Can shockwave therapy help me avoid a cortisone shot?

Often, yes. In our clinical experience, the large majority of tendinopathy patients who come to us before having a cortisone injection are able to avoid one. Shockwave aims to help the tendon heal rather than just mask pain. It isn't guaranteed, and we'll give you an honest assessment at your evaluation.

How many shockwave sessions will I need?

It varies by condition and how long it's been there. Many patients complete a course over several weekly sessions; we reassess as we go and stop when you've got the result you came for.

Does shockwave therapy hurt?

Most patients tolerate it well. You'll feel the pulses and some tenderness during treatment, which we adjust to your comfort. Any soreness afterward is usually mild and short-lived.

Is shockwave therapy FDA-approved?

ESWT is FDA-cleared for chronic plantar fasciitis and is widely used for other tendinopathies such as Achilles and elbow tendon pain. We'll explain how the evidence applies to your specific condition.

Shockwave vs. PRP — which is better?

Both aim to promote healing rather than just mask pain. Shockwave is non-invasive (no injection) and done in a series of sessions; PRP is injection-based and often costlier. The better choice depends on your tendon and goals, which we'll talk through.

Is shockwave covered by insurance?

Coverage varies and ESWT is sometimes an out-of-pocket service. We'll go over the cost and your options up front — no surprises.

Do I need a referral?

No. New Jersey allows direct access to physical therapy, so you can book an evaluation with Dr. Letizia directly.

Medically reviewed by Dr. Rob Letizia, PT, DPT — owner, Spectrum Therapeutics of NJ. Last reviewed 2026-06-17.

Shockwave Therapy vs. Cortisone for Stubborn Tendon Pain in Wayne, NJ

The short version:

We've treated tendon and fascia pain — plantar fasciitis, Achilles tendinopathy, tennis and golfer's elbow, and more — in Wayne for over a decade and hundreds of patients.
Extracorporeal shockwave therapy (ESWT) has become our go-to for stubborn cases that haven't responded to rest, stretching, and standard rehab.
In our clinical experience, roughly 8 in 10 appropriate shockwave candidates achieve major relief — on the order of an 80%+ reduction in pain.
Patients who come to us before getting a cortisone injection are, in the large majority of cases, able to avoid one altogether.
These are real-world, clinician-reported outcomes — see "How we measure this" below.

The cortisone question

For chronic tendon pain, a cortisone shot is still the common next step. But the evidence on steroid injections for tendinopathy has grown more cautious: they can calm pain in the short term while doing little for — and sometimes weakening — the underlying tendon, and the benefit often fades over the following months. That has pushed many patients, and the physicians who refer to us, to look for something that helps the tendon heal rather than just quiet it down.

What shockwave therapy actually is

Extracorporeal shockwave therapy (ESWT) delivers focused acoustic pulses into an injured tendon or fascia. Rather than masking pain, the pulses provoke a controlled healing response — stimulating blood flow and the body's own tissue-repair processes in a structure that's notoriously slow to heal on its own. It's non-surgical, needs no injection or anesthesia, and is performed right in our Wayne office. (ESWT is FDA-cleared for chronic plantar fasciitis and is widely used for other tendinopathies.)

The conditions we treat with it

Plantar fasciitis and chronic heel pain — the classic, most-studied use.
Achilles tendinopathy — both mid-tendon and insertional.
Tennis and golfer's elbow (lateral and medial epicondylitis).
Patellar tendinopathy ("jumper's knee"), gluteal and hip tendinopathy, and other stubborn enthesopathies.

These are conditions we've treated for more than a decade — shockwave is simply the newer, healing-focused tool we've added for the cases that used to get stuck.

Shockwave vs. cortisone vs. PRP vs. surgery

Every option has a place; the right one depends on your tendon, your timeline, and what you've already tried:

Cortisone — fast short-term pain relief, but limited (and possibly negative) effect on tendon healing; best reserved rather than repeated.
Shockwave — targets the underlying tendon over a series of sessions; no injection, minimal downtime; our go-to for chronic tendinopathy.
PRP and regenerative injections — another healing-focused route, injection-based and often more costly.
Surgery — effective for the right cases, but the highest-risk, longest-recovery path; usually a last resort.

For many chronic tendon problems, shockwave is a reasonable step to try before injections or surgery — which is exactly why "have you tried shockwave?" is worth asking.

What a session is like

A typical course runs a handful of weekly sessions. You'll feel the pulses and some tenderness during treatment, which we dial to your comfort; most people describe mild, short-lived soreness afterward and get back to normal activity the same day. We reassess as we go and stop when you've got the result you came for.

What we see

In our clinical experience, roughly 8 in 10 appropriate candidates get major relief — on the order of an 80%+ improvement in pain — and most patients who haven't already had a cortisone shot are able to avoid one. Results depend on the specific condition, how long it has been present, and how closely a patient follows the plan. Shockwave isn't right for every case, and we'll tell you plainly when it isn't a fit.

Who's a candidate — and who isn't

Shockwave tends to help most when conservative care has plateaued and the problem is a true, chronic tendinopathy. It isn't appropriate for acute injuries, certain medical conditions, or every ache, and there are specific contraindications we screen for. A one-on-one evaluation always comes first.

How we measure this

These figures reflect Dr. Letizia's first-hand clinical experience across our practice — patient-reported pain improvement over a course of care — not a controlled research trial. We're sharing what we consistently see, described plainly so you know exactly what it is. We're also building structured outcome tracking so we can put hard, audited numbers behind it.

About Dr. Letizia

Dr. Rob Letizia, PT, DPT, owns and personally treats every patient at Spectrum Therapeutics of NJ in Wayne — a one-on-one orthopedic, sports, and vestibular practice. He brings 25+ years of clinical experience, fellowship training in manual therapy, and more than 300,000 completed patient visits.

Considering shockwave for stubborn tendon pain? Call (973) 689-7123 or book an evaluation — no referral needed in New Jersey.