Shockwave Physiotherapy near Harley Street

A handheld applicator is pressed against the skin over the painful area, with a layer of gel between the two, and fires acoustic pulses into the tissue below. The dose is described as energy flux density, in millijoules per square millimetre, and NICE puts the line between low and high energy at 0.12. Below it, treatment can be repeated without anaesthetic. Above it, treatment can hurt enough that a local anaesthetic is offered, and there is evidence that using one may work against the result.

What the pulses then do to a tendon is not settled. Reviewing Achilles tendinopathy, NICE states that the mechanism by which the therapy might affect a tendinopathy is not known. Clinics describe changes in blood flow, in nerve endings and in degenerate tissue. Those are hypotheses, and a practitioner who says so is telling you something good about how they practise.

It is worth considering when three things are true. The pain has lasted months rather than weeks. A loading programme has genuinely been done, at a sufficient load and for long enough, which for most tendons means months. And the diagnosis is settled rather than a label on the pain. Three of the four NICE documents describe it for a refractory problem, one that has not settled with the treatments tried first.

It is the wrong answer for a tendon that started hurting three weeks ago, for a suspected tear, and for pain that has not been examined. Adding shockwave to a wrong diagnosis produces an expensive nothing. If the assessment finds a problem outside its scope, the practitioner should say so and point you to your GP or the right service.

Shockwave is not used, or needs medical advice first, in these situations. The practitioner checks them at the assessment.

• Pregnancy, and treatment over the abdomen or lower back at any stage of it
• A blood-clotting disorder, or treatment while taking an anticoagulant, without medical advice first
• Active infection, an open wound, or a tumour in or near the area to be treated
• Treatment directly over an open growth plate, which rules it out for many under-18s
• A complete or high-grade tendon rupture, which needs assessment rather than shockwave
• A cardiac pacemaker or implanted electronic device, without checking with the treating clinician first

The musculoskeletal uses, with what NICE has said about each. Shockwave energy is also used in other fields of medicine under different guidance, and none of that is covered here.

Plantar fasciitis and heel pain

Pain under the heel, worst with the first steps of the morning. NICE assessed shockwave for refractory plantar fasciitis (HTG200) and found no major safety concerns and inconsistent evidence on efficacy.

Achilles tendinopathy

Pain and stiffness in the tendon above the heel. NICE reviewed it in 2016 (HTG426) and reached the same conclusion, adding that the evidence was limited in quality and quantity.

Tennis elbow

Pain on the outside of the elbow when gripping or lifting. NICE assessed refractory tennis elbow (HTG201) with the same finding: safe enough, efficacy inconsistent.

Calcific tendonitis in the shoulder

A deposit in a shoulder tendon, often visible on ultrasound, which makes a before and after comparison possible.

Pain on the outside of the hip

Greater trochanteric pain syndrome. NICE (HTG248) described the evidence on both efficacy and safety as limited in quality and quantity, the weakest of the four.

Knee tendon pain

Pain at the front of the knee from the patellar tendon, often in people who jump or run. No NICE guidance covers it, so ask what evidence the practitioner is relying on.

Most people describe low-energy treatment as uncomfortable rather than painful: a rapid tapping that is sharper over the sorest spot. The practitioner starts low and builds up, and you can ask them to turn it down. High-energy treatment, above 0.12 mJ per square millimetre, can hurt enough that NICE notes a local anaesthetic is sometimes offered, while also noting evidence that using one may work against the result. Ask which energy your course uses before the first session.

The usual effects are reddening of the skin over the treated area, swelling, bruising and an ache that can be worse for a day or two before it settles. NICE has assessed the treatment four times and raised no major safety concerns.

Pain after shockwave therapy

Soreness for 1 to 3 days is usual. Pain that is getting worse after that, or swelling that keeps growing, is a reason to call the practitioner who treated you.

Can you exercise after shockwave therapy?

Yes, with a pause. Heavy loading of the treated tendon is normally avoided for about 48 hours, then the loading programme carries on, because it is the part of the treatment with the stronger evidence.

What not to do after shockwave therapy

Do not start a new training block or a race in the same week, and check with the practitioner before taking anti-inflammatory tablets, since several protocols ask you to avoid them around the course.

NICE says shockwave may be given in one session or several. Private courses are usually sold as 3 sessions about a week apart: a practice at UNTIL Marylebone prices a course of 3, and one Mayfair clinic says most people have 3 to 6. Agree the number, and the date of the review, at the assessment rather than session by session.

How long does shockwave therapy take to work?

Change in a tendon is slow. The result is judged at a review some weeks after the last session, against where the pain was before the course began, with the loading exercises carrying on throughout.

A physiotherapy practice at UNTIL Marylebone publishes £150 for a single session and £400 for a course of 3, checked on 29 September 2026. Shockwave Therapy Harley Street charges nothing, sets no price and takes no fee for an introduction. London shockwave prices compared, and what a quote should include.

Is shockwave therapy covered by insurance?

Often not. Several insurers exclude it, and those that fund it usually want a named diagnosis and a record that conservative treatment has failed. Ask your insurer before the first session and get the answer in writing.

Shockwave therapy on the NHS

Availability varies by area and condition. One NHS trust's leaflet offers it once symptoms have lasted 3 to 6 months without settling. Your GP can tell you what is funded where you live.

A great many practitioners around Harley Street hire a consulting room by the session in a building run by somebody else. That is legitimate, and it is how much of private practice in central London works, UNTIL's clubs included. It does mean an address in W1G describes a building rather than the person who will treat you.

Ask for the full name of the person who will deliver the treatment, then search it on the HCPC register, which lists physiotherapists and podiatrists and takes under a minute. Ask who holds clinical responsibility if something goes wrong, who you contact in the week after a session, and whether the review is with the same person. A practitioner who answers easily has been asked before. The glossary explains the rest of the vocabulary on a quote.

1. Who will deliver the treatment, and what is their HCPC registration number?
2. What do you think is wrong, and how sure are you of the diagnosis?
3. Is my problem one that NICE has assessed shockwave for?
4. Have I done enough of the loading exercises for this to be the next step?
5. Is the machine radial or focused, and why that one for me?
6. What energy will you use, and will it need an anaesthetic?
7. How many sessions do you suggest, and when will the result be reviewed?
8. Does the price include the assessment and the review?
9. Can I have the written information about the uncertainty that NICE asks for?
10. What happens, and what does it cost, if the course does not help?

A practitioner who answers all ten easily has been asked them before. Shockwave Therapy Harley Street suggests asking them at the assessment, before a card payment.

Assessments arranged through Shockwave Therapy Harley Street take place at UNTIL Marylebone, 1 Orchard Street, London W1H 6HJ. It is a 13-minute walk from the south end of Harley Street, 6 minutes from Marble Arch on the Central line and 7 minutes from Bond Street on the Central, Jubilee and Elizabeth lines. The club opens at 06:00 on weekdays and 08:00 on Saturdays. The site itself holds no clinic: it is owned by the UNTIL group and routes enquiries to UNTIL Health Concierge. See directions, parking and hours near Harley Street, the contact page or who runs this site.