major cause) find meaningful relief within one year of standard treatments. This is where shockwave therapy enters the picture as a much-needed alternative. Shockwave therapy doesn’t just mask pain; it aims to stimulate actual healing and reset dysfunctional tissues in and around the SI joint. Before we discuss how that works, let’s review what evidence-based research says about using shockwave therapy for SI joint problems.
Shockwave therapy is not a magic bullet or “quick fix,” but growing evidence supports its benefits for chronic musculoskeletal pain – including SI joint dysfunction or closely related low back conditions. Because SI joint dysfunction as a diagnosis has only recently gained more attention, direct studies on shockwave for SI joints are somewhat limited (so far). However, the studies that do exist are promising, and research on shockwave for chronic low back pain in general adds further support.
Significant Pain Relief in SI Joint Pain (Randomized Trial): One of the first controlled studies on SI joint pain treated with shockwave was published in 2017. In this trial, 30 patients with SI joint pain were randomly assigned to true shockwave therapy or a sham (placebo) treatment. The shockwave group received a series of acoustic pulses (about 2,000 shocks per session at an energy level the patient could tolerate) applied along the back of the SI joint. The sham group thought they were getting treatment, but the device was positioned differently to avoid therapeutic effect. After 4 weeks, the shockwave-treated patients had significantly less pain – their average pain scores dropped from about 6.4/10 down to 3.6/10, a notable improvement. In contrast, the sham group’s pain stayed almost the same (around 6/10). Functionally, the shockwave group also showed improvement in disability scores (Oswestry Disability Index), though this change wasn’t statistically significant in that short timeframe. The key takeaway is that shockwave therapy outperformed placebo for SI joint pain reduction, suggesting it can truly help and is more than just a placebo effect.
Focused Shockwave vs. Traditional Therapy: A more recent study in 2024 looked at postpartum women with SI joint dysfunction, comparing focused shockwave therapy to manual therapy exercises and a combination of both. After 1–2 weeks of treatment, all groups improved, but there were some differences. Shockwave therapy showed a faster improvement in disability scores (how well patients could move/function) after just one week, and had the highest overall improvement rate (66.7%) among the groups. The combination of shockwave + manual therapy achieved the highest “cure” rate (~73% reporting near-total relief), indicating that pairing shockwave with other therapies can be very effective. Interestingly, by two weeks, pain levels in the shockwave-only group were similar to the hands-on therapy group, and the combo group had the best pain relief. This suggests that shockwave can play a major role in SI joint pain rehab, especially in kick-starting improvements early on, while a comprehensive approach may yield the best long-term results. Importantly, no adverse events were observed in any group during two months of follow-up, reinforcing that shockwave therapy is generally safe for this condition.
Evidence in Chronic Low Back Pain: Because the SI joints are a common contributor to low back pain, it’s worth noting the broader research on shockwave for low back issues. A 2023 meta-analysis compiled results from 12 randomized trials (total 632 patients) with chronic low back pain (lasting >3 months). The findings were encouraging: adding shockwave therapy led to significantly greater pain relief than control treatments at both 4 weeks and 12 weeks after therapy. Patients who got shockwave reported, on average, about 1 point lower pain on a 0–10 scale at 1 month compared to controls, and nearly 0.85 points lower at 3 months – these are meaningful differences when you’re dealing with daily pain. Shockwave-treated patients also showed better functional improvement, with disability index scores improving more than control groups at 1 and 3 months. Perhaps just as crucial, there were no serious side effects reported in any of those studies. This aligns with other reviews noting that shockwave therapy has a strong safety profile for chronic pain management. For SI joint dysfunction sufferers, this broad evidence suggests that shockwave can reduce chronic back/SI pain and improve mobility, giving hope even if you’ve had pain for years.
How Does Shockwave Therapy Work? In simple terms, shockwave therapy sends high-energy sound waves into the affected tissues of the body. For musculoskeletal conditions, these waves create micro-mechanical stress that stimulates the cells and nervous system in a beneficial way. Research shows that shockwave may trigger a healing cascade: it can increase blood circulation and the formation of new blood vessels, which helps bring nutrients and remove waste in the injured area. It also prompts the release of growth factors and the recruitment of stem cells that aid tissue repair. In chronic SI joint dysfunction, often there is inflammation or even scar tissue around the ligaments and joint capsule – shockwaves help break up calcifications or adhesions (scar tissue) and provoke the body to rebuild healthier tissue. Another important effect is pain modulation: shockwave therapy can overstimulate nerve endings to essentially “reset” pain signaling (a mechanism called hyperstimulation analgesia). Additionally, shockwaves have been found to reduce muscle spasm and tightness in the low back and pelvic muscles by reducing nerve irritability and increasing nitric oxide, which improves neuromuscular function. In plain language, shockwave therapy turns on the body’s natural healing and pain-relief processes in areas that have been stuck in a chronic dysfunction.
