Shockwave Therapy for Scar Tissue: What Works, What Doesn’t, and Why
- Just Healthy
- Jun 17, 2024
- 8 min read
Updated: Jul 6
Shockwave Therapy (SWT) is a non-invasive treatment that’s been scientifically shown to help soften scar tissue, relieve pain, restore flexibility, and even improve appearance—without surgery or injections.
What Is Scar Tissue & Why It Matters
If you’re reading this, chances are you’re dealing with a scar that won’t let you forget what your body’s been through.
Maybe it’s the tightness you feel every time you try to stretch. Maybe it’s the deep, aching pain that flares up in the exact same spot, even years later. Or maybe it’s just the way the scar looks: raised, discolored, hard to ignore.
You might’ve been told, “It’s just scar tissue—it’s normal.” But what nobody explains is how that “normal” tissue can quietly hijack your movement, cause pain years later, or make you feel like your body still isn’t your own.
When your body repairs itself after an injury or surgery, it builds scar tissue as a natural part of healing. But unlike healthy tissue, where collagen fibers run in smooth, parallel lines, scar tissue is laid down in a disorganized, messy web. It’s thicker. Stiffer. And far less flexible.
Over time, this tangled collagen can:
Limit your range of motion (your joint won’t bend like it used to)
Trap nearby nerves, leading to dull aches, sharp pain, or strange tingling
Cause tightness or pulling, especially when stretching or working out
Change the appearance of your skin—raised, discolored, or uneven
📊 In fact, 28% of burn survivors report permanent joint contractures due to excessive scar tissue formation. (Gangemi 2008)
And it’s not just from major trauma. Even minor surgeries—arthroscopies, C-sections, or tendon repairs—can leave internal fibrosis that clings to fascia, muscle, or ligaments, creating long-term discomfort.
📚 One study found that fibrous adhesions form in nearly every surgical wound, especially in joints and the abdomen. (Olabanji 2011)
So if you’re feeling stiffness, pain, or a constant tug at a “healed” spot, you’re not imagining it. Scar tissue is a real barrier to comfort and mobility. And now, there’s a way to do something about it—without more surgery.
Studies show that more than 70% of people who try shockwave therapy see their skin get more flexible and feel less pain. And this isn't just one person's story. It's a fact supported by research from the International Journal of Dermatology in 2021.
How Shockwave Therapy Works on Scar Tissue
If you’ve ever wished you could soften your scar, break it up, or just get your normal movement back — this is where it starts to make sense.
Shockwave Therapy (SWT) isn’t magic, but the science behind it almost feels like it.
At its core, SWT sends mechanical pressure waves (think of them like sound pulses) into the tissue beneath your skin. These pulses don’t just “hit” the scar — they wake up your body’s own healing processes through something called mechanotransduction.
What that means is:
The shockwaves create gentle stress on the cells
Your body translates that into a cellular repair signal
That signal tells your tissue: “It’s time to rebuild — but the right way this time.”
🧬 Another found SWT actively suppressed scar-forming proteins while remodeling the matrix (Zhao 2022)
Here’s what happens inside your scarred tissue:
Fibroblasts, the cells that lay down collagen, get reprogrammed to stop overproducing stiff, tangled fibers
Scar-driving proteins like TGF-β1 and alpha-SMA drop
Healing factors like VEGF (for new blood vessels) and Nitric Oxide (for circulation) go up
New, organized collagen starts forming in place of the old, rigid scar
In one study, low-energy SWT increased blood vessel growth factors like VEGF and eNOS within just 3 hours of treatment (Kuo et al. 2009)
In plain terms, SWT doesn’t just reduce symptoms — it tells your body to fix the problem at the cellular level.
The result: softer, smoother, more flexible tissue.Less pain.More movement. And a scar that finally starts to feel like part of you, not something holding you back.
