MEDISPA.PRO
Ministry of Health code: A22.30.015 Axis M4 · Musculoskeletal system and kinesiotherapy CEBM: Level A (Device-based physiotherapy and revitalisation)

Extracorporeal shock wave therapy (ESWT)

Extracorporeal Shockwave Therapy (ESWT)

Industry clinical and economic procedure passport. Full biological mechanism (MoA), patient preparation protocol, first-choice equipment fleet, integration into the resort's master treatment rooms and market price benchmarks.

To the procedure catalogue Equipment fleet Integration treatment rooms Rates and economics
Session duration
20 min
Turnover: ~35 min
Recommended course
5 sessions
5 treatments – an assumption for the economic calculation; the course is prescribed by a physician
Throughput capacity
14 pts
per 8-hour shift
Median rate
5 250 ₽
4 050 ₽ – 6 750 ₽
Course cost
26 250 ₽
at market median
Publication volume
Level A
9 publ. in PubMed

Clinical profile

Application of acoustic shock waves to tendons and fasciae. Plantar fasciitis is the best studied, with a large effect on pain and function according to high-quality evidence; there is evidence in calcific tendinopathy of the shoulder and lateral epicondylitis. In patellar and Achilles tendinopathy the results are so far modest.

Every statement links to a publication in the list below. This is a snapshot of published research, not a final assessment of the method: international practice and integrated protocols often run ahead of official publications. Draft based on published research; requires review by a physician. Revision: 2026-10-17.

Where studies show an effect

  • Plantar fasciitis: large effect on pain and function (high-quality evidence); in the medium and long term, the only method with an effect versus control. [1, 2]
  • Calcific rotator cuff tendinopathy: better than sham for pain and function at 24 weeks. [4]
  • Insertional Achilles tendinopathy: evidence in favour of ESWT or its combination with eccentric exercise. [8]
  • Lateral epicondylitis: reduced pain and improved grip strength. [6]

Open questions and study limitations

  • Patellar and Achilles tendinopathies: in a 2023 meta-analysis the effect on pain and function was small. [1]
  • Lateral epicondylitis: review conclusions differ; a 2023 umbrella review rated injection methods higher. [7]
  • Calcific tendinopathy: ultrasound-guided needle lavage reduced pain better than ESWT. [4]
  • Non-calcific rotator cuff tendinopathy: evidence is limited. [5]

Safety

  • In sports medicine ESWT is used without serious adverse events. [9]
  • Tolerability and adherence to treatment depend on the exposure parameters. [3]

Protocol in studies

  • In calcific tendinopathy, high-energy ESWT is more effective than low-energy; no differences were found between focused and radial. [4]
Contraindications. Contraindications are determined by the physician according to the equipment or drug instructions; they are not given in study abstracts.

Equipment fleet and fit-out

Certified first-choice medical equipment and compatible device systems

Equipment registry
Base configuration (Hero Device)
Shockwave therapy device

Device platform with proven validation of the biological response. Includes built-in biofeedback sensor systems, patient protection protocols and precision dosing of exposure.

Certification: Russian Ministry of Health registration certificate / CE Medical Device Directive Class IIa/IIb.
Compatible platforms in the MEDISPA.PRO registry
BTL-6000 FSWT shockwave therapy unit
Medical device, Roszdravnadzor registration certificate / CE
In the registry →
BTL-6000 FSWT3 shockwave therapy device
Medical device, Roszdravnadzor registration certificate / CE
In the registry →
Zimmer Z-Wave
Medical device, Roszdravnadzor registration certificate / CE
In the registry →

Architectural integration and treatment rooms

Resort rooms housing the treatment station (with SanPiN norms and MEP loads)

All treatment rooms →
1.1.3 30.0 m² · Class V

Orthopaedic trauma surgeon's room with treatment room

Physicians' consulting and examination rooms · Equipment: 5 681 450 ₽

Treatment room passport →
1.1.5 45.0 m² · Class V

Urologist consulting room with treatment room

Physicians' consulting and examination rooms · Equipment: 8 262 112 ₽

Treatment room passport →
1.1.19 20.0 m² · Class V

General physiotherapy room

Physicians' consulting and examination rooms · Equipment: 258 000 ₽

Treatment room passport →
1.1.6 20.0 m² · Class V

Urological physiotherapy room

Physicians' consulting and examination rooms · Equipment: 2 183 100 ₽

Treatment room passport →
HMI.SHOC.04 14.0 m² · Class V

Shock wave therapy room (ESWT)