Realistic Expectations: It’s important to have realistic expectations with shockwave therapy for SI joint dysfunction. It’s not usually a one-and-done treatment – most treatment plans involve a series of sessions (commonly around 3 to 6 sessions, typically one session per week) to achieve lasting results. Many patients start to notice improvement after the first one or two sessions (for example, less morning pain or improved mobility), but deeper, more permanent changes often take a few weeks as the tissues gradually heal and strengthen. In the RCT mentioned, significant pain relief was seen at 4 weeks post-treatment, and in the meta-analysis many trials measured outcomes at 4 and 12 weeks, showing continued benefit. This suggests that patience is key – shockwave’s effects are cumulative. Some individuals respond faster, while others might need additional integrative therapy (like specific exercises or adjunct treatments) alongside shockwave to get the full benefit. Also, the degree of improvement can vary: some patients experience dramatic pain reduction and return to near-normal function, while others may see moderate improvement that still enhances their quality of life (for instance, being able to sit or walk longer with less pain). Every case of SI joint dysfunction is a bit different, so results may vary. The good news is that if shockwave therapy is going to help, you’ll typically know within a few sessions – you won’t be left guessing for months on end. And if it does help, the relief can be long-lasting as the therapy addresses underlying healing, not just temporary pain masking.
Overall, the research paints an optimistic picture: shockwave therapy can reduce chronic SI joint pain and improve function, with minimal risks. Now let’s look at how we apply this cutting-edge treatment at Unpain Clinic, and why our approach may succeed where others failed.
At Unpain Clinic, shockwave therapy is one of our signature treatments for chronic pain. Our philosophy in treating SI joint dysfunction is holistic and root-cause focused. In other words, we don’t just ask, “Where does it hurt?” — we dig deeper to ask “Why does it hurt?” Often, SI joint pain is actually a result of dysfunction elsewhere: for example, stiff hip muscles, an old surgical scar weakening the core, or poor movement patterns that overload the SI area. Simply cracking the joint or prescribing rest might give short-term relief, but to fix the problem for good, we need to correct those underlying issues. That’s why we combine advanced regenerative therapies like shockwave with hands-on manual therapy and targeted exercise. This comprehensive plan gives you relief and long-term resilience. Here’s what you can expect from our approach:
Thorough Assessment: First, we perform a detailed initial assessment (similar to the one described in our CTA at the end of this post). A trained physiotherapist or chiropractor will evaluate your entire movement pattern – from head to toe – because the SI joint often doesn’t act up in isolation. We’ll test which motions provoke your SI pain, check the mobility of your lumbar spine and hips, and look for muscle weaknesses or imbalances (for instance, are your glutes activating properly? Are tight hip flexors pulling your pelvis forward?). Sometimes we find clues like an old C-section scar or sports injury that is causing compensation patterns. Our team maps out these contributing factors so we can address why your SI joint is painful, not just chase the pain itself.
Shockwave Therapy Sessions: Extracorporeal Shockwave Therapy (ESWT) is usually front and center in our treatment plan for SI joint dysfunction. A typical shockwave session at Unpain Clinic involves using a focused shockwave device (or sometimes radial shockwave for more superficial targets) applied to the relevant areas around your SI joint. We often target the posterior SI ligaments (the strong bands that hold the sacrum to the ilium), the attachments of muscles that stabilize the SI region (such as the gluteus medius and piriformis on the back of the hip, or even lower back muscles), and any myofascial trigger points contributing to pain. By moving the probe methodically along the joint line and surrounding tissues, we ensure the entire area gets therapeutic stimulation. Shockwave therapy can be a game-changer for chronic SI joint pain that hasn’t responded to conventional therapy. Patients often describe a sensation of intense vibration or pressure during treatment – it can be a bit uncomfortable, but we adjust the intensity to your tolerance and it only lasts a few minutes per spot. There is no anesthesia needed and no downtime after; typically just mild soreness that fades within a day. In fact, most patients leave the session feeling looser. Over the next days, shockwave triggers a healing response: you might notice reduced pain, or that you can move with better range of motion. We usually perform one session per week, and most SI joint cases require a series of about 3–5 sessions for maximal benefit (severe cases might need a few more). We track your progress carefully – if you’re improving each week, it’s a great sign we’re on the right track.
