EPAT Shockwave Therapy: What It Is & How It Works | DPM

Quick answer: Need a podiatrist’s opinion on this? Call Balance Foot & Ankle at (810) 206-1402 for same-week appointments in Howell or Bloomfield Hills, Michigan. Most insurance accepted, including Medicare.

✅ Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatrist · Last updated April 6, 2026

EPAT Shockwave Therapy [The Best EPAT Near Me & EPAT Reviews]

We review the scientific research reviews of EPAT therapy for plantar fasciitis & Achilles tendonitis.  We also review the best EPAT therapy.

What is EPAT therapy?

EPAT Therapy is also known as Extracorporeal Pulse Activation Technology (AKA Extracorporeal pulse activation therapy EPAT) and can successfully address fresh injuries and chronic pain. EPAT is also known as ESWT (Extracorporeal shock wave therapy) EPAT Therapy is a effective treatment method: high-energy sound waves are introduced into the painful areas of the body. It is one of the most advanced and effective non-invasive treatment methods cleared by the FDA. EPAT therapy is extensively studied and proven to have excellent results for foot & ankle problems.

• The treatment works by helping to improve the regenerative potential and enhancing blood circulation to regenerate damaged tissue.
• Beneficial effects are often experienced after only 1 or 2 treatments, and there is no downtime.
• The non-surgical therapy for pain eliminates pain and restores mobility, thus quickly improving the quality of life for patients.
• Learn more about how EPAT Therapy can address your pain, accelerate your healing and optimize your health.

PROs vs. CONs of EPAT shockwave therapy:

There have been numerous research studies validating the effectiveness of EPAT shockwave therapy. These are some of the

Pros of EPAT therapy:

• 91% Success rate in relieving medical problems (as per clinical studies)
• Non-invasive.
• No anesthesia is required.
• No risk of infection.
• No scarring.
• No downtime.
• Over 80% patient satisfaction.
• Cost-effective.
• Faster, easier healing.

Cons of EPAT therapy:

• Some insurance plans do not cover EPAT.
• No readily available in most regions or cities.
• It can be a very costly machine to acquire for most medical practices.
• It is not 100% successful for every patient.
• Proper patient selection is needed for best results.

EPAT therapy near me:

At Balance Foot & Ankle Specialists, we are proud to be offering extracorporeal pulse activated therapy for the following conditions:

• Plantar fasciitis.
• Achilles tendinitis.
• Morton's neuroma.
• Scar tissue.
• Soft tissue pain.
• Overuse injuries.
• Plantar fibroma pain.
• Plantar fibromatosis.

We do provide NO OBLIGATION consultation and evaluation to see if EPAT therapy may be right for you.

• Not every treatment is for every type of patient. We recommend getting evaluated to see if this treatment is something that is a good idea.
• We personally stand by EPAT therapy results and excellent results at our clinic for foot and ankle pain and will do whatever it takes to make things right.

Does EPAT therapy work?

We frequently hear the question, “How does EPAT therapy work?” and “Does EPAT therapy work?” Shock wave therapy is hypothesized to work by inducing microtrauma to the tissue affected by these problems.

• This microtrauma initiates a healing response by the body. This can create new blood vessel formation and thick, stiff scar tissue remodeling.
• The healing response causes blood vessel formation and increased delivery of nutrients to the affected area for remodeling and faster healing.
• Microtrauma is thought to stimulate a repair process and relieve the symptoms of pain.
• This has shown to be effective for plantar fasciitis, Achilles tendonitis, scar tissue, plantar fibroma pain, and other medical problems throughout the body.

EPAT Therapy Scientific Reviews:

EPAT therapy for plantar fasciitis:

• Plantar fasciitis is one of the most effective conditions treated by radial shockwave therapy.
• This 2021 study says shockwave therapy is a very effective treatment, but it is limited by a few providers and lacks equipment availability.
• This scientific study literature review attests to the high effectiveness of shockwave treatment for plantar fasciitis.
• We list numerous studies above about how cost-effective and beneficial this can be for this condition.

EPAT Shockwave Therapy for Achilles tendonitis:

• This 2019 study shows that shockwave therapy is a validated and effective treatment for Achilles tendon pain.
• Achilles tendinitis is also a very successful condition that is treated by shockwave therapy.
• This treatment is effective for both insertional Achilles tendonitis and midsubstance Achilles tendonitis.
• We see specific benefits in the region 2-6 cm above the heel insertion.
• We also see excellent results at the Achilles tendon insertion site into the back of the heel bone.

