Shockwave Therapy for
Tendinopathies & Musculoskeletal Pain
Focused shockwave therapy is a non-surgical treatment that uses externally delivered acoustic energy and may be considered for certain chronic tendon and musculoskeletal conditions. At Monarch Lifestyle Medicine, treatment decisions begin with an evaluation of the underlying condition, symptoms, medical history, and previous care — rather than assuming shockwave therapy is appropriate for every source of pain.
Focused shockwave therapy is a non-surgical treatment that uses externally delivered acoustic energy and may be considered for certain chronic tendon and musculoskeletal conditions. At Monarch, treatment decisions begin with an evaluation of the underlying condition, symptoms, medical history, and previous care.
Physician DirectedFor illustrative purposes only. Actual medication and product appearance may vary.
DUOLITH Shockwave Therapy for Tendinopathy in Rochester Hills, MI
Physician-directed regenerative therapy for musculoskeletal conditions in Metro Detroit
DUOLITH focused shockwave is an advanced regenerative therapy that uses focused acoustic energy to stimulate circulation, cellular repair, collagen production, and tissue healing deep beneath the skin. Unlike surface-level treatments, focused shockwave penetrates deeper structures to address chronic tendon pain, persistent tendinopathies, and musculoskeletal recovery limitations.
Best For
Chronic tendon pain, tendinopathy, plantar fasciitis, athletic recovery
Method
Focused acoustic wave energy delivered to target tissue
Frequency
Series of sessions spaced over several weeks
Eligibility for HSA or FSA reimbursement depends on your individual plan and medical necessity. Patients are responsible for confirming eligibility with their HSA/FSA provider. A prescription or Letter of Medical Necessity may be provided.
What Is Shockwave Therapy?
Focused extracorporeal shockwave therapy (ESWT) is a non-surgical treatment that uses externally delivered acoustic energy directed at a targeted area of tissue. The energy is delivered from outside the body — no incisions, no anesthesia, and no invasive procedure.
Shockwave therapy has been studied for certain chronic tendinopathies and may be considered when clinically appropriate. It may stimulate biological responses within treated tissue and may support the body's healing response. However, it is not a universal solution, and treatment decisions should always be based on an individual clinical evaluation.
Tendinopathies That May Be Evaluated
Conditions that may be evaluated for shockwave therapy include the following. Whether shockwave therapy is appropriate for your specific situation depends on your diagnosis and a medical assessment by a qualified provider.
Achilles Tendinopathy
Pain or stiffness in the Achilles tendon at the back of the heel, often related to running or repetitive loading.
Patellar Tendinopathy
Pain at the front of the knee, sometimes called jumper's knee, associated with repetitive jumping or running.
Lateral Epicondylitis (Tennis Elbow)
Pain on the outer elbow where forearm tendons attach, commonly linked to repetitive gripping or wrist extension.
Plantar Fasciitis / Plantar Heel Pain
Pain in the bottom of the heel or arch of the foot, often most noticeable with the first steps of the day.
Rotator Cuff Calcific Tendinopathy
Shoulder pain associated with calcium deposits within rotator cuff tendons, which may limit overhead movement.
Proximal Hamstring Tendinopathy
Pain deep in the buttock or upper hamstring, often aggravated by running, sitting, or stretching.
This list is not exhaustive. Other persistent tendon-related conditions may also be evaluated when clinically appropriate. Listing a condition here does not guarantee that Monarch treats it — candidacy is determined through consultation.
Why Tendon Pain Can Become Persistent
Chronic tendon symptoms can involve more than simply "inflammation." Persistent tendon pain may be influenced by a combination of factors, and understanding these factors is an important part of determining the most appropriate approach to care.
This information is for educational purposes and does not constitute a diagnosis. Only a qualified medical provider can evaluate your specific symptoms and condition.
How Shockwave Therapy Works
Treatment begins with an evaluation by a medical provider to determine whether focused shockwave therapy is appropriate for your condition. This includes a review of your symptoms, medical history, previous treatments, and activity demands.
During a treatment session, a handheld applicator is positioned over the targeted treatment area. Externally delivered acoustic energy is directed at the specific tendon or musculoskeletal structure being addressed. Treatment intensity is determined clinically based on the condition and individual tolerance.
Treatment sessions are typically short and performed in-office. The number and frequency of sessions vary according to the condition and individual clinical assessment — there is no fixed protocol that applies to everyone. Your provider will recommend a plan based on your specific situation.
Follow-up and reassessment are an important part of the process. Your provider will monitor your response to treatment and determine whether any adjustments to your care plan are needed.