Cutting-Edge Combination Therapies: While shockwave is the star player, we often combine it with other advanced modalities to enhance results (tailored to each patient’s needs). One example is EMTT (Extracorporeal Magnetotransduction Therapy) – a pulsed high-frequency magnetic therapy that we can apply right after shockwave. EMTT penetrates deep without any sensation and helps reduce inflammation and “dial down” pain pathways at a cellular level. Think of EMTT as recharging your cells’ batteries to further encourage healing. We’ve found that pairing EMTT with shockwave provides a one-two punch: shockwave handles the mechanical/tissue side (breaking scar tissue, stimulating repair) while EMTT handles the cellular and neuro-inflammatory side. This combo is especially useful for very sensitive patients or winter flare-ups when everything is extra stiff. Another adjunct we may include is Neuromodulation therapy, like microcurrent stimulation or NeuroElectric Therapy (NESA), to “reset” an overactive nervous system. Chronic SI pain can cause certain muscles to shut down and nerves to amplify pain signals; gentle electrical stimulation can coax the nervous system back into balance (for instance, helping your brain re-engage your deep core muscles while calming pain signals).
Hands-On Manual Therapy: Our physiotherapists and chiropractors will also use manual therapy and mobilization techniques alongside shockwave. This might involve carefully mobilizing the SI joint itself if it’s stuck or misaligned, or using soft tissue massage and myofascial release on tight muscles like the piriformis, quadratus lumborum (QL), or hip flexors that connect to the pelvis. We address neighboring areas too – for example, ensuring your lumbar spine and hip joints are moving well, since stiffness there can force the SI to compensate. On occasion, a gentle chiropractic adjustment to the SI joint can provide immediate relief by unlocking the joint – but we only do high-velocity adjustments if appropriate and if your muscles are relaxed and ready (often after shockwave has done its job of relaxing tissues). Crucially, any joint mobilization or adjustment is followed by active techniques (like exercises) to stabilize the new movement. Research shows that combining manual therapy with exercise yields better outcomes for SI joint pain than either alone. That’s why our approach is multimodal.
Targeted Exercise Rehabilitation: No SI joint rehab is complete without strengthening and stabilization exercises. After we’ve used shockwave to reduce pain and improve tissue quality, we want to solidify those gains by activating the right muscles. We’ll prescribe exercises tailored to your specific weaknesses – commonly, this includes glute activation exercises (to help your gluteal muscles support and control the SI joint) and core strengthening, especially the deep abs and multifidus muscles that stabilize the spine and pelvis. We might start with simple moves like pelvic tilts or abdominal bracing (to find your transverse abdominis), then progress to exercises like glute bridges, bird-dogs, clamshells, and side planks as you improve. Flexibility work is included as needed – for instance, tight hamstrings or hip flexors can tug on the pelvis and SI joint, so we ensure those are stretched out. We also incorporate functional training: if certain movements trigger your SI pain (say, lunging or getting out of a car), we break down and retrain those patterns in a pain-free way. You’ll have a home exercise program to continue between sessions, which is critical for long-term success. Essentially, shockwave opens the window of opportunity by reducing pain and restrictions, and exercise then builds the support to keep the SI joint healthy.
Monitoring and Adjusting: Throughout your treatment plan, the Unpain Clinic team continuously monitors your progress. We love data – we’ll reassess your pain levels, movement tests, and functional improvements regularly. If something’s not improving as expected, we adjust the plan. Fortunately, many patients start noticing positive changes within a few visits. We’ve seen patients who hobbled in with SI pain for years start doing activities they love again (hiking, playing with their kids, sitting through a movie pain-free) after completing a course of shockwave therapy with us. While we can’t guarantee outcomes, our personalized, whole-body approach aims to set you up for the best possible result.
Real Patient Example: In our podcast Episode #13 – “How chronic back pain stopped when C-Section was treated” (June 2025) – we discussed a case that illustrates the power of shockwave therapy for SI region pain. The patient, a mother who had two cesarean sections, suffered chronic lower back and SI joint pain for years. Traditional therapies didn’t provide lasting relief. During her assessment, we found her old C-section scar had disrupted her core muscle activation. Our therapist used focused shockwave therapy over the scar and SI joint area, and the results were remarkable. Shockwave “rebooted” her core muscles and eliminated her chronic SI pain by breaking down adhesions and restoring proper nerve-muscle communication. In fact, she noticed feeling “lighter” in her pelvis and improved balance after just one session. Over a few sessions, her strength and stability returned as the shockwave combined with exercises “reawakened” muscles that had been inhibited since surgery. This story (shared with permission in the podcast) is a powerful example of how Unpain Clinic looks beyond the obvious and targets root causes – in her case, treating the scar as part of the SI joint dysfunction plan. (Note: individual results vary, and not everyone will have such a dramatic response, but it shows what is possible with a tailored shockwave therapy approach.)
