Extracorporeal shock wave therapy (ESWT) for musculoskeletal conditions

Extracorporeal shock wave therapy (ESWT) is a noninvasive treatment based on ultrasound technology. ESWT is used for a variety of conditions including treatment of kidney stones. ESWT for soft tissue injuries is applied with the goal of promoting healing. ESWT may have multiple effects thought to impact healing including breaking calcium deposits and causing an inflammatory response that may stimulate tissue healing.

Status: Decision completed

Why is ESWT being reviewed?

ESWT is increasingly being used to treat a variety of musculoskeletal conditions, the efficacy and safety of this procedure remain unclear. The objective of this report is to systematically review and critically appraise the evidence of the comparative efficacy, effectiveness, and safety of ESWT for the treatment of musculoskeletal conditions such as tendinopathies and plantar fasciitis. The differential effectiveness and safety of ESWT for subpopulations will be evaluated, as will the cost effectiveness.

Primary criteria ranking

  • Safety = High
  • Efficacy = High
  • Cost = Medium/High


Assessment timeline

  • Draft key question published: August 12, 2016
    • Public comment period: August 12 to 25, 2016
  • Final key questions published: September 20, 2016
  • Draft report published: December 29, 2016
    • Public comment period: December 30 to January 30, 2017
  • Final report published: February 16, 2017
  • HTCC public meeting: March 17, 2017