El Paso Back Clinic ESWT for Chronic Pain Relief

El Paso Back Clinic Shockwave Therapy: A Non-Surgical Option for Chronic Pain

Why Real ESWT Matters for Deep Healing at an Integrative El Paso Back Clinic

When people hear the term shockwave therapy, they often assume every machine is the same. It is not.

Some devices are true medical Extracorporeal Shockwave Therapy (ESWT) systems. Other devices are weaker radial pressure wave tools that are sometimes marketed as shockwave devices, even though they work differently. That difference matters if your goal is real tissue healing, not just short-term soreness relief. Mayo Clinic explains that focused shockwave (FSW) and radial pressure wave (RPW) are distinct waveforms, and only FSW is considered a “true shockwave” in a strict physical sense.

For a clinic like El Paso Back Clinic, where patients often come in with chronic pain, sports injuries, auto injuries, soft-tissue damage, and complex back conditions, the type of device and the treatment plan can make a big difference. The clinic’s site emphasizes multidisciplinary care, non-surgical recovery, and an integrative model that includes chiropractic, rehab, and functional medicine support.

This article explains, in plain language, what “real” shockwave therapy is, why focused shockwave is different from weaker devices, and how it fits into a complete recovery program in an integrative chiropractic setting.

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What Is Real Shockwave Therapy?

Extracorporeal Shockwave Therapy (ESWT) is a non-invasive treatment that sends acoustic energy (sound waves) into injured tissue from outside the body. It is used in musculoskeletal care to help reduce pain and support healing in stubborn injuries. UCHealth describes ESWT as a noninvasive option for people who have not responded well to more conventional treatments, noting that it delivers high-energy acoustic waves to injured areas.

Mayo Clinic also describes shockwave therapy as a growing tool in physical medicine and sports medicine, especially for tendon and fascia problems.

In simple terms

Shockwave therapy is used to help the body “restart” healing in tissue that has been painful or stuck for a long time, such as:

• tendons

• fascia

• ligaments

• some chronic soft-tissue injuries

• certain bone healing problems (in selected cases)

Mayo Clinic lists many musculoskeletal uses, including plantar fasciitis, Achilles tendinopathy, patellar tendinopathy, and lateral epicondylitis (tennis elbow).

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Not All “Shockwave” Machines Are the Same

This is the most important part of the topic.

Many clinics use the word shockwave, but there are two main categories of devices used in musculoskeletal care:

• Focused Shockwave (FSW / F-ESWT)

• Radial Pressure Wave (RPW / radial therapy)

Mayo Clinic clearly explains that these are different technologies and should not be treated as identical. In fact, Mayo states that only focused shockwave generates a true shockwave, while radial devices generate a radial pressure wave.

Why that matters

The difference is not just marketing. It affects:

• how deep the energy goes

• how precise the treatment is

• how much energy reaches the target tissue

• what conditions may respond best

If a patient has a deep tendon problem, scar tissue, or a stubborn chronic injury, the provider should know exactly what machine is being used and why.

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Focused Shockwave vs. Radial Pressure Wave

Here is the practical difference in plain language.

Focused Shockwave (FSW)

Focused shockwave is designed to deliver energy to a specific target depth. It is more precise and is often the better choice when the provider wants to treat a deeper structure or a smaller, more exact area. Mayo Clinic notes that focused shockwave has different physical properties and can be used alone or in combination with radial treatment, depending on the condition.

Radial Pressure Wave (RPW)

Radial therapy spreads energy more broadly and is often more surface-level. Mayo Clinic explains that radial devices generate pressure waves and notes tissue penetration of about 4 to 5 cm in its 2022 discussion of radial ESWT.

That does not mean radial is “bad.” It means it is different. In many cases, radial therapy remains helpful. But if a clinic claims “shockwave” and the patient expects high-energy focused treatment, the patient should ask which device is being used.

Quick comparison

• Focused shockwave

  • More precise targeting

  • True shockwave physics

  • Often used for deeper or more exact lesions

  • Better fit for some regenerative goals

• Radial pressure wave

  • Broader spread

  • Pressure-wave technology

  • Often, more superficial or diffuse treatment

  • Can still be useful in the right case

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Why Energy Dose Matters

Real ESWT is not just “machine on, machine off.” It is dosed.

One of the main ways clinicians describe ESWT dose is Energy Flux Density (EFD), and the standard unit is mJ/mm² (millijoules per square millimeter). A PubMed Central review explains that EFD is the professional parameter used to describe shockwave energy flow through tissue, and specifically notes the unit of measurement as mJ/mm².

