Terapia por ondas de choque
Revisado por Dr Krishna Vakharia, MRCGPAutoria de Dr Colin Tidy, MRCGPPublicado originalmente 23 Ago 2023
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Shockwave therapy is mainly used for treating soft tissue problems, especially tendon injuries, and inflammation of tissues lying deep under the skin (fasciitis).
Em resumo
Shockwave therapy uses high energy sound waves to help healing by increasing blood flow.
It is usually offered when other treatments have not been effective.
A course of treatment typically involves weekly sessions, lasting about 10 minutes each.
It can be used for conditions like plantar fasciitis, patellar tendinitis, and Achilles tendinopathy.
Side effects can include bruising, pain, and swelling, which should resolve within a week.
Shockwave therapy should be avoided by pregnant people or those with certain medical conditions.
O que é terapia por ondas de choque?
Shockwave therapy uses high energy sound waves, which pass through the skin to the affected area, increasing the blood flow to help accelerate the healing process.
Shockwave therapy, also called extracorporeal shockwave therapy (ESWT), is a treatment usually offered when symptoms have not responded to other treatments, such as physiotherapy, modifying daily activities, pain relief, and steroid injections.
A course of treatment normally requires one treatment session each week and treatment sessions should not be more than 2 weeks apart. The number of sessions will depend on the underlying problem and the progress made with treatment. Shockwave therapy is best used as part of a rehabilitation programme, including advice on activities and exercises, and other interventions that may be needed such as medicines for pain relief.
The National Institute for Health and Care Excellence (NICE) recommends that there are no major safety concerns but the evidence whether shockwave therapy is an effective treatment is limited in quality and quantity, and therefore does not recommend it as an evidence based therapy to be used as a routine treatment. Therefore the potential benefits of shockwave therapy need to be carefully considered for each person before treatment begins.
Although shockwave therapy is generally safe, it should be avoided for some people including those who:
Are pregnant, or trying to conceive.
Have received a steroid injection into the area to be treated within the previous 12 weeks.
Have any increased risk of bleeding (haemorrhage), such as haemophilia.
Have a heart pacemaker, any other heart device, or any unstable heart condition.
Have a fracture, tumour or infection at the site of treatment.
Currently have a thrombosis.
Have epilepsy.
Are taking certain type of antibiotics called fluoroquinolone antibiotics eg, ciprofloxacin.
Have fragile bones, eg, osteogenesis Imperfecta.
Have increased sensitivity or decreased sensation over the area to be treated.
What is shockwave therapy used for?
Shockwave therapy can be effective for a wide range of problems, such as:
Is shockwave therapy painful?
Each shockwave treatment takes around 10 minutes. A gel is applied to the skin over the area to be treated, and the shockwave therapy will then be delivered through a handheld probe. When the therapy is happening, you may feel a little discomfort, but it is not painful.
Shockwave therapy side-effects
Potential side effects at the treated area include:
Hematomas.
Dor.
Local swelling.
Skin reddening.
Numbness or altered sensation.
These side effects should resolve within a week after the treatment. There is also a small risk of tendon rupture (such as rupture of the Achilles tendon) or ligament rupture and damage to the soft tissue.
Escolhas do paciente para Terapia

Cuidado dos pés
Fascite plantar
Dor no calcanhar e no pé são muito comuns. Uma causa comum é a fasciite plantar, que causa dor sob o calcanhar. Geralmente desaparece com o tempo, mas vários tratamentos podem ajudar.
por Dr. Surangi Mendis, MRCGP

