Shockwave Therapy vs Cortisone Injections: How They Differ

Dr. Catie Cortner, DC — Arise Family Chiropractic
Medically reviewed by Dr. Catie Cortner, DC. Last reviewed: September 2026.

When weighing shockwave therapy vs cortisone injections for chronic pain, the two options work through fundamentally different mechanisms — one suppresses inflammation temporarily while the other aims to stimulate the body's own tissue-healing response. Research suggests that acoustic wave therapy promotes neovascularization and growth-factor signaling in treated tissue, which may support longer-lasting relief for musculoskeletal conditions [1]. At SoftWave Therapy Cumming on Bethelview Road in Cumming, GA, Dr. Catie Cortner, DC, helps patients in Forsyth County understand both options and find a non-invasive, drug-free path forward.

What Is Shockwave Therapy, and How Does It Work?

Shockwave therapy — also called extracorporeal shock wave therapy (ESWT) — is a non-invasive technology that delivers high-energy acoustic waves into injured soft tissue. At SoftWave Therapy Cumming, the device used is SoftWave TRT, an FDA-cleared electrohydraulic system that produces broad, unfocused acoustic waves capable of penetrating tissue up to several centimeters deep.

Unlike focused ESWT or radial pressure wave devices, SoftWave's electrohydraulic wave geometry covers a larger treatment area in a single session, making it well suited for tendons, fascia, joints, and surrounding soft tissue.

The underlying science is rooted in a process called mechanotransduction: when acoustic wave energy contacts tissue, it triggers a cascade of biological responses — including stimulation of growth factors, promotion of new blood vessel formation (neovascularization), and modulation of local inflammatory signals [2][1]. In plain terms, the treatment signals to the body that repair work is needed, initiating a healing process rather than simply masking pain.

SoftWave TRT is FDA-cleared for temporary relief of minor muscle and joint pain, stiffness, local blood circulation increase, and muscle spasm relaxation. Sessions at SoftWave Therapy Cumming last approximately 10 to 15 minutes, and a typical course of care runs 6 to 8 sessions over 6 to 8 weeks — though individual plans are discussed and tailored for each patient.

What Are Cortisone Injections, and How Do They Work?

Cortisone injections deliver a synthetic corticosteroid directly into an inflamed joint, tendon sheath, or bursa. The drug works by suppressing the local immune and inflammatory response, which can produce meaningful pain relief — sometimes within days.

Cortisone is a well-established medical tool and is appropriate in many clinical situations. However, it is important to understand that cortisone addresses the symptom (inflammation and pain) rather than the underlying structural or tissue pathology driving that symptom. When the injection's effect wears off, the underlying problem remains.

Physicians and patients should also be aware of a frequently asked question: Does cortisone weaken tendons? The evidence suggests that repeated corticosteroid injections can have a weakening effect on tendon collagen structure over time, which is why most providers limit the number of injections in a given area. This is not a reason to avoid cortisone entirely — it is a reason to weigh it carefully and consider whether a tissue-stimulating alternative may be more appropriate for chronic tendon conditions.

Can You Do Shockwave After a Cortisone Shot?

This is one of the most common questions from patients who have already received an injection and are looking for a next step. The general clinical guidance is that shockwave therapy is typically deferred for several weeks after a cortisone injection, allowing the corticosteroid to clear the tissue before acoustic wave treatment begins. Timing is always individualized, and Dr. Cortner reviews each patient's history before recommending a care approach.

If you have received one or more cortisone injections and are still experiencing pain, shockwave therapy may be worth discussing as a next step — particularly for tendon-related or soft-tissue conditions where tissue-level healing is the goal.

How Does Each Approach Fit Into a Broader Care Plan?

Neither shockwave therapy nor cortisone injections are cure-alls, and honest comparison requires acknowledging that both have appropriate use cases.

Cortisone can be an effective short-term tool for acute inflammatory flare-ups — reducing pain enough to allow participation in rehabilitation. It is a reasonable first step in some acute presentations.

Shockwave therapy, by contrast, is typically positioned for chronic or recurrent musculoskeletal conditions — cases where initial conservative care (rest, anti-inflammatories, physical therapy) has not produced lasting relief. Peer-reviewed research supports its use in chronic plantar fasciitis, calcific tendinopathy of the rotator cuff, and related tendinopathies [3][4]. The goal is not simply pain suppression but tissue-level signaling that supports the body's repair process.