This is important because:

• stronger energy is not always better

• tissue type matters

• the diagnosis matters

• different injuries need different treatment settings

A quality clinic should be able to explain the treatment plan in a way that matches your condition, rather than using the same approach for every patient.

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Does Shockwave Therapy Create “Microtrauma”?

Many people explain shockwave therapy by saying it creates “microtrauma” that triggers healing. That is a common explanation, and Mayo Clinic Sports Medicine uses this language in a patient-friendly way, noting that acoustic waves can create microtrauma to help reinitiate a healing response in tendons.

That said, many experts also describe the process in a more modern way as mechanotransduction—meaning the waves create a mechanical signal that helps cells activate repair pathways. Mayo Clinic’s 2025 article also highlights mechanotransduction and regenerative effects like cellular signaling and neovascular changes.

A simple way to think about it

Shockwave therapy helps by:

• stimulating local tissue response

• improving healing signaling

• reducing pain pathways over time

• helping stubborn tissue become more “active” in repair

So the short answer is:

• Yes, “microtrauma” is a common way to explain it.

• But the bigger idea is that the shockwave creates a healing signal, not uncontrolled tissue damage.

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FDA Regulation and Why It Matters

Another reason patients should ask questions is that regulatory status matters.

The FDA has approved/cleared specific extracorporeal shockwave devices for specific uses. For example, the FDA PMA listing for the OrthoSpec Extracorporeal Shock Wave Therapy device states that it is indicated for adults with proximal plantar fasciitis (with or without a heel spur) who have had symptoms for 6 months or more and have failed conservative treatment.

That helps patients understand two important points:

• real ESWT is a recognized medical technology

• device claims should match actual indications and training

If a clinic says “shockwave,” it is fair to ask:

• What exact device is this?

• Is it focused or radial?

• Is it FDA-cleared/approved for a musculoskeletal indication?

These are smart questions, not rude questions.

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Why Real ESWT Is Useful in an Integrative Chiropractic Clinic

Shockwave therapy can be very effective, but it works best when the diagnosis is correct, and the rest of the care plan supports healing.

That is where an integrative clinic model is helpful.

The El Paso Back Clinic describes on its website a multidisciplinary, non-surgical, and functional recovery approach that includes chiropractic care, rehab, and broader wellness support. It also describes care for back, auto, and sports injuries, tendinopathy-related issues, and chronic pain.

Why this pairing makes sense

Shockwave therapy targets soft tissue and the healing response.

Chiropractic and rehab help restore:

• joint motion

• spinal alignment

• posture

• movement control

• load tolerance

When these are combined, the patient gets a more complete plan.

Example of an integrative recovery setup

A patient with chronic Achilles pain, plantar fasciitis, or post-accident scar tissue restriction may benefit from:

• Focused shockwave or radial therapy (depending on the tissue depth and goal)

• Chiropractic adjustments to improve joint mechanics

• Mobility work to reduce compensation patterns

• Strength training/rehab exercise to improve tissue tolerance

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• Lifestyle support (sleep, inflammation control, nutrition)

This is especially important for back and soft-tissue injuries, as pain often has multiple causes. The tissue may be irritated, but there may also be a movement issue, posture problem, or old compensation pattern keeping it from healing.

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Clinical Observations in Dr. Alexander Jimenez’s Integrative Model

Public information on dralexjimenez.com and El Paso Back Clinic describes Dr. Alexander Jimenez as a Doctor of Chiropractic and board-certified Family Nurse Practitioner (DC, APRN, FNP-BC) who uses a multidisciplinary, integrative approach focused on non-surgical recovery, diagnostics, and personalized care.

His El Paso Back Clinic content also emphasizes:

• advanced injury rehabilitation

• chronic pain care

• sports injury care

• auto injury care

• functional medicine support

• team-based recovery planning

These clinic observations support the idea that shockwave therapy should not be used as a stand-alone “gadget” treatment. Instead, it fits best within a broader care plan that includes biomechanics, rehab, and whole-person recovery.

Why dual training matters in this setting

In a clinic model that blends chiropractic and nurse practitioner perspectives, the provider can often look at a case more completely, including:

• musculoskeletal pain drivers

• nerve irritation patterns

• inflammation

• healing delays

• activity limitations

• overall recovery readiness

That type of clinical reasoning is helpful when deciding whether a patient should receive:

• focused shockwave

• radial therapy

• chiropractic and rehab only

• imaging first

• referral or co-management

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What Conditions Often Respond to Shockwave Therapy?

