ESWT (Extracorporeal shockwave therapy) has been documented to have various effects on bone and soft tissue. Clinically ESWT seems to induce a transient and incomplete analgesia and promote healing. Shock waves are high energy acoustic waves that in essence create micro trauma that is thought to increase blood supply to the treated area, manipulate inflammatory processes, stimulate osteoclasts and fibroblasts to rebuild injured tissues, promote a linear pattern of healing in tendons and ligaments, decrease pain, increase immune response in acute injuries and jump-start the immune system to promote healing of chronic injuries. Many of the indications treated using ESWT occur in the lower limbs. Since the bones, tendons and ligaments of these areas have a limited blood supply, increasing the blood supply to injured or diseased areas can decrease healing times by providing nutrients and more effectively remodeling damaged tissues. ESWT may also modify the immune response by increasing the response in acute injuries and jump-starting the response in chronic injuries. ESWT has also shown results in relieving muscle tension in areas such as backs, necks, and shoulders.