A SoftWave therapy session involves a clinician applying coupling gel to the affected area, then using a handheld applicator to deliver acoustic waves to the target tissue over roughly 15 to 20 minutes. Most patients describe the sensation as tapping or pressure that is generally tolerable, since clinicians titrate the energy to your comfort. Guidance from the ISMST and some clinics typically frame this as one visit in a course of three to five sessions spaced one to two weeks apart.
TL;DR:
- Proper protocol involves three to five sessions spaced one to two weeks apart, with 2,000 to 3,000 pulses per session for tendinopathies.
- Discomfort during treatment is expected to stay below a median pain score of 6 to 7 out of 10, with real-time energy adjustments as needed.
- Mild side effects like soreness and redness are common and temporary, but serious complications are rare when clinicians follow safety guidelines.
- Results typically start with temporary pain relief immediately after sessions, but real tissue healing occurs over several weeks to months.
- Patients should avoid NSAIDs during treatment to maximize effectiveness and are usually able to resume normal activities immediately afterward.
Table of Contents
- What Happens Step by Step During a SoftWave Appointment
- What Does SoftWave Therapy Feel Like
- How Long Does a Session Take and What Does a Full Course Look Like
- Is SoftWave Therapy Safe and What Are the Side Effects
- What to Do After Your SoftWave Session
- When Do Results Typically Show Up
- How Nowak Orthopedic Associates Delivers SoftWave Therapy
- The Real Question Isn’t Whether SoftWave Works, It’s Whether the Protocol Is Followed
- Schedule a SoftWave Consultation With Nowak Orthopedic Associates
- Sources
- FAQ
What Happens Step by Step During a SoftWave Appointment
Walking into a SoftWave session for the first time is easier when you know the sequence in advance. The visit follows a consistent pattern designed to keep treatment focused and safe.
- Screening and consent. Your clinician reviews your medical history, current medications, and any prior injections to rule out contraindications before treatment begins.
- Positioning and prep. You will be positioned comfortably on an exam table with the treatment area exposed, and a coupling gel is applied to help the acoustic waves transmit into the tissue.
- Clinical focusing. Rather than relying solely on imaging, the clinician presses on the area to find your exact pain point, a technique called clinical focusing that research suggests improves targeting of symptomatic tissue, per best-practice guidance for musculoskeletal ESWT.
- Application. The handpiece delivers a set number of pulses to each marked spot, with brief pauses so the clinician can check in on your comfort and adjust energy as needed.
- Wrap-up. Before you leave, staff document the session and walk you through activity and medication guidance for the days ahead.
The entire appointment, including the assessment and paperwork, usually runs longer than the active treatment time itself, so plan for a visit that extends beyond just the minutes the applicator is in contact with your skin.
What Does SoftWave Therapy Feel Like
Most patients describe the sensation as a rhythmic tapping, pulsing, or pressure rather than sharp pain, though intensity depends on the energy level and the tissue being treated. Deeper or denser tissue, such as tendon insertions near bone, tends to feel more intense than softer soft-tissue areas.
- Clinicians typically start at a low energy setting and increase it gradually, watching your reaction as they go, which reflects the start-low, titrate-up approach recommended in clinical best practices.
- An international Delphi panel of sports medicine experts recommends keeping discomfort during application below a median pain score of 6 out of 10 for tendon conditions and 7 out of 10 for bone-related conditions.
- Local anesthesia is usually skipped, since numbing the area would interfere with clinical focusing and may reduce the treatment’s effectiveness, though your clinician can make exceptions for particularly sensitive patients.
- Mild redness or tenderness right after application is common and typically fades within hours, but tell your clinician if you notice unusual swelling, dizziness, or a lightheaded feeling during the visit.
Pro Tip: If a spot feels too intense during treatment, say so immediately. Clinicians expect to adjust energy in real time rather than push through discomfort.
How Long Does a Session Take and What Does a Full Course Look Like
A single application to one area usually takes between 5 and 15 minutes, though a session treating multiple sites can run longer. Add time for the initial assessment and positioning, and a typical visit fits within a standard appointment slot.