Cuidado dos pés
Tendinopatia de Aquiles
A tendinopatia de Aquiles é uma condição que causa dor, inchaço e rigidez do tendão de Aquiles que liga o osso do calcanhar aos músculos da panturrilha. Acredita-se que seja causada por pequenas lesões repetidas no tendão de Aquiles. Estas podem ocorrer por várias razões, incluindo o uso excessivo do tendão - por exemplo, em corredores. O tratamento inclui repouso, compressas de gelo, analgésicos e exercícios especiais para ajudar a alongar e fortalecer o tendão de Aquiles. Para a maioria das pessoas, os sintomas da tendinopatia de Aquiles geralmente desaparecem dentro de 3-6 meses após o início do tratamento.
por Dr. Doug McKechnie, MRCGP
Perguntas frequentes
How long does a typical course of shockwave therapy last?
A course of treatment normally involves one session each week. The total number of sessions needed can vary depending on the specific problem being treated and how well the treatment is progressing.
What should I do after a shockwave therapy session?
Shockwave therapy works best when it's part of a wider rehabilitation plan. This includes advice on activities, specific exercises, and potentially other treatments like pain relief medication if needed. Following these recommendations will help maximise the benefits of the therapy.
How soon after a steroid injection can I have shockwave therapy?
You should not have shockwave therapy if you have received a steroid injection into the area that needs treatment within the previous 12 weeks.
Are there any medicines that prevent me from having shockwave therapy?
Yes, if you are currently taking certain types of antibiotics called fluoroquinolone antibiotics, such as ciprofloxacin, shockwave therapy should be avoided.
How quickly do side effects from shockwave therapy usually disappear?
Any potential side effects at the treated area, such as bruising, pain, swelling, skin reddening, numbness, or altered sensation, should typically resolve within one week after the treatment.
Leitura adicional e referências
- Terapia por ondas de choque extracorpóreas para tendinopatia de Aquiles; Orientação sobre Procedimentos Intervencionistas do NICE, dezembro de 2016
- Wang CJ; Extracorporeal shockwave therapy in musculoskeletal disorders. J Orthop Surg Res. 2012 Mar 20;7:11. doi: 10.1186/1749-799X-7-11.
- Burton I; Combined extracorporeal shockwave therapy and exercise for the treatment of tendinopathy: A narrative review. Sports Med Health Sci. 2021 Nov 11;4(1):8-17. doi: 10.1016/j.smhs.2021.11.002. eCollection 2022 Mar.
- Al-Siyabi Z, Karam M, Al-Hajri E, et al; Extracorporeal Shockwave Therapy Versus Ultrasound Therapy for Plantar Fasciitis: A Systematic Review and Meta-Analysis. Cureus. 2022 Jan 2;14(1):e20871. doi: 10.7759/cureus.20871. eCollection 2022 Jan.
- Smallcomb M, Khandare S, Vidt ME, et al; Therapeutic Ultrasound and Shockwave Therapy for Tendinopathy: A Narrative Review. Am J Phys Med Rehabil. 2022 Aug 1;101(8):801-807. doi: 10.1097/PHM.0000000000001894. Epub 2021 Oct 4.
Sobre o autorVer biografia completa

Dr Colin Tidy, MRCGP
Médico Generalista, Autor Médico
MBBS, MRCGP, MRCP (Paediatrics), DCH
Dr Colin Tidy é um médico do NHS, baseado em Oxfordshire.
Sobre o revisorVer biografia completa

Dr Krishna Vakharia, MRCGP
Diretor Médico de Saúde, Optum UK
MBChB, MRCGP(2013), BMedSci (hons), DFSRH, DRCOG, PGDipDerm (Distn)
Dr. Krishna Vakharia é uma médica de clínica geral do NHS. Ela também é examinadora regular do Diploma de Pós-Graduação em Dermatologia Prática na Universidade de Cardiff, além de ser a Diretora Médica de Saúde na Optum UK.
Histórico do artigo
As informações nesta página são escritas e revisadas por clínicos qualificados.
Artigo também disponível em Inglês, Alemão, Espanhol, Francês, Italiano, Português, Hindi, Hebraico, Árabe, e Sueco.
Próxima revisão prevista: 21 Ago 2028
23 Ago 2023 | Publicado originalmente
Escrito por:
Dr Colin Tidy, MRCGPRevisado por
Dr Krishna Vakharia, MRCGP

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