In summary, at Unpain Clinic we leverage shockwave therapy as the centerpiece of SI joint dysfunction treatment, supported by other modalities and exercises as needed. The goal is not just short-term pain relief, but to get you moving confidently again and address the “why” behind your pain. Next, let’s look at a hypothetical patient journey to tie it all together.
Meet “John,” a 45-year-old avid golfer and office worker who came to us with chronic SI joint dysfunction. (This is a fictionalized example based on real patient experiences, with identifying details changed.) John had been living with right SI joint pain for 3 years. It started as a mild ache after a minor slip-and-fall, and gradually worsened. He felt sharp pain in his right lower back and buttock when getting out of bed, couldn’t sit for more than 30 minutes without pain, and had to give up golf because the rotational movements left him hobbling. He tried the usual route: rest, anti-inflammatory meds, and regular physio exercises. He even had a steroid injection in the SI joint which helped briefly, but the pain roared back within two months. By the time John visited Unpain Clinic, he was frustrated and worried this pain would be lifelong.
Initial Assessment: During John’s assessment, our therapist noticed a few key things. His right hip was extremely tight and his glute muscles weren’t firing well. He also mentioned a decades-old hamstring injury on that side. We suspected his old injury led to lingering muscle imbalances that overloaded the SI joint. Sure enough, some tests showed that whenever John engaged his core and glutes better, his SI pain reduced. We explained to John that the pain wasn’t just coming from the joint itself, but from the whole system around it. This was actually good news – it meant we had multiple ways to help him.
Treatment Plan: We created a plan focusing on shockwave therapy to John’s SI ligaments, hip musculature, and that tight hamstring insertion, combined with targeted exercises. We also included some manual therapy to improve his hip mobility. John was a bit nervous about shockwave (he asked, “Does shockwave therapy hurt?”). We assured him it can be a little uncomfortable but generally well-tolerated and safe, and we would stop or adjust if it was too much. (Indeed, research shows shockwave is safe with no serious side effects in chronic low back/SI pain trials.)
Shockwave Therapy Journey: In the first session, we used a focused shockwave probe around John’s right SI joint and gluteal area. He felt a strong tapping sensation – about 6/10 on a discomfort scale – but it was tolerable. We also treated his hamstring attachment near the sit bone. Afterward, John was surprised to feel that he could bend forward with less stiffness immediately. That night he had some mild soreness, as expected. Over the next week, he noticed he could sit through a one-hour meeting with only minimal discomfort, which was a big improvement. Encouraged, John continued weekly sessions. By the third session, he reported 50% less daily pain and found he could walk a couple of miles again. We also saw objective gains: his one-leg balance improved (a sign his glute medius was activating better) and his hip flexibility increased.
Combining Exercise: As John’s pain decreased, we ramped up his exercise program. We taught him how to properly do glute bridges and clamshells to strengthen his pelvic stabilizers. We also worked on core exercises like dead bugs and side planks. John was diligent with his home exercises, doing them every other day. He commented that the shockwave seemed to make stretching and exercising easier – he no longer felt that sharp catch in his SI when he moved a certain way, so he could exercise without fear. This is common: once pain is under control, patients move more freely and regain muscle function faster.
Outcome: After six sessions over about 6–7 weeks, John’s SI joint pain had reduced from a constant 7/10 to occasional mild twinges of 1–2/10 with prolonged sitting. Essentially, he was pain-free in daily activities. He resumed golfing at the two-month mark, easing in with 9 holes. To his delight, he got through a game without SI pain (just a bit of normal muscle soreness from swinging after a long break!). We followed up a month later and John was still doing great – he continued his exercises twice a week and scheduled a “maintenance” shockwave session once every few months just as a tune-up. John’s story illustrates that with a comprehensive plan, even years-long SI joint dysfunction can improve. Shockwave therapy helped unlock his body’s ability to heal, and combined with the right exercise, gave him his active life back.
Managing SI joint dysfunction isn’t just about in-clinic treatments – what you do at home can make a big difference in your progress. Here are some simple, safe tips to help keep your SI joints happier between visits:
Stay Gently Active: While high-impact activities (like jumping or running) might aggravate an inflamed SI joint, it’s important not to become too sedentary. Prolonged sitting or bed rest can actually stiffen the joint and weaken supporting muscles. Try to incorporate light movement throughout your day. Short walks (even 5-10 minutes around the block) a few times a day can maintain blood flow. If sitting a lot for work, stand up at least every 30 minutes to stretch or walk in place. Consider using a sit-stand desk or an exercise ball chair for part of the day to engage your core subtly.