EPAT Shockwave for therapy myofascial pain:

• Radial shockwave therapy is especially effective in treating myofascial pain.
• It treats the myofascial pain by sending radial shockwaves deeper than a treatment like ultrasound would.
• This 2021 study says shockwave therapy is a very effective treatment, but it is limited by a few providers and lacks equipment availability.
• It can also stimulate remodeling of the myofascial and stimulate blood vessel growth even 2-3 months after treatment.

EPAT Shockwave therapy for tendinopathy:

• This treatment has been shown in the studies to be very beneficial for tendinopathy.
• This 2021 study says shockwave therapy is a very effective treatment for tendinopathy, but it is limited by a few providers and lacks equipment availability.
• Specifically, we have seen better results than ultrasound as the shockwaves can penetrate more unidirectional and deep fascia than ultrasound therapy.
• The studies have been shown just as effective as eccentric loading with better results at 3 and 4 months due to tissue remodeling and increased blood vessel growth.

EPAT Shockwave therapy for posterior tibial tendonitis:

• Shockwave therapy can be very effective for posterior tibial tendonitis.
• In our opinion, posterior tibial tendonitis is an acute condition that can be corrected well with good shoes, custom orthotics, and a good lace-up ankle brace.
• We believe that shockwave therapy is not a primary treatment protocol for posterior tibial tendonitis.
• This 2021 study says that shockwave therapy is a very effective treatment for tendon and ligament pain. Still, it is limited by a small number of providers and a lack of equipment availability.
• If there is chronic scar tissue visualized on ultrasound, then shockwave therapy can be beneficial.
• We do not recommend utilizing shockwaves for acute posterior tibial tendonitis.

EPAT Plantar fibroma shockwave therapy:

• This 2020 study shows that shockwave therapy is an effective and validated treatment for reducing Lederhose disease, plantar fibromatosis, and plantar fibroma formation to both feet.
• Utilizing shockwaves and shockwave treatment for plantar fibroma is one of the most beneficial treatment options that we see.
• We have seen outstanding improvement for plantar fibroma pain utilizing shockwave therapy.
• This is probably the most beneficial treatment that we can perform for plantar fibroma pain.
• Personally, we have significantly reduced the amount of surgery do for plantar fibroma formation with the ability to use a device like a shockwave therapy.

EPAT Shockwave therapy for arthritis:

• There have been numerous studies detailing how effective shockwave therapy can be for osteoarthritis.
• This 2019 study shows that knee osteoarthritis is not reversed.
• We have at length some of the above under the plantar fascia evidence section.
• There have been studies in the past regarding shockwave treatment for knee osteoarthritis.
• It is also beneficial for treating calcification of tendons and bone spur formation that extends out into the tendons.

EPAT Shockwave therapy for bone spurs:

• Shockwave therapy is fairly effective for the treatment of calcification within tendons and bone spur formation.
• We see particular effectiveness for heel spur formation both on the heel’s bottom and back.
• Studies show shockwave therapy can action remodel scarred thick tendon tissue, remodeling calcified tendon tissue, and bone, and stimulating new blood vessel growth to create tissue regeneration within the area.
• We use shockwave therapy for plantar fascia pain.
• Plantar fasciitis heel spurs, the bottom of the heel spurs, insertional Achilles tendonitis heel spurs, which are back of the heel spurs.

EPAT Shockwave therapy for scar tissue:

• Utilizing shockwaves to break up scar tissue is very beneficial for us.
• We specifically see good benefits for Morton’s neuroma scars, old hard bunion scars.
• Bottom of the foot scars from puncture injuries, the bottom of the heel scars from previous plantar fascia surgeries, and Achilles tendon rupture and repair scars.
• We believe that shockwave therapy in our hands has shown excellent results.
• We have seen even in just 1 or 2 treatments significant softening and improvement of the scar.

EPAT Shockwave therapy for proximal hamstring tendinopathy:

• This is an off-label use for us as podiatrists, so we do not provide proximal hamstring tendinopathy treatment at our clinic.
• But studies show that it can be very beneficial at a high setting and break up the stiffness and scar tissue within the hamstring.
• The difficulty is that this is deep tissue, and if there is a significant fat pad between the hamstring and the skin, this can limit the ability of the shockwave to break up the scar tissue in its intense region.
• Studies do show that shockwave therapy can penetrate deeper than ultrasound therapy can.