At SoftWave Therapy Cumming, patients frequently arrive having already tried cortisone injections — sometimes multiple rounds — without sustained results. The question Dr. Cortner hears most often is: "Is there something that might actually help the tissue heal rather than just turning down the inflammation temporarily?" Shockwave therapy is often the answer worth exploring.

What to Expect at SoftWave Therapy Cumming in Forsyth County

If you are considering shockwave therapy as an alternative — or as a follow-up — to cortisone, here is what the process looks like at SoftWave Therapy Cumming, located at 5456 Bethelview Road in Cumming, GA.

Your first visit includes a thorough health history review, an examination, and a review of any existing imaging or records. Dr. Cortner will discuss your condition and help you understand whether SoftWave therapy is an appropriate fit. The initial visit runs 45 to 60 minutes.

SoftWave sessions themselves are brief — approximately 10 to 15 minutes — and require no anesthesia, no needles, and no downtime. Most patients return to normal daily activities immediately after each session.

A typical course of care is 6 to 8 sessions over 6 to 8 weeks. Specific care recommendations are reviewed with each patient individually; Dr. Cortner does not apply a one-size-fits-all protocol.

The practice serves patients throughout Cumming, South Forsyth, Windermere, Vickery, Sawnee, and the surrounding communities — including Alpharetta, Johns Creek, Milton, Suwanee, and Dawsonville. Whether you work at Forsyth County Schools, Northside Hospital Forsyth, or anywhere else in the area, the Bethelview Road location is accessible to most of north metro Atlanta.

Why Forsyth County Patients Are Asking About Non-Injection Alternatives

Across Cumming and the broader Forsyth County community, a growing number of patients are asking their providers about non-invasive options before committing to repeated injections or surgical consultations. The frustration is consistent: a cortisone shot brings relief, but the pain returns — sometimes worse — a few weeks later, and the cycle repeats without resolution.

SoftWave Therapy Cumming was built for exactly this patient: someone who has been through the standard path and is looking for an option that targets the tissue directly, without needles, without medication, and without recovery downtime. For residents near Sawnee Mountain Preserve, The Collection at Forsyth, or Cumming City Center, the practice offers a convenient location with same-week appointments typically available.

The answer to the question "Is shockwave better than cortisone?" depends entirely on the condition, its chronicity, and what the patient's goals are. For many chronic tendon and soft-tissue conditions, research increasingly supports acoustic wave therapy as an option worth serious consideration — particularly when injections have not produced lasting results [2][4][1]. Shockwave therapy vs cortisone is not a competition; it is a conversation worth having with a qualified provider who can evaluate your specific situation.

Comparison

Frequently Asked Questions

Is shockwave therapy better than cortisone?

The answer depends on the condition and its history. Cortisone can be effective for short-term inflammation relief, particularly in acute presentations. Shockwave therapy is generally positioned for chronic musculoskeletal conditions — especially where repeated injections have not produced lasting results. Research supports shockwave for chronic tendinopathy and plantar fasciitis in adults. The two approaches are not mutually exclusive, and many patients pursue shockwave therapy after finding that cortisone only provided temporary relief.

Does cortisone weaken tendons?

This is a valid concern. Evidence suggests that repeated corticosteroid injections may affect tendon collagen structure over time, which is why most providers limit how often they inject a given area. A single well-timed cortisone injection is generally considered low risk. For patients with chronic tendon conditions who need multiple rounds of injections, discussing alternatives — including shockwave therapy — with a qualified provider makes sense.

Can you do shockwave after a cortisone shot?

Generally, yes — but timing matters. Most clinical protocols call for waiting several weeks after a cortisone injection before beginning shockwave therapy, allowing the corticosteroid to clear the tissue. If you have had a recent injection and are interested in SoftWave therapy, Dr. Cortner will review your history at your first visit to determine the appropriate timing for your individual situation.

What conditions does shockwave therapy address?

At SoftWave Therapy Cumming, shockwave therapy is used for a range of musculoskeletal conditions including plantar fasciitis, tendinitis, tennis and golfer's elbow, shoulder pain, hip and knee pain, neck and back pain, sciatica, neuropathy, and sports or overuse injuries. SoftWave TRT is FDA-cleared for temporary relief of minor muscle and joint pain, stiffness, local blood circulation increase, and muscle spasm relaxation.

