What this treats
This protocol works well for chronic, well-localized musculoskeletal complaints that haven't fully responded to physiotherapy or anti-inflammatories alone:
- Shoulder pain: calcific tendinitis of the supraspinatus, subacromial impingement, chronic rotator cuff tendinopathy
- Tennis elbow: lateral epicondylitis, and medial epicondylitis (golfer's elbow)
- Hip & pelvis: greater trochanteric pain syndrome, proximal hamstring tendinopathy
- Knee pain: patellar tendinopathy, IT-band syndrome — the soft tissue around the joint, not the joint surface itself
- Heel & foot: plantar fasciitis, Achilles tendinopathy (Achilles tendonitis)
- Neck and back pain: chronic muscular neck pain, trapezius tension and low-back pain, as an adjunct to mobility work
- Muscle trigger points: the tight, tender knots of myofascial pain that keep re-forming in the neck, shoulders and upper back
How it works
Radial shockwave therapy (rESWT) delivers high-energy mechanical pressure waves that spread radially from the applicator head into the targeted tissue. The mechanical energy disrupts pathologic calcium deposits, releases trigger points in chronically tight muscle, and — most importantly — provokes a controlled inflammatory response that re-starts a stalled healing cycle in chronic tendinopathy.
Pulsed electromagnetic field therapy (PEMF) applies low-frequency magnetic pulses to the same area. The mechanism, supported by both lab and clinical data, is the modulation of intracellular calcium signaling and mitochondrial activity in resident cells, accelerating ATP availability for repair and reducing inflammatory cytokine load. PEMF has been studied for non-union fractures, osteoarthritis, and post-surgical bone healing for decades, with a strong safety profile.
Shockwave is mechanical: it disrupts and provokes. PEMF is bioelectric: it accelerates cellular repair. Used together, the disruption phase is paired immediately with an accelerated remodeling phase. Patients consistently report faster pain reduction than with either modality alone, particularly for calcific tendinitis and chronic plantar fasciitis.
The protocol — session by session
Diagnostic and mapping phase. We palpate trigger points, treat the densest pathology first. About a third of patients report a 24–48 hour "treatment ache" after session 1 — this resolves and is followed by improvement.
The window when most patients begin to notice meaningful change — particularly improved range of motion and lower nighttime pain. We re-assess and confirm we're on the right tissue.
Consolidation. If response is good, we taper and add a home loading or mobility program. If response is partial, we re-image and consider referral.
How long before you see results?
Most patients with calcific tendinitis, plantar fasciitis, and lateral epicondylitis report meaningful pain reduction by session 3 or 4. Chronic conditions of longer duration (more than 18 months) tend to need the full 6-session course. Functional outcomes (range of motion, returning to sport) continue to improve for 8–12 weeks after the last session as remodeling completes.
Does shockwave actually work for my problem?
It depends entirely on which problem, and the honest answer is not the same for all of them. Below is what the published trials support, condition by condition, including the three where the evidence is weaker than you would guess from most clinic websites. We would rather you knew before you paid.
Two different questions get blurred together in most write-ups, and they have different answers: does shockwave beat a placebo, and does it beat the other things you could do instead. Several of these pass the first and not the second. Where that is the case, it says so.
| Condition | How strong is the evidence? | What the trials actually found |
|---|---|---|
| Shoulder pain — calcific tendinitis of the rotator cuff | Strongest | Pooled across 16 randomised trials and 1,093 patients, shockwave improved both pain and shoulder function against controls. Calcium deposits clear more often with it — though whether that is why people feel better is not settled, and the trials carried a moderate-to-high risk of bias. |
| Plantar fasciitis — heel pain | Good | Consistently better than placebo. But in one review the effect was small, and vanished when only the highest-quality trials were counted; another found no advantage over other non-surgical treatments. Best evidence is for heels that have hurt more than six months and have not responded to stretching and footwear. |
| Muscle trigger points — neck and upper back | Works, but not uniquely | Better than sham and better than ultrasound therapy. No better than dry needling, trigger-point injection or laser. If one of those is already working for you, this is a sideways move, not an upgrade. |
| Neck and back pain — chronic muscular low-back pain | Moderate, as an add-on | Supported when added to physiotherapy rather than used instead of it. That is how we use it — alongside a loading and mobility plan, not as a replacement for one. |
| Tennis elbow — lateral epicondylitis | Mixed, and depends when you measure | Against a steroid injection, shockwave did worse at one month and better at three. Other reviews find no clear advantage over a dummy treatment at all. A reasonable option for a stubborn elbow; slower to help than an injection, and possibly further ahead by three months. |
| Knee pain — patellar tendinopathy | Weak | Low-to-moderate quality evidence puts the effect on pain and function close to negligible against placebo, with or without eccentric exercise. Shockwave has done better in knee osteoarthritis trials — but that is the joint surface, which we do not treat and nothing here regrows. |
| Achilles tendonitis — Achilles tendinopathy | Weakest of the group | Earlier reviews were positive; more recent work found no clear benefit over a dummy treatment for the chronic form, with a hint of short-term relief only where symptoms have lasted under a year. We will still treat it, and we will tell you this first. |
Why publish the weak ones. Because you can check them, and because a clinic that only lists its wins is telling you nothing you can act on. If your problem sits in the bottom two rows, shockwave may still be worth trying — but it should be a considered decision with a realistic ceiling, not a purchase made on a promise. We will say the same thing at the consultation.
