Pressure Ulcers (Bedsores)

Common Symptoms

• An area of skin breakdown, often over a bony area such as the sacrum, heels, or hips
• Redness or discoloration that doesn't fade with pressure relief (early stage)
• An open wound that may be shallow or extend into deeper tissue (later stages)
• Pain, drainage, or odor from the affected area

Why It Happens

Sustained pressure on the skin, especially over bony prominences, cuts off local blood flow to the tissue; if the pressure isn't relieved, the tissue can break down and ulcerate — friction, shear forces, and moisture can make it worse.

Why It Can Become Persistent

Areas of pressure damage tend to have poor local blood supply to begin with, which is part of why they became damaged in the first place, and that same poor circulation slows the wound-healing process — combined with ongoing pressure exposure in people with limited mobility, these wounds can become chronic.

Who Commonly Gets It

Pressure ulcers most often affect people with limited mobility — including those who are bedbound, wheelchair users, and people recovering from spinal cord injury, stroke, or prolonged hospitalization.

How It Is Usually Diagnosed

Diagnosis is visual and clinical, based on wound location, appearance, and staging criteria that describe how deep the tissue damage extends.

Traditional Treatment Options

• Pressure redistribution and repositioning: The foundation of both prevention and treatment — specialized mattresses, cushions, and repositioning schedules.
• Wound debridement and dressing: Removing dead tissue and using appropriate dressings to support healing.
• Nutritional support: Adequate protein and overall nutrition support tissue repair.
• Surgical closure: Considered for larger or non-healing wounds in select cases.

Why Someone Might Start Looking for Another Option

For pressure ulcers that aren't healing with standard care alone, care teams are often interested in adjunct therapies that might help stalled chronic wounds progress.

Where Shockwave Therapy May Fit

A double-blind, placebo-controlled trial of 40 patients found a single session of shockwave therapy produced significant improvement in wound size and wound-bed quality scores immediately afterward compared with a sham treatment, and a small randomized cross-over trial of chronic pressure ulcers found improved healing regardless of which order patients received the real versus placebo treatment. Case reports describe complete healing of severe pressure ulcers when shockwave therapy was combined with standard wound care and rehabilitation. The controlled trial evidence here is real but still preliminary — the authors of the largest sham-controlled study describe the evidence for shockwave therapy in pressure ulcers as limited, and none of this evidence suggests skipping standard pressure-relief care.

How Shockwave Treatment Works for This Area

Shockwave therapy would only be considered as an adjunct to standard pressure-ulcer care — appropriate pressure redistribution, repositioning, wound care, and nutrition — never as a replacement for it.

What the Treatment Feels Like

Patients typically describe a tapping or pressure sensation around the wound edges; your provider will discuss what to expect based on your evaluation.

What Happens During Your First Visit

Your visit begins with a provider evaluation focused on your history and a physical exam relevant to your complaint. If shockwave therapy is determined to be clinically appropriate, your first treatment can typically be provided the same visit. See our What to Expect page for the full walkthrough.

Who May Not Be Appropriate

• Anyone not already receiving standard pressure-ulcer care (pressure redistribution, repositioning, wound management)
• Active, uncontrolled infection, which needs to be addressed first
• Wounds with exposed bone, hardware, or other complicating factors, per your provider's evaluation
• Certain circulatory, neurological, or bleeding-related conditions, per your provider's screening

This list is not exhaustive. Your provider will screen for contraindications during your evaluation.