Shockwave or a cortisone shot?

One suppresses the inflammation quickly. The other tries to restart a stalled repair process. They pull in genuinely different directions.

The short answer

A cortisone injection suppresses inflammation and often reduces pain within days, but it does not repair tendon tissue and repeated injections carry tissue-quality concerns. Shockwave therapy applies acoustic pulses to stimulate blood flow and a repair response in tendon that has stopped healing on its own. Shockwave is slower and takes a course of sessions, but it targets the underlying tissue rather than the pain signal. For chronic tendon problems, that difference matters.

— THE TWO OPTIONS

What each one is actually for.

Shockwave therapy

Acoustic pressure waves delivered through the skin to stimulate circulation and provoke a repair response in stalled, chronically degenerated tendon.

Choose this when

Chronic tendon problems that have plateaued — plantar fasciitis, tennis elbow, Achilles tendinopathy
Pain that has persisted for months rather than days
Patients who want to avoid or delay injection and surgery
Cases where previous injections helped briefly and then wore off

Where it falls short

Slower than an injection — improvement builds over a course of sessions
Treatment itself is uncomfortable during application
Not appropriate over certain regions, in pregnancy, or with some clotting disorders
Less suited to acutely, intensely inflamed tissue

Cortisone injection

A corticosteroid delivered into the affected area to suppress the inflammatory response, usually producing rapid symptom relief.

Choose this when

Severe pain that needs to come down quickly
Getting a patient comfortable enough to begin rehabilitation
Diagnostic clarification when the pain source is uncertain
Short-term function for a specific near-term event

Where it falls short

Relief is frequently temporary and symptoms often return
Does not repair degenerated tendon — it quiets the response to it
Repeated injections raise concerns about tendon and local tissue quality
Injections are limited in number, so the option runs out

— SIDE BY SIDE

Side by side

	Shockwave therapy	Cortisone injection
What it targets	The tissue — stimulating a repair response.	The inflammation — suppressing the pain signal.
Speed of relief	Gradual, building across a course of sessions.	Often within days.
Durability	Aims at structural change, so gains tend to hold when paired with loading.	Frequently temporary; symptoms commonly return.
Invasiveness	Non-invasive, delivered through the skin.	An injection into the affected area.
Repeatability	Can be repeated as a further course.	Limited — repeated injections are generally discouraged in the same site.
At Meridian	Provided in-house at both locations.	Not performed here. We coordinate with the appropriate physician.

— OFTEN THE REAL ANSWER

Sometimes the injection buys the window that shockwave and loading need.

These are not strictly either-or. There are cases where pain is severe enough that nothing productive can happen until it comes down, and an injection creates the opening. The mistake is treating that window as the treatment.

An injection can make a person comfortable enough to start loading the tendon properly.
Shockwave and progressive loading are what change the tissue over the following weeks.
Repeated injections without a plan to rebuild the tendon is the pattern that ends in surgery.
We do not perform injections. If that is the right next step, we will say so and coordinate.

— WHEN IT IS NEITHER

When it is not a tendon problem at all.

Tendon pain can be mimicked by other things. These warrant evaluation before either treatment.

A sudden pop followed by loss of function — possible rupture, needs urgent assessment
Hot, swollen, red joint with fever — needs medical evaluation to exclude infection
Pain with numbness or weakness rather than local tenderness
Multiple joints involved symmetrically, which points toward a systemic cause

— QUESTIONS

Common questions

Is shockwave therapy better than a cortisone shot?

For chronic tendon problems, shockwave targets the actual tissue rather than suppressing the pain response, so the effect tends to hold better over time. A cortisone injection is faster but temporary. Which is better depends on your timeframe: if you need relief this week, the injection wins on speed; if you want the tendon to be different in three months, shockwave is the more direct route.

How many shockwave sessions will I need?

A course rather than a single visit, typically spaced over several weeks, with re-evaluation to confirm you are responding. We check that deliberately, because if a tendon is not responding, extending the course is not the answer.

Does shockwave therapy hurt?

It is uncomfortable during application — most people describe a strong tapping sensation over the sore area, and intensity is adjusted to what you can tolerate. It is brief, and soreness afterward usually settles within a day or two.

Can I have shockwave if I have already had cortisone injections?

Usually yes, and it is a common scenario — people often arrive after injections that helped briefly and then wore off. Timing after a recent injection matters, so tell us when your last one was.

Does Meridian do cortisone injections?

No. We provide shockwave therapy at both locations. If an injection is genuinely the right next step for you, we will tell you and coordinate with the appropriate physician rather than steer you toward what we happen to sell.

— NEXT STEP

Not sure which one you need?

A visit starts with an exam, not a treatment plan. If what you need is something we do not provide, we will tell you and point you to who does.

Book an evaluation