EPAT Morton’s neuroma shockwave therapy:

• As posterior tibial tendonitis, shockwave therapy is probably not the ideal treatment for Morton’s neuroma pain.
• At our clinic, we specialize in treating Morton’s neuroma pain and treating revision surgery for Morton’s neuroma.
• Our personal recommendation is to not focus on utilizing shockwave therapy for Morton’s neuroma, as we have not had a great success as we have had for other conditions.
• If you have Morton’s neuroma pain, we have numerous treatment methods such as first appointment premade orthotics that can be modified, custom orthotics, various injection therapies.
• We believe that we can get almost every Morton’s neuroma better if given a chance!

EPAT Shockwave therapy for bursitis.

• We have had a lot of success for retrocalcaneal heel bursitis and back of the heel bursitis utilizing shockwave therapy.
• This is a very beneficial treatment for back of the heel pain and insertional Achilles tendon pain, which has shown outstanding results.
• As the bottom of the heel pain, the back of the heel pain has shown outstanding improvement with shockwave therapy.
• We have numerous patients that have had surgery and other treatment options that have seen excellent results very rapidly from this type of treatment.

EPAT Shockwave therapy for calcific tendonitis:

• We do list numerous studies above where shockwave treatment can be very beneficial for calcific tendonitis.
• Studies show that the mechanisms of shockwave treatment’s action are remodeling of the scarred thick tendon tissue, remodeling calcified tendon tissue and bone, and stimulating new blood vessel growth to create tissue regeneration within the area.
• We do list specific case reports where a bone spur did regress and close down in size.
• This is with the working theory of new blood vessel formation and remodeling of the tissue.

EPAT Shockwave therapy knee tendonitis:

• Studies do show that shockwave treatment is beneficial for her knee tendonitis.
• Further studies do show that shockwave therapy is a cost-effective and worthwhile treatment.
• As we are podiatrists, we do not perform knee therapy.

EPAT Shockwave therapy for heel pain:

• We have had significant improvement with shockwave therapy for both bottoms of the heel pain and the back of the heel pain.
• We believe shockwave treatments for plantar fasciitis heel pain and Achilles tendonitis heel pain to be extremely beneficial.
• Numerous studies cite the cost-effective nature, the rapid results, and the low-risk nature of pursuing shockwave treatment for heel pain.

Frequently asked questions:

What are the EPAT therapy side effects?

Does EPAT therapy pose any side effects? The answer is every type of medical therapy is never risk-free. Shockwave therapy is FDA approved for foot and ankle conditions such as plantar fasciitis. We list studies that show how effective shockwave therapy can be, how cost-effective it can be, and how beneficial the results and evidence for shockwave therapy can be. We believe once weighed against therapy such as surgery and injections, shockwave therapy is by far the safest and low-risk option. There are minimal to no major known side effects for EPAT therapy for the lower extremity.

How much does EPAT therapy cost?

The biggest question most patients have is, “how much does shockwave therapy cost?” The answer is shockwave therapy is generally not covered by medical insurance even though it is FDA approved.

Does insurance cover EPAT therapy?

The cost of shockwave therapy is lower than a standard medical appointment, but unfortunately most insurance plans do not cover shockwave therapy. We offer different packages that are reduced in cost for more chronic injuries that may require more treatment. We believe that it is not much more than a standard co-pay or co-insurance for a standard insurance plan in some cases. We reference studies above that show between 2-6 treatments over a period of approximately 2 weeks has shown the best results at 1 month in 3 months compared to other treatments. The studies we reference above showed that shockwave therapy is more cost-effective when weighed against repeated doctor’s visits, time off work, and potentially laying plantar fasciitis or Achilles tendonitis surgical options. We would recommend scheduling an appointment with us and potentially even performing a non-obligation test session to see how well shockwave therapy will work for you. We stand behind the benefits of radial shockwave therapy and are cold laser therapy. We will do our best to ensure that it is a cost-effective treatment for all of our patients and work with them to make their treatment successful.