What is a session actually like?
Each session is 20–30 minutes per area treated. You remain clothed except for the treatment site. The radial shockwave portion produces a percussive, vibratory sensation; intensity is adjustable and we titrate to your tolerance. PEMF is silent and almost imperceptible — it feels like a warm coil resting on the area. No anesthesia is used. You can drive yourself home and return to normal activity, including exercise (with reduced intensity for 24 hours).
What about gout?
This is one of the commonest questions we are asked, and it deserves a straight answer rather than a hopeful one.
Gout is not a tendon problem. It is a metabolic one — uric acid crystallising inside a joint. That means the treatment that actually changes the course of gout is a blood test, a diagnosis, and where appropriate urate-lowering medication from a doctor. Shockwave and PEMF do none of that, and we do not treat gout itself.
What we can help with is narrower and worth being precise about:
- The stiffness and ache between attacks. Many people with long-standing gout have a joint that never fully settles — a knee, ankle or midfoot that stays sore and stiff for weeks after a flare has passed. That residual soft-tissue pain is the kind of problem this protocol is built for.
- The tendon problems that travel with it. Achilles tendinopathy and plantar heel pain are both more common in people with gout, and shockwave is an established treatment for both — though the trials were done in people without gout, so we cannot promise you the same results.
- Movement, after the flare. Getting a joint moving again once the acute episode is over, alongside whatever your doctor has prescribed.
What we will not do: treat an actively inflamed joint, tell you whether you have gout, or suggest you stop or reduce medication a doctor has prescribed. If you have never been formally diagnosed, the first useful step is a serum uric acid test and a doctor's opinion — not a device.
One note on which device we use. The protocol described elsewhere on this page — the one priced at ₱2,500 per treated area — uses radial shockwave. For gout joint pain we use the focused machine instead, the same device used in our ED protocol. They are two different machines rather than two settings on one, so it is worth stating plainly rather than leaving you to assume.
A joint that suddenly becomes hot, swollen or too painful to move can be septic arthritis — an infection inside the joint — and it can look exactly like an acute gout flare. Gout can often be recognised clinically; infection cannot be ruled out that way. The only way to exclude it is to draw fluid from the joint, and finding urate crystals does not settle it either, because roughly one in twenty-five flares that get aspirated turn out to have an infection in the same joint.
It is time-critical: permanent cartilage damage can follow if treatment does not begin within 24 to 48 hours. So a first-ever attack, a joint that is hot to the touch, a joint you cannot put weight on, or more than one joint flaring at once, belongs in an emergency department today rather than in a clinic — and that holds whether or not you have a fever, because most people with an infected joint never run one. If you describe any of that to us, on the phone or by message, that is exactly what we will tell you, and we will not book you in instead.
What about rheumatic pain, or rayuma?
Rayuma is one of the most useful words in Filipino and one of the least precise. It gets used for osteoarthritis, for the ache that comes with cold weather, for frozen shoulder, for gout, and for rheumatoid arthritis — conditions with almost nothing in common except that a joint hurts. So the honest answer depends entirely on which one you have.
What we can help with is the same narrow thing described above for gout: the soft-tissue pain and stiffness around a joint, the tendon problems that develop alongside chronic joint disease, and getting movement back once an inflamed period has settled. That is what shockwave and PEMF do.
What we do not do is treat the disease underneath. Osteoarthritis is worn cartilage; nothing available here regrows it. Rheumatoid arthritis is an autoimmune condition, and it is the one that matters most on this page — because it is treated with disease-modifying drugs prescribed by a rheumatologist, and because delay causes permanent joint damage. Our osteoarthritis guide covers what genuinely helps that condition, most of which is not a device.
If the small joints of both hands are stiff and swollen, and it takes more than an hour each morning to loosen them, that is one of the patterns that should send you to a rheumatologist rather than to us. Prolonged morning stiffness is the part that distinguishes it — quite unlike the "stiff for ten minutes when I get up" of wear-and-tear arthritis. But it is not the only way rheumatoid arthritis starts: it can begin in one large joint, or on one side only, so a different pattern is not a reason to relax. If that sounds like you, please see a doctor for a proper work-up rather than booking a pain session. Early treatment changes the long-term outcome; a shockwave session does not.
None of this means you have wasted your time here. Plenty of people with diagnosed rheumatic disease still have a specific tendon or a specific stiff shoulder that responds well, and are already under a specialist for the condition itself. That is exactly the situation this protocol suits — alongside your doctor's treatment, not instead of it.
Who isn't a good candidate?