Shockwave therapy is often used for chronic injuries that have not improved enough with standard care.

Mayo Clinic and UCHealth commonly describe these types of cases:

• Plantar fasciitis

• Tennis elbow (lateral epicondylitis)

• Achilles tendinopathy

• Patellar tendinopathy

• Shoulder tendinopathy

• Other chronic tendon or fascia pain problems

Mayo’s clinical articles also note that ESWT has roles in treating tendons, ligaments, fascia, and even in selected bone-healing situations.

It may be especially helpful when:

• pain has lasted for months

• the patient plateaued in regular therapy

• surgery is being considered, but not yet desired

• the injury is painful with loading (walking, running, lifting, gripping)

• the provider wants a non-invasive option

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How to Tell if a Clinic Is Offering “Real” Shockwave Therapy

Because the market uses confusing language, patients should ask direct questions before paying for treatment.

Ask these questions

• Is this focused shockwave (FSW) or radial pressure wave (RPW)?

• What condition are you treating, and why is this device the right choice?

• How do you set the energy dose (EFD/mJ/mm2)?

• How many sessions are usually recommended for my condition?

• Will I also get rehab or movement treatment?

• If my pain is deep, how will you target it?

• Is the device FDA-cleared/approved for musculoskeletal use?

A strong clinic should be comfortable answering these questions in simple language.

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Why Device Hype Alone Is Not Enough

Some clinics advertise shockwave therapy as a miracle treatment. That is not the best way to present it.

Shockwave therapy can be a powerful tool, but results depend on:

• correct diagnosis

• correct wave type

• correct dose

• correct treatment schedule

• correct rehab support

• patient compliance (movement, loading, recovery habits)

Even the best technology will not work well if the diagnosis is wrong or if the patient returns to the same harmful movement pattern right away.

This is one reason integrated care models, like the one described at El Paso Back Clinic and Dr. Jimenez’s clinical sites, can be so useful for complex injuries: patients receive more than one treatment option and more than one clinical lens.

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Bottom Line: Focused ESWT Is the Better Choice for True Regenerative Shockwave Goals

If your goal is real regenerative shockwave therapy, focused shockwave (FSW/F-ESWT) is usually the benchmark because it is the true shockwave form and offers more precise targeting. Mayo Clinic makes this distinction very clearly.

Radial devices can still be helpful in many cases, but they are not the same technology. Patients should not be told they are identical.

For patients in El Paso dealing with:

• chronic tendon pain

• back-related soft tissue problems

• sports injuries

• accident-related soft tissue injury

• stubborn pain that has not improved

An integrative clinic model like El Paso Back Clinic can be a strong fit because it combines:

• non-invasive care

• structural assessment

• chiropractic and rehab

• broader healing support

• multidisciplinary planning

That is often what it takes to move from “temporary pain relief” to true recovery.

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References

El Paso Back Clinic. (n.d.). Dr. Alex Jimenez – Doctor of Chiropractic | El Paso, TX Back Clinic (About Us)

El Paso Back Clinic. (n.d.). El Paso Back Clinic® | El Paso, TX Wellness Chiropractic Care Clinic

El Paso Back Clinic. (n.d.). Dr. Alex Jimenez DC, APRN, FNP-BC, Injury Medical & Chiropractic Clinic | Chiropractors El Paso TX

Jimenez, A. (n.d.). El Paso, TX Family Practice Nurse Practitioner and Chiropractor: Dr. Alex Jimenez, DC, APRN, FNP-BC

Mayo Clinic. (2022, February 4). The evolving use of extracorporeal shock wave therapy in managing musculoskeletal and neurological diagnoses

Mayo Clinic. (2025, October 10). Shockwave treatment: A new wave for musculoskeletal care

Mayo Clinic Orthopedics & Sports Medicine. (n.d.). A shocking treatment for tendinopathy provides unique therapy

Simplicio, C. L., et al. (2020). Extracorporeal shock wave therapy mechanisms in musculoskeletal regenerative medicine PubMed Central.

UCHealth Today. (2023, November 15). Shockwave therapy can help those who have chronic injuries

U.S. Food and Drug Administration. (n.d.). Premarket Approval (PMA): OrthoSpec Extracorporeal Shock Wave Therapy Device (P040026)