International flagship high-tech modalities · Equipment: 3 100 000 ₽

Treatment room passport →

Unit economics and resort price benchmarks

Market analysis based on a sample of premium sanatoriums, wellness hotels and preventive medicine clinics

Market price corridor
25th percentile (P25) 4 050 ₽
Market median 5 250 ₽
75th percentile (P75) 6 750 ₽

Median of prices in industry facilities' price lists, 2026

Basis of the price benchmark

Prices for this procedure appear in the price lists of 6 industry facilities; the median and interquartile range across facilities are shown (each facility counts once).

Evidence base

In plantar fasciitis there is high-quality evidence of a large effect; in other tendinopathies the results are mixed.

Publication level A · Plenty of data
  1. 1.
    The effectiveness of shockwave therapy on patellar tendinopathy, Achilles tendinopathy, and plantar fasciitis: a systematic review and meta-analysis.
    Front Immunol, 2023 · Systematic review and meta-analysis · PMID 37662911
    Plantar fasciitis: large effect (high quality); patellar and Achilles tendinopathies: small.
  2. 2.
    Effects of therapeutic interventions on pain due to plantar fasciitis: A systematic review and meta-analysis.
    Clin Rehabil, 2023 · Systematic review and meta-analysis · PMID 36571559
    Plantar fasciitis: in the medium and long term only ESWT reduced pain.
  3. 3.
    Efficacy and tolerability of extracorporeal shock wave therapy in patients with plantar fasciopathy: a systematic review with meta-analysis and meta-regression.
    Eur J Phys Rehabil Med, 2024 · Systematic review, meta-analysis and meta-regression · PMID 39257331
    Plantar fasciitis: ESWT is effective and well tolerated; parameters affect the outcome.
  4. 4.
    The effectiveness of extracorporeal shock wave therapy for rotator cuff calcific tendinopathy. A systematic review with meta-analysis.
    Physiother Res Int, 2024 · Systematic review and meta-analysis · PMID 38878302
    Calcific tendinopathy of the shoulder: ESWT is better than sham; high energy is better than low; needle lavage is more effective.
  5. 5.
    Effect of extracorporeal shockwave therapy for rotator cuff tendinopathy: a systematic review and meta-analysis.
    BMC Musculoskelet Disord, 2024 · Systematic review and meta-analysis · PMID 38704572
    Rotator cuff tendinopathy: limited evidence of better pain relief.
  6. 6.
    Efficacy of Extracorporeal Shock Wave Therapy for Lateral Epicondylitis: A Systematic Review and Meta-Analysis.
    Biomed Res Int, 2020 · Systematic review and meta-analysis · PMID 32309425
    Lateral epicondylitis: reduced pain and improved grip strength; study quality is limited.
  7. 7.
    Treatment Options for Tennis Elbow - An Umbrella Review.
    Folia Med Cracov, 2023 · Umbrella review · PMID 38310528
    Lateral epicondylitis: an umbrella review rated autologous blood and PRP injections above shock wave therapy.
  8. 8.
    Nonoperative treatment of insertional Achilles tendinopathy: a systematic review.
    J Orthop Surg Res, 2021 · Systematic review · PMID 33785026
    Insertional Achilles tendinopathy: evidence in favour of ESWT or ESWT with eccentric exercise.
  9. 9.
    Use of extracorporeal shockwave therapies for athletes and physically active individuals: a systematic review.
    Br J Sports Med, 2024 · Systematic review · PMID 38228375
    Sports injuries: ESWT may be effective alone or with exercise, without serious adverse events.

Publications were found in PubMed; titles and journals are given verbatim, conclusions are a brief summary of the abstracts under the conditions of the specific studies. The level shows the volume of published data, not the value of the method: A — Plenty of data: consistent systematic reviews and meta-analyses of RCTs; B — Some data: reviews or several RCTs, results are heterogeneous; C — Little data: single RCTs or controlled studies; D — Scarce data: mainly reviews, observational and experimental studies. The passport is updated as new work is published and with regard to international practice.