SoftWave therapy may be a valuable non-surgical treatment option for certain chronic pain and musculoskeletal conditions, but research does not establish that it is universally better than surgery. Clinical studies suggest that extracorporeal shockwave therapy (ESWT), the broader treatment category that includes SoftWave, may help reduce pain and improve function in selected patients. However, its effectiveness depends on the condition being treated, and some injuries still require surgical intervention.
For people living with persistent joint pain, tendon injuries, or recurring discomfort, the possibility of surgery can raise important questions. Is an operation truly necessary? Are there treatments worth trying first? Could a non-invasive approach provide meaningful relief?
At DK Chiropractic in Honolulu, Hawaii, Dr. Doo Hyun Kwak, DC, offers SoftWave therapy as part of a personalized approach to pain management and musculoskeletal care.
Understanding what the research actually says can help patients make more informed decisions about their treatment options.
What Is SoftWave Therapy and How Does It Work?
SoftWave is a non-invasive treatment that uses acoustic waves to stimulate biological responses in targeted tissues. It belongs to a broader category of treatments known as extracorporeal shockwave therapy (ESWT).
During treatment, a handheld applicator delivers acoustic energy through the skin to the affected area. Researchers have investigated how this energy influences biological processes associated with circulation, cellular signaling, pain modulation, and tissue repair.
Unlike surgery, SoftWave does not involve incisions, general anesthesia, or surgical reconstruction.
Potential advantages include:
Non-invasive treatment: No surgical incisions or stitches are required.
Minimal interruption to daily life: Patients can generally return to routine activities after treatment, although activity recommendations vary.
Drug-free approach: Acoustic energy is delivered without injecting medication into the treatment area.
Potential pain and function improvements: Some research involving ESWT has demonstrated benefits for specific musculoskeletal conditions.
Compatibility with rehabilitation: Treatment may be considered alongside appropriate exercise, physical therapy, and other conservative care.
These characteristics make SoftWave appealing to patients who want to explore non-surgical options.
However, an important distinction is that much of the published research evaluates different ESWT devices and treatment protocols rather than the SoftWave system specifically. Findings from other shockwave technologies cannot automatically be assumed to apply equally to SoftWave.
Related: Does SoftWave Therapy Hurt? The Truth Behind the Treatment
What Does the Research Say About Shockwave Therapy?
Clinical researchers have studied extracorporeal shockwave therapy for conditions such as plantar fasciitis, tennis elbow, and several types of tendinopathy.
The findings are encouraging in some areas, mixed in others, and insufficient to establish shockwave therapy as a general replacement for surgery.
Research on Plantar Fasciitis and Chronic Heel Pain
Plantar fasciitis is a common cause of heel pain, particularly among people who spend long periods standing, walking, or participating in physical activities.
For patients whose symptoms persist despite initial conservative care, ESWT may be considered as an additional non-surgical option.
A 2024 systematic review and meta-analysis published in Archives of Orthopaedic and Trauma Surgery analyzed 14 randomized controlled trials involving 867 participants.
Researchers found that ESWT significantly reduced plantar fascia thickness compared with other non-surgical treatments. However, the analysis did not establish a statistically significant advantage in pain relief over those comparison treatments.
What this means for patients: Shockwave therapy may have measurable effects on plantar fascia tissue, but meaningful pain relief is not guaranteed, and evidence does not establish that it is superior to every other conservative treatment.
Source: Simental-Mendía et al. (2024), Effect of extracorporeal shockwave therapy on plantar fascia thickness in plantar fasciitis: a systematic review and meta-analysis of randomized controlled trials.
https://pubmed.ncbi.nlm.nih.gov/39023569/
Research on Tennis Elbow and Tendon Pain
Tennis elbow, also called lateral epicondylitis, involves pain and reduced function around the outside of the elbow.
A 2024 systematic review and meta-analysis published in Orthopaedic Surgery compared ESWT with local corticosteroid injections for chronic tennis elbow.
The review included six randomized controlled trials.
Researchers reported that corticosteroid injections produced better outcomes at the one-month follow-up. However, ESWT demonstrated more favorable results for certain pain and functional measures at three and six months.
These results suggest that ESWT may offer benefits for selected patients seeking alternatives to injections, although the findings do not demonstrate superiority over surgery.
What this means for patients: The best treatment may depend on whether short-term pain relief or longer-term functional improvement is the main priority.