Mind Your Posture: Poor posture, especially slouching in a chair, can tilt your pelvis and strain the SI joints. At home and work, use a small cushion or rolled towel to support the curve of your lower back when sitting. Ensure your hips and knees are level (avoid chairs that are too low). When standing, try not to favor one leg or jut a hip out (a habit that can stress one SI joint). A quick posture reset: imagine a string lifting the top of your head, elongating your spine, and gently draw your shoulder blades back – this puts your low back and pelvis in a better alignment.
Heat for Tight Muscles, Ice for Flares: Simple home remedies can complement your treatment. If you feel muscle tightness around the SI area (e.g. a tight band in the buttock), a warm pack or hot bath can help soothe and loosen it. Heat increases blood flow and can relieve that achy stiffness. On the other hand, if you experience a pain flare-up with sharp inflammation (say you overdid an activity and your SI joint is throbbing), icing 15 minutes at a time may help numb the pain and reduce swelling. Always wrap ice in a cloth; never place directly on skin. Some patients alternate heat and ice to get the best of both – heat before activity to warm up, ice after to calm any irritation.
Gentle Stretches and Mobility Exercises: Doing a few targeted stretches each day can maintain flexibility in areas that affect the SI joint. Two useful stretches are the knees-to-chest stretch (lying on your back, gently hug one or both knees toward your chest to stretch the low back and glutes) and the figure-4 stretch (lying on your back, cross one ankle over the opposite knee and pull that knee toward chest to stretch the piriformis/hip). Hip flexor stretches (kneeling lunge position) can also relieve tilt on the pelvis if those muscles are tight. Perform stretches slowly and hold for ~20–30 seconds, avoiding any sharp pain. Additionally, pelvic tilts (lying on back, slowly rock your pelvis to flatten and then arch your low back) are a gentle way to keep the SI area mobile without strain. These exercises should feel comfortable; they’re meant to keep you limber, not to push into pain.
Sleeping Position Hacks: SI joint pain can sometimes disrupt sleep. If you feel discomfort at night, try adjusting your sleeping position. Many SIJD sufferers find relief lying on their side with a pillow between the knees – this keeps the pelvis neutral and prevents the top leg from pulling on the SI joint. If you’re a back-sleeper, placing a pillow under your knees can ease the tension on your lower back and pelvis. Stomach-sleeping is often hardest on the SI joints due to the twist it causes, so it’s best to avoid or minimize time on your stomach. Ensuring a good mattress (medium-firm tends to support the spine best) can also be beneficial.
Know When to Seek Help: While most SI joint dysfunction can be managed conservatively, certain red-flag symptoms warrant medical attention. If you experience severe pain with fever, loss of bladder/bowel control, numbness/weakness in your legs, or pain following significant trauma (like a fall or accident), you should contact a healthcare provider promptly. These could indicate something more serious than typical SI joint dysfunction (such as nerve compression or fracture) that needs urgent evaluation. Additionally, if your SI joint pain is not improving at all after a few weeks of home care and therapy, re-consult your practitioner – sometimes image-guided interventions or further diagnostic workup might be needed.
(These home tips are for general educational purposes and may not be suitable for everyone. Always follow the specific advice given by your clinician, and consult your healthcare provider before starting any new exercise or regimen, especially if you have other health conditions.)
Yes, shockwave therapy is generally considered safe for musculoskeletal conditions like SI joint dysfunction. Clinical studies have reported no serious adverse effects when using shockwave for chronic low back or SI joint pain. The most common side effects are mild and temporary – you might feel some soreness, redness, or bruising in the treated area for a day or two. This is similar to how you’d feel after a deep tissue massage and is a normal part of the body’s response. During treatment, it can be uncomfortable (patients describe it as a strong tapping or throbbing sensation), but we adjust the intensity to your tolerance and it’s brief. Shockwave is non-invasive (no incisions, no injections) and doesn’t involve any medications or anesthesia. However, there are a few contraindications: we avoid using shockwave therapy over areas of active infection or tumor, and it’s not used on pregnant patients’ lower back/pelvis as a precaution. Also, if you have a blood clotting disorder or are on heavy blood thinners, high-energy shockwave might be unsuitable due to a small risk of tissue bleeding. Your therapist will screen for these factors. For the vast majority, shockwave therapy is a safe treatment option – and one of its big appeals is avoiding the risks of surgery or long-term medications.