Clinical Results (Proof That It Works)
Outcome | Results | Study |
Pain relief | ↓ 3–4 points on VAS | Lee et al. 2020 |
Scar pliability | ↓ 2–3 points on Vancouver Scar Scale | Kim et al. 2018 (RCT) |
Range of motion (ROM) | ↑ 18–22% in hand/shoulder contractures | Liu et al. 2021 (RCT) |
Burn scar improvement | ↓ pruritus VAS by 2.2, ↑ elasticity scores | Zhao et al. 2022 |
Chronic wound healing | ↑ healing rate 2.73x, ↓ time by 19 days | Meta-analysis (2021, n=473 |
Ideal Shockwave Settings for Scar Tissue
If you’ve made it this far, you’re probably wondering: “Okay… but how do I know if I’m getting the right treatment?”
That’s a smart question — because when it comes to shockwave therapy, results depend heavily on settings. It’s not just about blasting the scar; it’s about precision.
Energy (EFD) Matters
Energy Flux Density (EFD) is how strong each shockwave is.
For general soft tissue injuries (like tendons or fascia), effective treatments use 0.08–0.25 mJ/mm².
But for scar tissue, which is denser and more fibrotic, studies show optimal effects in the range of 0.15–0.33 mJ/mm².
📈 At 0.12 mJ/mm², researchers saw a boost in mTOR-FAK — a key signaling pathway for proper collagen formation. (Lee 2017)
🔬 At 0.22 mJ/mm², fibroblasts — the cells responsible for repairing tissue — showed the greatest viability and activity. (Wang 2020)
Pulse Count & Frequency
Most clinics use 1,000 to 2,000 shocks per session
Delivered at 4–8 Hz, meaning 4 to 8 pulses per second
These levels are strong enough to activate cellular healing — but gentle enough to avoid overwhelming the tissue.
Number of Sessions
The typical course is:
3–6 weekly sessions
Many patients report noticeable changes by the third visit
You might feel something earlier (like reduced tightness), but structural changes in scar pliability and blood flow build up over several weeks.
Choosing the Right Device Type
Focused shockwave: Targets deeper or precise areas (like surgical adhesions or internal scars)
Radial shockwave: Covers a broader surface, great for flatter, wider scars (like burn scars or superficial post-op scars)
Too little energy, and nothing changes. Too much, and you risk bruising or cellular stress. But with the right dose, depth, and rhythm, shockwave therapy becomes a surgical-grade tool — without the surgery. This isn’t guesswork. It’s calibrated. Clinically studied. And tailored to help your scar remodel itself the right way.
What to Expect During a Session
You’ll lie down or sit comfortably while the therapist places the applicator on the area being treated. Instead of “shocks,” you’ll feel rhythmic tapping or pulsing, kind of like a firm vibration or a rapid thud.
On a pain scale (VAS), most people rate it a 2 to 3 out of 10
It might feel more intense over areas where the scar tissue is particularly dense—but it’s always tolerable
Many patients describe it as “weird but not painful”
🧪In over 20 randomized controlled trials (RCTs), no serious side effects have been reported. Minor redness, swelling, or soreness occurred in less than 5% of cases—and resolved within 24–48 hours.
How Long Does It Take?
Each session lasts about 10–20 minutes, depending on the size of the area.
There’s no downtime afterward—you can walk out of the clinic and go right back to your normal day. Work, errands, workouts, no problem.
What’s Used During Treatment?
Your provider will apply a coupling medium—usually castor oil or gel—to help the shockwaves travel smoothly through the skin into deeper tissue. Some clinics prefer castor oil because it’s gentler on the skin and may help reduce discomfort.
Benefits You Can Expect
1. Pain Relief
Scar tissue traps nerves, causes inflammation, and puts pressure on surrounding structures. By breaking up those tight fibrotic bands, SWT helps reduce pain right at the source.
🧾 Studies show VAS pain scores drop by 3–4 points after just 3–6 sessions (Lee et al., 2020)
2. Improved Flexibility & Range of Motion
As the rigid tissue softens and blood flow increases, your movement returns. That stuck joint or tight tendon finally begins to loosen.