- Expert consensus points to courses of a few sessions spaced one to two weeks apart for many soft-tissue conditions, according to the international Delphi study on ESWT use in sports medicine.
- Protocol research on hip and pelvis tendinopathies found many clinics use 2,000 to 3,000 pulses per session across 3 to 4 weekly visits, per a systematic review of ESWT for tendinopathies.
- Other reviews cite a recurring pattern of several sessions at roughly one-week intervals with a few thousand impulses per session for conditions like plantar fasciopathy, based on RCT data collected in the PEDro database.
- Bone-related conditions often call for higher energy levels and a schedule that differs from tendon protocols, sometimes paired with orthobiologic treatments for added support.
Your clinician sets the exact numbers for your case, since tissue type, condition severity, and your response to earlier sessions all factor into how the course is adjusted.
Is SoftWave Therapy Safe and What Are the Side Effects
SoftWave therapy is generally well tolerated, and serious complications are rare when clinicians follow established protocols, according to a review of extracorporeal shock wave therapy safety data. Still, screening matters before your first session.
- Clinicians typically screen out active infection near the treatment site, suspected malignancy in the area, pregnancy, and uncontrolled bleeding disorders before proceeding.
- Extra caution applies near the lungs, over pacemakers, and in patients on blood thinners, since the acoustic waves interact differently with these tissues and devices.
- Common, mild side effects include temporary pain at the applicator site, redness, minor bruising, or a small superficial hematoma, with a systematic review on hip and pelvis tendinopathies reporting mostly minor adverse events in a minority of cases.
- Rare reactions include brief dizziness or a vagal response, which is why staff monitor you during and immediately after treatment.
Clinics that adhere to ISMST and expert consensus guidelines train staff specifically in contact pressure, energy titration, and recognizing an adverse response early, which lowers risk considerably. A clinical summary of shockwave therapy side effects offers additional detail on what to watch for after treatment.
What to Do After Your SoftWave Session
Aftercare for most tendon conditions is light. You can usually resume normal activities the same day unless your clinician has treated a bone-related issue or given you specific restrictions.
- Avoid NSAIDs such as ibuprofen during your treatment course, since expert consensus guidance suggests they may blunt the tissue response SoftWave is meant to stimulate.
- Acetaminophen is generally considered acceptable for breakthrough pain if you need it between sessions.
- Fluoroquinolone antibiotics are discouraged during a course of treatment due to a known association with tendon rupture risk.
- Ask your clinician whether ice is appropriate for your specific bruising or soreness, since guidance varies by case and tissue type.
Many clinics schedule your next session one to two weeks out and may recommend physical therapy alongside SoftWave to reinforce the tissue’s response between visits.
Pro Tip: Keep a simple log of your pain levels between sessions. It gives your clinician real data to fine-tune your protocol instead of relying on memory alone.
When Do Results Typically Show Up
Some patients notice a temporary reduction in pain right after a session, an effect researchers attribute to short-term hyperstimulation analgesia rather than tissue healing itself. The more meaningful change, tissue remodeling, unfolds over weeks to months as the body responds to the acoustic energy.
- Many patients report noticeable improvement within several weeks of finishing a course, though full benefit can take longer to develop depending on the condition.
- A patient-focused overview of shockwave treatment timelines describes healing windows extending out to 8 to 12 weeks for active patients returning to sport or heavy activity.
- Outcomes tend to be stronger when SoftWave is combined with physical therapy, load management, or orthobiologic treatments like PRP rather than used alone.
- If pain worsens rather than improves, or you develop new numbness or weakness, contact your clinician for reassessment rather than waiting out the full course.
Learn more about the underlying mechanism behind SoftWave therapy if you want the fuller physiological picture behind these timelines.
How Nowak Orthopedic Associates Delivers SoftWave Therapy
A certain orthopedic practice is led by a board-certified orthopedic surgeon and includes a dedicated Regenerative Medicine Clinic offering SoftWave therapy alongside platelet-rich plasma injections, orthobiologic treatments, and guided stretch therapy. This approach reflects the same principles found in published ESWT guidance: careful screening, individualized planning, and clinician-directed sessions.
