Shockwave Therapy vs. Cortisone Injections

What Each Treatment Is Intended to Do

Cortisone (corticosteroid) injections deliver an anti-inflammatory medication directly to the painful area, aiming to reduce inflammation and pain relatively quickly. Shockwave therapy delivers acoustic pressure waves to stimulate a biological response in the tissue, without medication or needles, generally aiming for improvement over a course of several sessions.

Invasiveness

Cortisone injections involve a needle and medication. Shockwave therapy does not involve needles or medication as part of treatment.

Speed of Relief

Corticosteroid injections can provide faster short-term relief for some patients and conditions. Shockwave therapy's benefit typically develops over a course of sessions and can continue to improve for weeks afterward in some tendon conditions.

What the Evidence Shows

Evidence comparing the two varies by condition. For example, a 2024 systematic review with meta-analysis comparing shockwave therapy to corticosteroid injection for chronic lateral epicondylitis (tennis elbow) found different tradeoffs between the two approaches at different follow-up points — see our Tennis Elbow page and Research Center for the specific study and its limitations. Evidence for other conditions may show different patterns; we don't generalize a single conclusion across every diagnosis.

Repeated Use Considerations

Some research suggests repeated corticosteroid injections in certain tendons may carry their own considerations over time, which your provider can discuss. Shockwave therapy protocols in the research literature typically involve a defined, limited course of sessions.

The Honest Takeaway

These are not simply "old way vs. new way." Both have a role in musculoskeletal care, and some patients reasonably use one, the other, or — in some clinical situations — both at different points in their care. The right approach depends on the underlying condition and an individualized medical evaluation, not a blanket rule.