Source: Extracorporeal Shock Wave Therapy Versus Local Corticosteroid Injection for Chronic Lateral Epicondylitis: A Systematic Review with Meta-Analysis of Randomized Controlled Trials (2024).
https://pubmed.ncbi.nlm.nih.gov/39198038/
Research on Achilles Tendon Conditions
Not every condition responds equally well to shockwave therapy.
A 2026 systematic review and meta-analysis published in the Journal of Orthopaedic & Sports Physical Therapy examined shockwave therapy for midportion and insertional Achilles tendinopathy.
The researchers found no consistent, clinically meaningful improvement in pain or disability compared with control treatments. They concluded that shockwave therapy should not be routinely recommended for these Achilles tendon conditions based on the available evidence.
What this means for patients: Even though SoftWave and other ESWT treatments are used for different tendon-related concerns, the evidence varies considerably by diagnosis.
Source: Shockwave Therapy for Midportion and Insertional Achilles Tendinopathy: A Nail in the Coffin? A Systematic Review With Meta-Analysis (2026).
https://pubmed.ncbi.nlm.nih.gov/42063301/
SoftWave vs. Surgery: Understanding the Differences
SoftWave therapy and surgery are fundamentally different approaches to treating musculoskeletal conditions. Understanding these differences can help patients make informed decisions about their care.
Treatment Procedure
SoftWave Therapy: A non-invasive treatment that uses acoustic waves to stimulate biological responses in targeted tissues. No incisions, stitches, or surgical procedures are required.
Surgery: An invasive or minimally invasive procedure that may involve repairing, removing, stabilizing, or reconstructing damaged tissues.
Anesthesia Requirements
SoftWave Therapy: Generally does not require anesthesia, allowing patients to remain awake and comfortable throughout treatment.
Surgery: Depending on the procedure, local, regional, or general anesthesia may be necessary.
Recovery and Downtime
SoftWave Therapy: Typically involves minimal treatment-related downtime. Many patients can return to normal daily activities shortly after a session, although activity restrictions may vary.
Surgery: Recovery time depends on the type and complexity of the procedure. Some surgeries require weeks or months of rehabilitation.
Tissue Repair and Healing
SoftWave Therapy: May stimulate biological responses associated with tissue recovery, but it does not physically reconstruct damaged structures.
Surgery: Can directly repair or reconstruct damaged tissues, making it necessary for certain structural injuries.
Potential Risks and Side Effects
SoftWave Therapy: Possible side effects include temporary soreness, redness, or discomfort around the treated area.
Surgery: Potential risks vary by procedure but may include infection, bleeding, anesthesia-related complications, and postoperative discomfort.
Treatment Effectiveness
SoftWave Therapy: Research suggests that extracorporeal shockwave therapy may help improve pain and function for certain musculoskeletal conditions. However, results depend on the diagnosis, treatment protocol, and individual response.
Surgery: Effectiveness depends on the underlying condition, surgical procedure, and patient-specific factors. Surgery may provide a more appropriate solution when significant structural damage requires medical intervention.
Which Treatment Is Right for You?
SoftWave may be worth considering for certain chronic musculoskeletal conditions when conservative treatment is medically appropriate. However, it is not a replacement for every surgical procedure.
At DK Chiropractic, Dr. Doo Hyun Kwak, DC, helps patients in Honolulu, Hawaii and surrounding areas explore whether SoftWave therapy may be suitable for their individual needs.
Related: How SoftWave Therapy Supports Active Aging and Joint Health
Can SoftWave Help You Avoid Surgery?
SoftWave may help some patients manage symptoms and improve function without requiring an operation, but there is not enough high-quality direct comparative research to conclude that SoftWave consistently prevents surgery.
For people with persistent pain, the decision often involves determining whether conservative care has been adequately explored.
Depending on the condition, non-surgical treatment options may include:
Therapeutic exercise and rehabilitation
Activity modification
Chiropractic care when clinically appropriate
Bracing or supportive devices
Medication or injections when indicated
Extracorporeal shockwave therapy
If pain and functional limitations improve sufficiently, some patients may decide with their treating clinician that surgery is no longer necessary.
However, SoftWave cannot repair a completely ruptured tendon, stabilize a significantly displaced fracture, or resolve every condition that requires an operation.
Surgery or urgent specialist evaluation may be necessary for certain serious injuries, progressive neurological deficits, infections, or other structural problems.
Patients should never postpone medically necessary surgery solely to try SoftWave therapy.
Related: Can SoftWave Therapy Treat Tennis Elbow Effectively?