The number of sessions can vary based on the chronicity and severity of your condition, but most treatment plans range from 3 to 6 sessions for SI joint dysfunction. At Unpain Clinic, we often start with a package of 3 sessions and then re-assess your progress. Research often measures outcomes at the 4-week (around 4 sessions) and 12-week marks, because shockwave’s effects are cumulative. Many patients experience noticeable pain reduction or mobility gains after just 1–2 sessions – for example, feeling less pain when getting out of a chair or improved flexibility. However, to solidify the improvement and address the underlying tissue healing, a few more sessions are usually needed. In our experience, chronic SI joint issues (pain > 6 months) tend to require the higher end of that range (5–6 sessions) to achieve lasting relief, whereas more recent or mild cases might resolve with only 3 sessions. Sessions are typically scheduled about one week apart. This weekly frequency allows the tissue changes from one treatment to take effect, while still building on momentum with the next treatment. After your initial series, we again evaluate – if you’re significantly better, we may stop there and simply follow up in a month. If there’s improvement but still some way to go, we might add a couple more sessions or integrate additional therapies. Remember, the goal is not an arbitrary number of sessions, but reaching a point where your pain and function are dramatically improved. Your therapist will tailor the plan to your progress. And don’t worry – if shockwave therapy isn’t helping by the second or third session, we would re-think the approach (since we expect to see some early positive signs if it’s going to work for you).
Shockwave therapy can cause mild discomfort during the treatment, but it is usually well-tolerated. Patients often describe the sensation as a rapid tapping or thumping feeling on the skin and deeper tissues. The intensity can range from a 3–4/10 up to maybe 6–7/10 on a discomfort scale, depending on the energy settings and the sensitivity of the area. The good news is that each “pulse” is very quick, and the most intense portion of treatment to any single spot lasts only a few minutes. We always communicate with you and can adjust the intensity or take short breaks if needed. Most people find that as the session continues, the area becomes less sensitive (possibly due to increased blood flow and the analgesic effect of shockwaves). After the session, you might feel a bit sore or achy in the treated area, similar to post-massage soreness. This typically subsides within 24–48 hours. There’s no lasting pain – in fact, because shockwave is triggering a pain-relief response, many patients feel less pain in the days following treatment. We do advise you to avoid high-impact or strenuous activities for about 48 hours after treating the SI joint, just to let the body’s healing processes work without undue strain. If needed, you can use an ice pack or a Tylenol that evening, but most people don’t find it necessary. Overall, while shockwave therapy does involve some discomfort, it is far from intolerable – and when you start feeling the results (pain easing, mobility improving), most patients say it’s absolutely “worth it.” Remember, we are targeting tissues that have been causing pain for a long time, so a little short-term discomfort is often a trade-off for significant long-term relief.
Yes, it potentially can. Shockwave therapy is specifically valuable for chronic conditions – those stuck, hard-to-heal issues that haven’t resolved with time. In fact, many of the studies on shockwave focus on chronic pain cases (including SI joint pain and low back pain lasting many months or years) and find positive results. Chronic SI joint dysfunction often involves poor healing or adaptation: perhaps ligaments have micro-tears that never fully healed, or there’s longstanding inflammation and scar tissue, or muscle inhibition that has become the “new normal.” Shockwave therapy directly targets these chronic changes by stimulating a fresh healing response. We have seen patients who suffered 5, 10, even 15+ years of SI joint pain get improvement with shockwave therapy – sometimes for the first time in ages they feel a noticeable difference. Of course, every individual is unique. The longer an issue has been present, the more entrenched some compensations (like altered movement patterns or widespread muscle weakness) might be. That’s why we often combine shockwave with other therapies to address all aspects of a chronic condition. For example, if you’ve had SI joint dysfunction for years, you might also need a thorough retraining of your movement and strengthening of key muscle groups in addition to shockwave. The shockwave can make those other therapies more effective by reducing pain and breaking up old scar tissue. Patience is important – chronic conditions don’t reverse overnight – but the regenerative power of shockwave gives even long-term sufferers a reason for optimism. We’ll assess your specific situation, but in general, having a pain for years does not disqualify you from shockwave; on the contrary, you might be exactly the kind of person who benefits the most from this treatment designed to “reboot” stalled healing.
While shockwave therapy is safe for most people, there are a few cases where it’s not recommended. You should not have shockwave therapy in the following scenarios:
Pregnancy: We avoid shockwave therapy over the pelvic or abdominal area in pregnant patients, since the effects on a developing fetus are not studied. It’s purely precautionary; expectant mothers can consider other treatments and postpone shockwave until after delivery.