The Monarch Approach to Musculoskeletal Shockwave Therapy
At Monarch, shockwave therapy is not approached as a stand-alone solution for every injury. Our medical team evaluates the condition, treatment history, activity demands, and individual goals before determining whether focused shockwave therapy may have a role within a broader care plan.
Clinical Evaluation
A medical provider reviews your symptoms, medical history, and activity demands to understand the full clinical picture.
Review of Treatment History
We assess what conservative approaches you have already tried — such as rest, physical therapy, or medications — and how your symptoms responded.
Identification of the Affected Area
The specific tendon or musculoskeletal structure causing symptoms is identified through clinical evaluation.
Determination of Appropriateness
Your provider determines whether focused shockwave therapy may have a role within a broader care plan for your specific condition.
Individualized Treatment Plan
If shockwave therapy is appropriate, a treatment plan is developed tailored to your condition, goals, and activity level.
Reassessment of Progress
Follow-up evaluations help assess your response to treatment and determine whether adjustments to your care plan are needed.
What Treatment Feels Like
During treatment, patients may feel repetitive pulses or pressure over the treatment area as the acoustic energy is delivered to the targeted tissue. Tolerance varies from person to person — some areas of the body may be more sensitive than others. Your provider can adjust treatment intensity based on your comfort and clinical needs. The experience is generally described as tolerable, but individual responses vary.
Who May Be a Candidate?
People with certain persistent tendon-related symptoms that have not adequately improved with other conservative approaches may be evaluated for focused shockwave therapy. Candidacy depends on the diagnosis and a medical assessment by a qualified provider.
If you have been dealing with chronic tendon pain that has not responded to rest, activity modification, physical therapy, or other conservative measures, a consultation can help determine whether shockwave therapy may have a role in your care.
This page does not encourage self-diagnosis. Only a qualified medical provider can evaluate your symptoms and determine appropriate treatment.
When Shockwave Therapy May Not Be Appropriate
Shockwave therapy is not appropriate for everyone. A number of clinical considerations may affect whether it is suitable for you, including:
- Medical history and current health conditions
- Medications you are currently taking
- Location of the intended treatment area
- Underlying conditions affecting tissue healing
- Pregnancy status, when applicable
- Other clinical considerations identified during evaluation
Your provider will review these factors during your evaluation. This is not an exhaustive list of contraindications.
Shockwave Therapy vs. Other Approaches
Management of tendinopathy may include multiple strategies depending on the diagnosis. Shockwave therapy is one option that may be considered alongside or after other approaches — it is not inherently superior to all alternatives. A comprehensive care plan may incorporate several of the following:
Your provider can help you understand which combination of strategies may be most appropriate for your condition and goals.
Why Evaluation Matters
Pain in a tendon region does not automatically mean tendinopathy. Other conditions — such as nerve entrapment, referred pain, joint pathology, stress fractures, or systemic conditions — can produce similar symptoms. Appropriate diagnosis matters before treatment begins.
This is why Monarch's approach is physician-guided and medical-provider-guided. Treatment decisions are based on a clinical evaluation rather than assumptions. Our medical team takes the time to understand what is actually causing your symptoms before recommending any therapy.
Monarch also uses shockwave technology within certain sexual wellness evaluations. That application is addressed separately on our shockwave therapy for erectile dysfunction page. The treatment discussed on this page is focused on musculoskeletal and tendinopathy applications only.
Frequently Asked Questions
Medical Review
This page was reviewed by the medical team at Monarch Lifestyle Medicine. Content is intended for educational purposes and does not constitute individualized medical advice.
Medical References
The following sources provide authoritative information on extracorporeal shockwave therapy and tendinopathy. These references are provided for educational purposes.
Systematic review of extracorporeal shockwave therapy for tendinopathy
PubMed — National Library of Medicine (NCBI) →Clinical practice guidelines for tendinopathy management
American Academy of Orthopaedic Surgeons (AAOS) →Focused extracorporeal shock wave therapy for musculoskeletal conditions
PubMed — National Library of Medicine (NCBI) →ESWT for plantar fasciitis: systematic review and meta-analysis
PubMed — National Library of Medicine (NCBI) →
These links point to searchable databases and professional organizations. Monarch Lifestyle Medicine does not control the content of external sites. Always consult a qualified medical provider for diagnosis and treatment.
Schedule a consultation at Monarch Lifestyle Medicine in Rochester Hills to discuss whether focused shockwave therapy may be appropriate for your condition.
For illustrative purposes only. Actual medication and product appearance may vary.