How long does shockwave therapy take to work for Achilles tendinitis?

Shockwave therapy for Achilles tendinitis usually works gradually, and improvement may develop over several weeks rather than immediately after treatment. The timing differs with the duration of the tendon problem, the severity of pain, daily activity, and how consistently the tendon is loaded during rehabilitation. Some people notice an early change in pain, while others need more time after the treatment course has finished.

Shockwaves are applied to the painful tendon area to stimulate a local healing response and influence pain sensitivity. This is different from a numbing treatment, so the tendon may remain sore after a session. A short-term flare in discomfort can occur, and a lack of immediate relief does not by itself show that the treatment has failed. Tendon tissue adapts slowly, so progress is better judged by walking tolerance, morning stiffness, stair use, and exercise capacity than by one painful day.

Follow the activity and exercise plan given by your physiotherapist. It may include carefully progressed calf and ankle strengthening, while temporarily reducing activities that sharply increase tendon pain, such as sprinting, jumping, or steep hill work. Wear supportive footwear and record how the tendon responds during the day and the following morning. Do not add extra shockwave sessions or return suddenly to sport without checking the plan. Your clinician may adjust the loading programme if pain remains elevated or function is not improving.

Contact the treating clinician if pain is steadily worsening, the treatment area becomes increasingly red or swollen, or you cannot progress ordinary walking. Seek urgent assessment after a sudden snap in the tendon, sudden loss of push-off strength, marked swelling, or difficulty standing on the affected toes; these can indicate a more serious tendon injury. Persistent symptoms also deserve reassessment because the diagnosis, exercise load, footwear, or treatment plan may need review.

Ask which changes should count as progress, how to modify running or jumping, and when strengthening should be increased. You can also ask how many treatments are planned, what soreness is expected after each session, and when the diagnosis should be reconsidered if function is not improving.