📈 Clinical trials show ROM improves by up to 20%—especially in shoulders, hands, and knees (Liu et al., 2021)
3. Cosmetic Improvement
SWT doesn’t just feel better—it often looks better too. Scars become flatter, softer, and less pigmented over time as new collagen forms in a more organized way.
✨ Patients in case reports saw up to 50% visual improvement—even in scars over 25 years old
4. Relief from Itching & Nerve Pain
Raised scars and burns often cause intense itching or nerve sensitivity. Shockwave therapy can calm overactive nerve endings and reduce that “crawling” or burning sensation under the skin.
5. Lower Recurrence vs. Injections or Surgery
Unlike steroid shots or surgical excision (which often regrow), SWT helps remodel the scar naturally—making results more sustainable.
🛑 Steroid injections have a 50%+ recurrence rate in keloids. ✅ Shockwave therapy has shown no recurrence in 12-month follow-ups across multiple trials
Who Is (and Isn’t) a Good Candidate for Shockwave Therapy?
If you’ve been living with a scar that hurts, limits your movement, or just won’t improve—chances are, you’ve already tried the “usual stuff.”
Creams. Silicone sheets. Massages. Maybe even steroid injections. But nothing truly changed how it felt or functioned.
That’s why shockwave therapy feels like a real opportunity—because it’s not just masking the problem, it’s helping your body rebuild scar tissue from within.
So the next question is: Is this right for you?
Surgical Scars
Whether from a C-section, joint replacement, hernia repair, or a tendon clean-up—scar tissue often forms beneath the surface and binds down tissue. Shockwave therapy helps break those adhesions and restore mobility.
Burn Scars
SWT has been used in clinical studies to reduce itching, improve elasticity, and flatten raised burn scars—even months or years after the burn occurred.
Muscle & Ligament Adhesions
If you’ve had a sports injury or overuse damage, and now feel “stuck,” shockwave can target the dense, fibrous tissue that’s formed between layers—especially in shoulders, hips, and hamstrings.
Fascia or Tendon Scarring
Tight, painful, or snapping fascia and tendons often have underlying micro-scar tissue. Shockwave can stimulate better gliding and function.
🧾 One patient saw a 50% cosmetic improvement in a 27-year-old facial scar (Shockwave Clinic, UK)
Many patients say it’s the first time in years they’ve felt relief.
You Should Avoid Treatment If:
You have an active infection or open wound near the scar
You’re currently pregnant (treatment area)
You’re on blood-thinners or have a bleeding disorder
You have a pacemaker or metal implant near the treatment site
📋 According to the ISMST (2024), shockwave providers should screen for conditions like pregnancy, cancer near the site, and clotting risks.
How Does SWT Compare to Other Treatments?
Treatment | Recurrence Rate | Invasiveness | Side Effects |
Shockwave Therapy | Low (no known recurrence in RCTs) | Non-invasive | Minimal (2–5%) |
Steroid Injections | 50%+ recurrence in 5 years | Minimally invasive | Skin thinning, rebound |
Laser Therapy | 30–50% recurrence | Minimally invasive | Pigment changes |
Surgical Excision | 45–100% recurrence in keloids | Invasive | Scar regrowth |
Bottom Line
If your scar is healed but still causing problems—whether it’s tight, painful, itchy, or just in the way—you’re probably a strong candidate.
And if you’re unsure? A trained clinician can assess your case and let you know within minutes if shockwave therapy is right for your specific scar, body, and goals.
FAQs
Does it hurt?
Most patients report 2–3/10 discomfort, usually mild tapping or tingling.
How fast does it work?
Most patients report noticeable change after 3 sessions. Full results by week 6.
Can it completely remove my scar?
No—SWT softens, flattens, and improves appearance/function. It won’t make the scar vanish entirely.
Is it covered by insurance?
Often not, but clinics may offer payment plans.
Can it make my scar worse?
No clinical evidence suggests worsening. SWT modulates healing, not disrupts it.