- SoftWave patients typically start with a review of medical history and imaging before a personalized treatment plan is built around their specific condition.
- Sessions are usually performed or directly supervised by trained clinical staff, with documentation kept at each visit to track progress across the course of treatment.
- When appropriate, SoftWave is paired with physical therapy or orthobiologic injections such as PRP to support a more complete recovery, an approach detailed further in the clinic’s explanation of SoftWave’s role in tissue healing.
- Condition-specific expectations, including timelines for knee applications, are outlined in the clinic’s guide to SoftWave therapy for chronic knee pain.
The Real Question Isn’t Whether SoftWave Works, It’s Whether the Protocol Is Followed
The evidence behind SoftWave and broader extracorporeal shockwave therapy is solid for several tendon and bone conditions, but a lot of the skepticism around it comes from inconsistent delivery, not a flawed premise. Too many patients judge the treatment after a single session, when expert consensus is clear that a course of three to five visits, properly spaced and energy-titrated, is what the evidence actually supports.
The overrated part of the conversation is the sensation itself. Patients often brace for pain that rarely materializes at the levels clinicians use, while underestimating how much the schedule and aftercare, skipping NSAIDs, pacing activity, showing up for the full course, actually determine the outcome. If you are considering SoftWave, prioritize finding a clinician who follows a structured protocol over chasing the lowest price or the fastest single-visit promise. The treatment rewards patience and consistency far more than it rewards intensity.
— Dr. Roger Nowak
Schedule a SoftWave Consultation With Nowak Orthopedic Associates
SoftWave therapy is offered as part of some Regenerative Medicine Clinics that also include PRP injections, orthobiologic treatments, and guided stretch therapy for patients dealing with joint pain, tendon injuries, and degenerative conditions. If you have been managing pain that has not responded to rest or basic conservative care, a consultation can determine whether SoftWave fits your recovery plan.
- Visit the SoftWave Therapy and regenerative services page to see the full range of non-surgical options available at the clinic.
- Some treatments may be billed through insurance, while others are handled as self-pay, so ask the front desk about payment options when you schedule.
- Physical therapy and injection-based care are also available if SoftWave is recommended alongside other rehabilitation services.
To take the next step, reach out through the contact page to set up an evaluation and find out whether SoftWave therapy is right for your condition.
This article is general information, not a substitute for advice from a qualified doctor. Consult a qualified healthcare professional about your own circumstances before acting on anything here.
Sources
- Extracorporeal shock wave therapy: an update – PMC
- Recommendations for use of extracorporeal shockwave therapy in sports medicine: an international modified Delphi study
- Extracorporeal Shockwave Therapy for Tendinopathies Around the Hip and Pelvis: A Systematic Review
FAQ
What Not to Do After SoftWave Therapy?
Avoid taking NSAIDs like ibuprofen during your treatment course, since expert consensus guidance suggests they may interfere with the tissue response the treatment aims to stimulate. It is also best to avoid fluoroquinolone antibiotics and to check with your clinician before resuming high-impact activity if you were treated for a bone-related condition.
What Is the Downside of SoftWave Therapy?
The main downsides are mild and temporary: soreness, redness, or minor bruising at the applicator site, with a systematic review reporting an adverse event rate around 12%, mostly minor. It also requires committing to multiple sessions over several weeks rather than a single quick fix.
How Long After SoftWave Do You See Results?
Some pain relief can show up right after a session, but that early effect is different from the tissue healing that develops over weeks to months. A patient-focused guide to shockwave treatment describes noticeable functional improvement extending out to 8 to 12 weeks for active patients.
How Many Days Should I Rest After Shockwave Therapy?
For most tendon conditions, extended rest is not required, and patients typically resume normal activity the same day unless a bone-related condition calls for specific restrictions. Your clinician will give you individualized guidance based on the area treated and how your tissue responded during the session.