We do not treat over implanted pacemakers (PEMF), over active infection or skin breakdown, over known tumor sites, in pregnancy, or in patients on any anticoagulant, or a bleeding disorder. Acute injuries within 6 weeks of onset are usually managed with conservative care first. An acutely inflamed joint — including an active gout flare or an inflammatory-arthritis flare — is not treated here; we wait until it has settled, and undiagnosed inflammatory arthritis is referred rather than treated.
Investment
₱2,500 per session, per treated area. A typical course is 3–6 sessions delivered weekly. We don't bundle into packages — you pay per session, and we'll stop the course as soon as your clinical signal says we should.
What that price includes — and how to compare
₱2,500 per area is the whole price. It covers both shockwave and PEMF in the same session, plus the assessment. No separate consultation fee and no package — billed one session at a time.
Comparing us with somewhere else? Ask one question: “Is that the total, or do consultation and follow-up cost extra?” A quoted headline price and the amount you actually hand over are often two different numbers. Compare the total, not the sticker.
And you will be the only patient here. Appointments are single-occupancy — there is no shared waiting room and no overlap with another patient, so you will not see anyone else in the clinic. For a lot of people that is the part that decides whether they book at all.
How we look after you
Treated by a named clinician
Your treatment is carried out by Jas Macusi, RN — a PRC-registered Registered Nurse and our founder and lead clinician — you can verify her yourself by name in the PRC's free public registry at prc.gov.ph. You will know who is treating you before you arrive.
One patient at a time
Appointments are single-occupancy. There is no shared waiting area and no overlap with another patient — you will not see anyone else here.
Published price, no lock-in
Our prices are published openly on this page and billed one session at a time. No packages, no upfront lock-in, and a written quote before anything begins.
Where it happens
This particular treatment is clinic-based — it needs the device and a proper treatment room. For select other services, home or hotel visits can be arranged in advance.
Ride a big bike? We run a dedicated rider recovery & men's health check for the wrist, shoulder and lower-back load that long rides put on you.
Pain & recovery — further reading
- How much does PEMF therapy cost in Manila? An honest breakdown
PEMF therapy cost in Manila (2026): typical per-session prices, home-device costs, why prices vary, and what it costs at - Does PEMF therapy really work for back pain? An honest look
An honest look at PEMF therapy for back pain — what the evidence shows, what it can't do, how it fits with shockwave and - PEMF for sciatica & nerve pain — what actually helps
PEMF for sciatica and nerve pain in Manila: what PEMF can and can't do for a pinched nerve, the red flags that need urge - PEMF for joint pain: what it can and can't do
An honest look at PEMF therapy for joint pain — knee, hip, and shoulder. What the evidence supports, what it can't do fo - Can PEMF help spinal stenosis? An honest answer
A careful, honest look at PEMF therapy for spinal stenosis — what the limited evidence shows, why a magnetic field can't - Osteoarthritis: what actually helps the pain
An honest guide to osteoarthritis treatment — the exercise and weight levers that matter most, where shockwave and PEMF - Does shockwave therapy work for plantar fasciitis? What the evidence actually says
Shockwave therapy for plantar fasciitis and heel pain in Manila — whether it works, how many sessions you need, how long - Shockwave therapy for sports injuries: what it treats, and when
How radial shockwave helps sports injuries — the tendon problems it treats, evidence for athletes, in-season use, realis - How much does shockwave therapy for pain cost in Manila? The honest breakdown
Radial shockwave and PEMF pricing for pain in Manila — per-session and full-course costs, whether PhilHealth or your HMO
PEMF vs shockwave — what is the actual difference?
People often assume these are competing versions of the same thing. They are not. They do different jobs, and for most conditions the honest answer is that they work best together — which is why we run them in the same session rather than asking you to choose.
| Radial shockwave | PEMF | |
|---|---|---|
| What it is | Mechanical pressure waves delivered through the skin | Pulsed electromagnetic fields passing through tissue |
| What it targets | The specific painful structure — tendon, insertion point, calcification | The wider area — swelling, circulation, cellular recovery |
| How it feels | Firm, percussive tapping. Briefly uncomfortable over a sore spot | Usually nothing at all, sometimes a faint tingle |
| Best suited to | Plantar fasciitis, tennis and golfer's elbow, calcific shoulder, stubborn tendon pain | Joint pain, arthritis, back and nerve pain, post-injury swelling |
| Where it is precise | Very — you can point at the spot | Broad — treats a region, not a point |
| Typical response | Often noticeable within 2–3 sessions | More gradual, building across the course |
| Price here | ₱2,500 per area — both modalities in the same session, not billed separately | |
So which one do you need?
In practice, rarely just one. A calcific shoulder responds to shockwave breaking down the deposit and PEMF settling the inflammation around it. Treating only the deposit leaves you sore; treating only the inflammation leaves the cause in place.
That is why we do not sell them as separate products. Your clinician decides the mix on the day based on what is actually going on, and the price is the same either way.
If the pain follows an injury you have not had imaged, is worsening rather than plateauing, or comes with numbness, weakness or fever — you need assessment before any therapy. We will say so and refer you, rather than book you in.