What if shockwave therapy does not relieve shoulder pain?

Shockwave therapy is directed at selected tissues, while shoulder pain can involve a tendon, bursa, joint, neck or nerve. Reaching overhead, repetitive work, sleeping on the painful side or a sudden increase in activity may continue to irritate the area. Stiffness, weakness, clicking, tingling and pain spreading below the elbow provide different clues. A fresh examination can distinguish a local shoulder problem from referred symptoms and decide whether imaging or another evaluation is useful.

Record the painful movements, night symptoms, range of motion and any tingling or weakness before your appointment. Reduce provocative overhead or lifting tasks without stopping all shoulder movement. Follow the prescribed mobility and strengthening programme, and do not add sessions or exercises without checking the plan. The clinician may change the load, address stiffness, evaluate the neck, or recommend a different treatment. See Shoulder Pain and Shockwave Therapy for related information.

Seek urgent assessment for shoulder pain after a major injury, a visibly deformed shoulder, sudden inability to lift the arm, a hot swollen joint with fever, or new loss of feeling or colour in the hand. Chest pressure, breathlessness, sweating or pain spreading to the jaw or arm requires emergency help rather than a routine shoulder review.

Ask which structure is causing the symptoms, whether the treatment target remains appropriate, which activities need modification, and whether a scan or neck assessment would change care. Ask what improvement should look like and when you should return if it does not occur.