Extracorporeal Shockwave Therapy (ESWT)
Extracorporeal Shockwave Therapy (ESWT) is a treatment option for pain to the outside of the hip, also known as greater trochanteric pain syndrome (GTPS).
What is Extracorporeal Shockwave Therapy (ESWT)?
Radial Extracorporeal Shockwave Therapy (ESWT) is a safe, non-invasive and effective treatment used for persistent lateral hip pain, particularly when standard physiotherapy alone has not provided sufficient improvement.
ESWT delivers low-energy sound waves to the painful area to help reduce pain, improve function, and stimulate the body’s natural healing processes. Clinical evidence suggests that around five to seven out of ten patients experience meaningful improvement in symptoms, especially when ESWT is combined with a structured rehabilitation and exercise programme.
How does ESWT work?
ESWT help increase local blood flow, improve tissue metabolism, and reduce nerve sensitivity associated with long-standing pain. It is thought to trigger a controlled healing response in the treated area, reducing pain
What does treatment involve?
Before starting ESWT, you will be assessed to confirm that the treatment is suitable for you. If appropriate, you will be asked to complete a consent form.
• Each session lasts approximately five minutes
• You may be sitting or lying depending on the area being treated
• A gel is applied to the skin
• Shockwaves are delivered through the skin using a handheld probe
ESWT is non-invasive and does not involve injections or surgery. Some discomfort during treatment is common but usually manageable.
What can you expect after treatment?
Some people notice pain relief immediately, while others improve gradually over several weeks.
It is not uncommon to experience soreness for one to two days after treatment. You may continue normal daily activities, but should avoid strenuous or pain-provoking for 48 hours. Your physiotherapist will provide individual guidance.
Managing discomfort after ESWT
If required, you may use simple pain relief such as paracetamol, unless advised otherwise by your doctor.
Please avoid ice application to the treated area and avoid anti-inflammatory medication such as ibuprofen or naproxen, as these may interfere with the healing response of ESWT.
Possible side effects
ESWT is generally well tolerated. Temporary side effects may include local discomfort, bruising, swelling, skin redness, or altered sensation. These effects usually settle within a few days.
Serious complications such as tendon or ligament injury are uncommon.
Who should not have ESWT?
ESWT is not suitable for everyone. You will not be offered ESWT if you are pregnant, under 18 years of age, have had a recent steroid injection to the area, have bleeding or clotting disorders, a pacemaker or powered implant, or have cancer, infection, or acute inflammation at the treatment site.
Your clinician will discuss suitability fully before treatment.
Giving consent and stopping treatment
Your clinician will explain the expected benefits, possible risks, and alternative treatments. If you decide to proceed, you will be asked to sign a consent form.
You may stop treatment at any time, although completing the recommended course is advised, as benefits may build over repeated sessions. You should discuss any concerns with your treating clinician.
Further information
Extracorporeal shockwave therapy for refractory greater trochanteric pain syndrome - www.nice.org.uk/guidance/ipg376