Shockwave Therapy vs. Cortisone Injections for Pain in Jacksonville
Shockwave therapy and cortisone injections address pain through completely different mechanisms. Cortisone suppresses inflammation temporarily. Shockwave restarts the healing process in tissue that has stopped repairing itself. For chronic tendon and soft tissue conditions, those are not equivalent options.
A patient came to us after his third cortisone injection for plantar fasciitis in 18 months. The first injection gave him six weeks of relief. The second gave him three weeks. The third barely made a difference. His orthopedist had told him more injections were not advisable and that surgery was the next step. He found us through a friend who had used shockwave for an Achilles problem. After five sessions with the StemWave device, the morning heel pain that had defined his mornings for a year and a half was gone. The tissue had repaired. Cortisone had been managing his symptoms. Shockwave changed the underlying condition.
How Cortisone Injections Work
Cortisone is a corticosteroid that suppresses the inflammatory response at the injection site. For acute inflammatory conditions, that suppression can be clinically useful. It reduces swelling, decreases pain, and allows a window of lower-pain function during which rehabilitation can occur. The effect is temporary because cortisone does not repair damaged tissue. It silences the body's response to the damage. Once the cortisone clears, if the underlying tissue problem has not been addressed, the pain returns. Repeated cortisone injections into the same tendon carry documented risks of further tissue weakening over time.
How Shockwave Therapy Works
Shockwave therapy delivers focused acoustic pressure waves into chronically damaged tissue, triggering a biological repair response at the cellular level. The waves stimulate fibroblast activity, promote collagen synthesis, increase local blood flow in poorly vascularized tissue, and break down calcific deposits when present. The result is actual tissue repair rather than symptom suppression. This is why shockwave produces durable outcomes in tendinopathy while repeated cortisone injections often produce diminishing returns.
Which Conditions Respond Better to Shockwave
Chronic tendinopathy is the category where shockwave most clearly outperforms cortisone. Plantar fasciitis that has been present for more than three months, patellar tendonitis, calcific shoulder tendinitis, Achilles tendinopathy, lateral epicondylitis, and chronic paraspinal conditions all respond well to shockwave therapy. These are conditions where the tissue has entered a non-healing state. Cortisone reduces the symptoms of that state. Shockwave reverses the state itself.
For acute inflammatory conditions, cortisone can still have a role. A fresh bursitis or an acute flare of inflammatory arthritis is a different situation from a chronic tendinosis. Dr. Muren reviews your history and clinical presentation before recommending shockwave and will tell you directly whether your condition is a good candidate or whether a different approach makes more sense first.
Can Both Be Used Together
There is some evidence that cortisone administered shortly before shockwave therapy may reduce shockwave's effectiveness by dampening the inflammatory cascade that shockwave is designed to initiate. We generally ask patients who have had recent cortisone injections to wait before starting shockwave. How long depends on the injection site and timing. Call us and we can discuss your specific situation before scheduling.
Scheduling and Coverage
Full Swing Healthcare is at 13770 Beach Blvd #4 in Jacksonville. Shockwave coverage varies by insurance plan. Call us at (904) 539-3352 and we will verify your coverage and discuss current self-pay rates, which are subject to change. We accept HSA and FSA cards.