EPAT (Extracorporeal Pulse Activation Technology) is a form ESWT (Extracorporeal Shock Wave Therapy) is a pulse-activation technology that has been approved by the FDA. It is an exciting treatment option with a number of studies published in a variety of journals worldwide. Many different musculoskeletal conditions have shown promise in the research studies with the most being done on foot, ankle and knee. If you are frustrated with being in chronic pain that prevents you from doing your normal activities then EPAT may be for you!

EPAT uses sound waves from different energy and frequency settings to create biological effects on the targeted tissue. It creates vibration which is transmitted through the tissue causing local micro-trauma to stimulate metabolism, increase blood flow, and increase migration of growth factors to the area of treatment to accelerate healing. The exact mechanism of action is unknown but there are several theories on what is happening during the wave therapy. We have found the analogy of a slow smoldering fire (chronic inflammation) will get ignored by the body (similar to a person that sees it going every day) that suddenly gets some gas thrown on it, the subsequent flame up will get your body’s attention (as would it with a bystander walking by the smoldering fire!) and jump start the healing process again. It’s kind of like hitting the “reset” button on healing!

This procedure is non-invasive, and does not require any down time. Patients are able to walk out of the office and resume normal weight bearing activities. Treatment usually is 1x per week for 3-5 weeks, although more chronic or more difficult cases may require a few extra treatment sessions, or occasionally a twice per week application. Each session will last 15-30 minutes depending upon the area treated.


Are there any risks to EPAT/ESWT?
This technology is FDA cleared for the treatment of acute and chronic musculoskeletal pain and connective tissue disorders; there are no known risks or complications.

When Does Improvements Start?
The beneficial effects of EPAT are often most commonly experienced after only 3 treatments, although some patients report immediate pain relief after just one treatment! Some people have conditions that will can take up to four weeks for pain relief to begin. We will be able to guide you when we consult with you regarding your case. The procedure eliminates pain and restores mobility, thus improving your quality of life.

What are the success rates of EPAT/ESWT?
Over 80% of patients see significant or complete resolution of symptoms. With this success rate and the fact that there is no down time, no scarring, no anesthesia, and no risk of infection it’s a great option!

Are there any contraindications?
EPAT is not recommended for patients on blood thinners, those with malignancies and those who are pregnant.

What Conditions Are Treated?
Pretty much any musculoskeletal problem and research has been published on a wide variety of conditions including plantar fasciitis, anterior tibial pain (shin splints), knee pain, osteoarthritis pain, tennis elbow, adhesive capsulitis (frozen shoulder), stenosing tenosynovitis (trigger finger) and more.