If you have been suffering from chronic tendon pain that has not responded to other conservative treatments, shockwave therapy may be an option for you. Extracorporeal shock wave therapy (ESWT) is a non-surgical and non-invasive treatment option for treating various musculoskeletal conditions such as subacute and chronic achilles tendinitis and heel pain (plantar fasciitis). A wand is used to deliver small waves of energy focused on the area of pain to help promote healing, increase collagen formation, break down calcifications, disperse substance P (which mediates pain) and improve blood flow to the area to encourage the body to heal itself. The treatment is done in the office, there is generally minimal discomfort and no down time (as is required after surgery). Generally multiple treatments are needed depending on response to the treatments. The effects of each of the treatments are cumulative and many patients experience some relief as soon as after the first treatment. In the right type of patients, it can help reduce pain significantly, return to work sooner and possibly even avoid the need for surgery. If conservative treatments such as stretching, physical therapy, cortisone injections, orthotics and immobilization have failed to provide relief of pain, ESWT may be considered in conjunction with the other treatments and prior to any surgical treatments.