How many shockwave therapy sessions will I need?

A typical course of SoftWave therapy at SoftWave Therapy Cumming is 6 to 8 sessions over 6 to 8 weeks. That said, every patient's situation is different. Dr. Cortner reviews your health history, examination findings, and goals at your initial visit, and specific care recommendations are discussed individually — not applied as a standard protocol.

Is shockwave therapy painful?

Most patients describe SoftWave therapy as producing a mild pressure or pulsing sensation during treatment, which is generally well tolerated. Sessions last approximately 10 to 15 minutes and require no anesthesia or numbing agent. Most patients return to their normal activities immediately after each session. If you have concerns about discomfort, Dr. Cortner and the team at SoftWave Therapy Cumming are happy to walk you through what to expect before your first session.

Is SoftWave therapy FDA-cleared?

Yes. SoftWave TRT is FDA-cleared for temporary relief of minor muscle and joint pain, stiffness, local blood circulation increase, and muscle spasm relaxation. It is not FDA-approved (approval applies to drugs) — FDA-cleared is the appropriate designation for this category of device. This means the device has met the FDA's standards for safety and effectiveness within its indicated uses.

Who is a good candidate for shockwave therapy instead of cortisone?

Patients who tend to benefit most from shockwave therapy are those with chronic or recurrent soft-tissue and tendon conditions — particularly when conservative care such as rest, anti-inflammatories, or physical therapy has not provided lasting relief. If you have received cortisone injections that helped temporarily but whose effects wore off, shockwave therapy may be a logical next step. Dr. Cortner evaluates each patient individually to determine whether SoftWave therapy is an appropriate fit.

Does SoftWave Therapy Cumming accept patients from Alpharetta, Johns Creek, and Suwanee?

Yes. SoftWave Therapy Cumming on Bethelview Road in Cumming, GA serves patients throughout Forsyth County and the surrounding north metro Atlanta area, including Alpharetta, Johns Creek, Milton, Suwanee, Dawsonville, and Ball Ground. The practice is conveniently located near major routes serving South Forsyth, Windermere, Vickery, and Sawnee.

What happens at my first visit to SoftWave Therapy Cumming?

Your initial visit runs 45 to 60 minutes. It includes a health history review, a physical examination, and a review of any existing imaging or records you bring. Dr. Cortner will explain her findings and discuss whether SoftWave therapy is appropriate for your condition. Specific care recommendations are reviewed at a follow-up visit so you have time to ask questions and make an informed decision.

If you have been offered a cortisone injection — or have already had one — and are wondering whether there is a non-invasive, drug-free alternative, SoftWave Therapy Cumming is ready to help you explore your options. Dr. Catie Cortner, DC, serves patients throughout Cumming, Alpharetta, Johns Creek, Suwanee, and Forsyth County from our Bethelview Road location. Call us at 770-406-8208 or visit softwavecumming.com to schedule your first visit and find out whether SoftWave therapy is right for your situation.

References

[1] Simplicio CL, Purita J, Murrell W, et al. Extracorporeal shock wave therapy mechanisms in musculoskeletal regenerative medicine. J Clin Orthop Trauma. 2020;11(Suppl 3):S309-S318. - https://doi.org/10.1016/j.jcot.2020.02.004
[2] Notarnicola A, Moretti B. The biological effects of extracorporeal shock wave therapy (ESWT) on tendon tissue. Muscles Ligaments Tendons J. 2012;2(1):33-37. - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3666498/
[3] Louwerens JKG, Sierevelt IN, van Noort A, van den Bekerom MPJ. Evidence for minimally invasive therapies in the management of chronic calcific tendinopathy of the rotator cuff: a systematic review and meta-analysis. J Shoulder Elbow Surg. 2014;23(8):1240-1249. - https://doi.org/10.1016/j.jse.2014.02.002
[4] Gollwitzer H, Saxena A, DiDomenico LA, et al. Clinically relevant effectiveness of focused extracorporeal shock wave therapy in the treatment of chronic plantar fasciitis: a randomized, controlled multicenter study. J Bone Joint Surg Am. 2015;97(9):701-708. - https://doi.org/10.2106/JBJS.M.01331

This post is for educational purposes and does not constitute medical advice. Consult a qualified healthcare provider for guidance specific to your condition.