Bleeding Disorders or Blood Thinners: If you have a severe coagulation disorder (hemophilia, for example) or are on strong blood-thinning medication, high-intensity shockwave might risk a bleed or extensive bruising. Your doctor can advise based on how well-controlled your condition is. Mild blood thinners (like aspirin) aren’t absolute contraindications, but we still use caution.
Cancer or Infection at Treatment Site: We do not apply shockwave directly over an area with an active tumor or cancer, as a safety measure (no evidence suggests shockwave spreads cancer, but we err on the side of caution). Similarly, an area with a serious infection (like osteomyelitis in a bone) should not be treated with shockwave. Those conditions need medical management first.
Acute Injury with Fragmentation: Shockwave is not for acute fractures or where there are bone fragments, as it’s a strong mechanical force. However, this isn’t typically relevant to SI joints unless there’s been a traumatic fracture, in which case you’d be under orthopedic care.
Nerve or Circulatory Conditions: If you have a severe peripheral neuropathy (nerve damage causing loss of sensation) in the treatment area, we might avoid shockwave because you wouldn’t be able to give feedback on pain. Also, severe circulatory issues (like advanced peripheral arterial disease) might warrant caution, but again that’s rarely an issue in the low back region for an otherwise healthy person.
During your initial consult, the therapist will review your medical history to screen for these contraindications. Most people with SI joint dysfunction will not fall into these categories and can proceed with shockwave therapy. If you cannot have shockwave for some reason, don’t lose hope – there are alternative treatments available (like laser therapy, specific exercises, or injections) that we can explore.
Coverage for shockwave therapy varies depending on your location and insurance plan. In some cases, yes, insurance may cover it under physiotherapy or chiropractic treatment if it’s performed by a licensed provider as part of a rehab program. At Unpain Clinic, shockwave therapy is often integrated into a physiotherapy session, and many extended health benefit plans will cover physiotherapy services. However, not all insurers recognize shockwave specifically, or they might consider it an “add-on” modality. It’s best to check with your insurance provider directly. Ask if physiotherapy or chiropractic treatments that include extracorporeal shockwave therapy are reimbursable. Some insurance plans have a special allowance for “shockwave therapy” or “radial pressure wave therapy” under therapeutic services. If insurance doesn’t cover it or you’ve maxed out benefits, clinics may offer package pricing to make it more affordable. Always inquire about the cost upfront. At our clinic, we are transparent about fees and can provide you with detailed receipts listing the service so you can submit for potential reimbursement. It’s worth noting that even if you pay out-of-pocket, shockwave therapy is generally a short-term treatment (a few sessions) and can be cost-effective compared to long-term reliance on medications or prolonged therapy that isn’t yielding results. Many patients feel the investment is worthwhile for the chance at lasting relief.
Shockwave therapy side effects are typically minor and short-lived. The most common ones include:
Temporary Pain or Soreness: Right after treatment (or later that day), you might feel a dull ache in the treated area. This is usually your body’s natural response to the micro-stimulation and inflammation that shockwave intentionally creates to spur healing. It should subside within 24-48 hours. Over-the-counter pain relievers or icing can help if needed, but many people don’t find it necessary.
Redness or Mild Bruising: The intense pulses can cause superficial capillaries to dilate or even break, leading to some skin redness or occasional bruising. This is more common in areas with thin skin. Any bruising is generally small and fades in a few days. We adjust the intensity if we see significant redness during treatment.
Numbness or Tingling: Very rarely, patients report a slight numb or tingling sensation in the area for a short time after therapy. This could be due to nerve endings being temporarily overstimulated. It resolves on its own, usually within hours.
Fatigue: Because shockwave can trigger a systemic response (release of endorphins, etc.), a few people feel a bit tired after a session. It’s a good idea to drink water and rest if needed post-treatment. This “healing fatigue” is generally mild and short-lived.
Uncommon Reactions: In extremely rare cases, if a very high-energy shockwave is used (often not necessary for SI joint area), there could be deeper tissue bruising or swelling. However, the settings used for SI joint dysfunction are well within safe limits. No long-term complications have been documented in the literature for shockwave on SI or back pain. There’s no radiation or anything like that involved.
Overall, shockwave therapy’s side effect profile is much gentler than surgical or injection-based interventions. There’s no anesthesia risk, no risk of infection (since nothing breaks the skin), and no significant downtime. Most people carry on with their day normally after a session. Your therapist will review all the potential effects and ensure you know what to expect. If you ever have concerns after a treatment, you should reach out to your provider – but rest assured, the vast majority of shockwave recipients have only mild, tolerable side effects if any.