List of services our podiatrist provide:

• Toenail Fungus Treatment (Oral or Laser ).
• Toenail Trimming.
• Orthotics Fitting.
• Ingrown Toenails.
• Infected Ingrown Toenails.
• Trimming of Corns, Trimming of Calluses, and Treatment of Pressure Blisters.
• Diabetic Foot Care & Diabetic Foot Wounds.
• Athletes Foot, Dry Skin, Eczema.
• Foot & Ankle Ulcer Care.
• Infection and Abscess Care.
• Staph Infections in the Toe or Foot Treatment.
• Treatment of Plantar Warts for Your Toes and Feet.
• Foot & Ankle Injections (Steroid or Natural Solutions.)
• Management of Foot & Ankle Fractures (Walking Boots for broken toes or broken feet).
• Heel Pain (Heel Spur or Plantar Fasciitis).
• Custom Orthotics for children and adults (In the office).
• Over the Counter Orthotics for children and adults.
• Podiatrist medical pedicure.
• Extra-Depth Shoes for Patients with Diabetes.
• Diabetic Shoes.
• Gout Treatment.
• Prescription (Refills).
• Telehealth appointments.
• Shockwave therapy (AKA ESWT or EPAT therapy)
• Cold laser therapy (In the office).
• MLS laser therapy (Multi-Wave Locked System laser therapy).
• Laser for peripheral neuropathy (In-Office).

List of procedures our podiatrists can provide:

We can perform toenail, toe, foot, heel & ankle surgery in the office! We can help with:

• Minimally invasive foot surgery.
• Minimally invasive bunion surgery.
• Minimally invasive hammertoe surgery.
• Corn and callus removal surgery.
• Plantar wart removal surgery.
• In-office permanent ingrown toenail removal surgery.
• Removal of unwanted spurs, bumps, or lumps on your feet.
• Shockwave therapy (AKA ESWT or EPAT therapy)
• Cold laser therapy.
• MLS laser therapy (Multi-Wave Locked System laser therapy).
• Laser for peripheral neuropathy.
• 3D custom orthotic scan.

---

Related Treatment Guides

• Plantar Fasciitis & Heel Pain Treatment
• Achilles Tendinopathy Treatment
• Custom 3D Orthotics
• Sports Foot & Ankle Injury Treatment

What is Foot pain?

Foot pain is a common foot/ankle condition that affects mobility and quality of life. Understanding the underlying cause is the first step in successful treatment. Our podiatrists at Balance Foot & Ankle perform a hands-on biomechanical exam, review your activity history, and use diagnostic imaging when appropriate to identify the root cause—not just treat the symptom. Many patients have been told to “rest and ice” without a deeper diagnostic workup; our approach is different.

Symptoms and warning signs

Common signs of foot pain include pain that worsens with activity, morning stiffness, swelling, tenderness when palpated, and difficulty bearing weight. If you experience sudden severe pain, inability to walk, visible deformity, numbness or color change, contact our office the same day or visit urgent care—these can signal a more serious injury such as a fracture, tendon rupture, or vascular compromise. Diabetics with any foot wound should seek same-day care.

Conservative treatment options

Most cases of foot pain respond to non-surgical care: structured rest, supportive footwear changes, custom orthotics, targeted stretching and strengthening protocols, anti-inflammatory medications when medically appropriate, and in-office procedures such as ultrasound-guided injections. We also offer advanced therapies including MLS laser therapy, EPAT/shockwave, regenerative injections, and image-guided procedures. Treatment is sequenced from least invasive to most invasive, and we explain the rationale at every step.

When is surgery considered?

Surgery is reserved for cases that fail 3-6 months of well-structured conservative care, when there is structural pathology (severe deformity, complete tear, advanced arthritis), or when imaging shows damage that will not heal without intervention. Our surgeons have performed 3,000+ foot and ankle procedures and prioritize minimally-invasive techniques whenever appropriate. We discuss recovery timelines, return-to-activity milestones, and realistic outcome expectations before any procedure is scheduled.

Recovery timeline and prevention

Recovery from foot pain varies based on severity and chosen treatment path. Conservative cases often improve within 4-8 weeks with consistent adherence to the protocol. Post-procedural recovery may range from a few days (in-office procedures) to several months (reconstructive surgery). Long-term prevention involves footwear assessment, activity modification, structured strengthening, and regular check-ins with your podiatrist if you have a history of recurrence. We provide written home-exercise plans and digital follow-up support.

In-Office Treatment at Balance Foot & Ankle

If home treatment isn’t providing relief for your foot and ankle conditions, our podiatry team at Balance Foot & Ankle can help with same-day evaluations and advanced in-office care.

Related Care at Balance Foot & Ankle

Clinical shockwave services at our Howell and Bloomfield Hills offices.

EPAT Shockwave TherapyPlantar Fasciitis SurgeryMLS Laser