Sacroiliac joint dysfunction can be a debilitating condition, but it doesn’t have to be a life sentence. By understanding what SI joint dysfunction is – an often misunderstood source of low back pain caused by irritation or instability in the joints linking your spine and pelvis – you’ve taken the first step toward relief. We’ve seen why SI joint pain can linger despite rest and conventional therapy: it often involves deeper issues like muscle imbalances or unresolved soft-tissue injuries that keep fueling the pain. This is exactly where shockwave therapy may help. As a non-surgical, evidence-backed treatment, shockwave therapy has shown it can reduce SI joint pain, improve mobility, and even address stubborn scar tissue or inflammation around the joint. It essentially jump-starts the body’s repair mechanisms and interrupts the chronic pain cycle – which is why shockwave therapy is helping so many patients move again without pain.
At Unpain Clinic, we combine shockwave with a whole-body approach: we assess why it hurts, not just where, and we tailor a plan to target those root causes. Whether it’s an old surgery scar inhibiting your core or tight hip muscles tilting your pelvis, we integrate solutions (shockwave, EMTT, manual therapy, exercise) to cover all bases. The goal isn’t a temporary fix; it’s long-term improvement so you can return to the activities you love. Shockwave therapy for SI joint dysfunction is especially promising for those who have been through the wringer of “tried everything, felt nothing.” If you’re a good candidate – meaning no contraindications and you have chronic SI pain affecting your life – shockwave might be the treatment that finally moves the needle for you.
In closing, living with SI joint dysfunction can be incredibly frustrating, but new therapies like shockwave offer hope. The research is still growing, and while we acknowledge more large-scale studies will further clarify its benefits, the current evidence and clinical successes are encouraging. If your SI joint pain has persisted for months or years, and you’re looking for a non-invasive treatment option that focuses on healing rather than just hiding pain, shockwave therapy could be worth considering. It has helped many patients regain mobility, decrease pain, and avoid more drastic measures like surgery.
You don’t have to accept SI joint pain as “normal.” There are innovative options available and professionals ready to help. A comprehensive assessment can determine if shockwave is right for you. We invite you to take that next step toward relief. Remember, results may vary, and it’s important to consult a qualified healthcare provider to discuss your specific case. But one thing is certain – you deserve a life not defined by SI joint pain, and we’re here to help you get there.
Now, as a next step, consider scheduling an in-depth assessment at Unpain Clinic to finally get answers and a personalized plan. Our team is dedicated to uncovering the “why” behind your pain and guiding you toward lasting relief. We’re not just treating symptoms; we’re empowering you with clarity and effective care. Ready to move again with confidence?
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. Moon Y.E., et al. (2017). Extracorporeal shock wave therapy for sacroiliac joint pain: A prospective, randomized, sham-controlled short-term trial. J Back Musculoskelet Rehabil, 30(4): 779–784. pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov
2. Tan K.L., et al. (2024). Effectiveness of focused extracorporeal shock wave vs. manual therapy in postpartum patients with sacroiliac joint dysfunction: a prospective clinical trial. J Orthop Surg Res, 19(1): 28. pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov
3. Liu K., 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(1): 455. pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov
4. Ferdinandov D., et al. (2024). Focused extracorporeal shockwave therapy for the treatment of low back pain: a systematic review. Frontiers in Medicine, 11: 1435504. frontiersin.orgfrontiersin.org
5.Unpain Clinic Podcast Episode #13: “How chronic back pain stopped when C-Section was treated.” (Published Nov 11, 2022). Discusses a case where shockwave therapy to a C-section scar restored core function and relieved chronic SI joint painunpainclinic.com.
6. Unpain Clinic Blog: “The November Slump: How Shorter Days Trigger SI Joint Pain & What You Can Do Daily.” (Nov 21, 2025). Explores why SI joint pain often worsens in winter and outlines treatment approaches (including shockwave) and home strategiesunpainclinic.comunpainclinic.com.
7. Unpain Clinic Blog: “The Science Behind Shockwave Therapy for Lower Back Pain: A Comprehensive Evidence Review.” (Aug 22, 2025). Summarizes research on shockwave therapy for lower back conditions, including SI-related pain – noting significant pain relief, functional improvement, and no serious adverse events across multiple studiesunpainclinic.comunpainclinic.com.
8. Muir J., McClure P. (2020). Contraindications for Shockwave Therapy. In: Physiopedia. – (Defines cases where ESWT should be avoided, such as pregnancy, coagulopathy, or local infection)pmc.ncbi.nlm.nih.gov.