Why Non-Surgical Treatment May Be Worth Exploring First
For many non-emergency musculoskeletal conditions, healthcare professionals recommend evaluating appropriate conservative treatment options before considering an operation.
This approach can be valuable because surgery involves additional considerations, including postoperative rehabilitation, potential complications, time away from work, and financial costs.
SoftWave may appeal to patients who want to:
Explore treatment options without surgical incisions.
Manage ongoing discomfort while maintaining daily activities.
Participate more comfortably in a rehabilitation program.
Understand whether additional conservative care is reasonable.
Discuss alternatives before making a decision about elective surgery.
Still, being non-invasive does not automatically make a treatment more effective.
A meaningful treatment decision should consider the diagnosis, published evidence, personal goals, previous treatment responses, and the consequences of delaying other care.
Related: Can SoftWave Therapy Help Shoulder Pain? A Non-Surgical Option in Honolulu
Who May Be a Good Candidate for SoftWave Therapy?
A patient may be considered for SoftWave therapy when they have a musculoskeletal condition for which shockwave treatment has reasonable clinical support.
Examples of conditions that may warrant an evaluation include:
Chronic Plantar Heel Pain
Patients with persistent plantar fasciitis who have not responded adequately to initial conservative treatments may wish to discuss whether shockwave therapy is appropriate.
Certain Tendon-Related Conditions
Patients with selected chronic tendon problems, including tennis elbow, may benefit from discussing ESWT alongside exercise-based rehabilitation and other treatment options.
Ongoing Musculoskeletal Pain
Some patients experiencing persistent discomfort may be interested in SoftWave, but an accurate diagnosis is essential. Not all causes of joint, muscle, nerve, or back pain have equally strong supporting evidence for ESWT.
A thorough assessment helps determine whether treatment is appropriate or whether referral, imaging, or another form of care is necessary.
What to Expect During SoftWave Therapy at DK Chiropractic
At DK Chiropractic in Honolulu, SoftWave therapy is offered as part of an individualized approach to musculoskeletal care.
Dr. Doo Hyun Kwak, DC, evaluates patients to better understand their symptoms, medical history, and treatment goals.
When SoftWave is considered appropriate, treatment involves applying acoustic waves to the targeted area using a handheld device.
Sessions are generally brief, and the treatment does not require surgical incisions or general anesthesia.
Some patients experience temporary soreness or sensitivity in the treated area. The number of sessions and expected response vary depending on the condition.
Importantly, treatment outcomes should be evaluated based on meaningful changes in pain, mobility, and everyday function rather than assumptions that everyone will respond the same way.
Frequently Asked Questions About SoftWave and Surgery
Is SoftWave scientifically proven to be better than surgery?
No. While research supports the potential usefulness of extracorporeal shockwave therapy for selected conditions, the current evidence does not establish SoftWave as universally more effective than surgery. Direct comparisons involving SoftWave specifically remain limited.
Can SoftWave permanently eliminate chronic pain?
SoftWave may help reduce certain types of pain, but permanent relief cannot be guaranteed. Outcomes depend on the underlying diagnosis, severity, individual response, and other aspects of care.
Does SoftWave work for arthritis?
Shockwave therapy has been investigated for some arthritis-related symptoms, but the evidence remains limited and varies by condition. It should not be described as reversing advanced arthritis or replacing joint replacement surgery when that procedure is medically indicated.
How many SoftWave treatments are needed?
Treatment schedules vary by condition and clinical evaluation. Some patients notice changes earlier than others, while some may not experience meaningful improvement. A personalized plan and reassessment can help determine whether continuing treatment is worthwhile.
Is SoftWave safer than surgery?
SoftWave avoids many procedure-related risks associated with operations, including surgical incisions and anesthesia. However, it can still cause side effects and may not be suitable for everyone. Safety must be considered alongside effectiveness and whether surgery is medically necessary.
Should I try SoftWave before a recommended operation?
That depends on your diagnosis and the reason surgery was recommended. If the procedure is elective and additional conservative treatment is medically reasonable, discussing SoftWave with your healthcare team may be worthwhile. If surgery is urgent or necessary to prevent further harm, delaying it may be unsafe.
Making an Informed Decision About SoftWave and Surgery
The research suggests that extracorporeal shockwave therapy can be a useful non-surgical option for certain musculoskeletal conditions.
However, the evidence does not support the claim that SoftWave is always better than surgery.
Some patients may benefit from exploring additional conservative treatments before undergoing an elective procedure. Others may have structural injuries or medical conditions for which surgery offers a more appropriate solution.
The goal should always be to choose care that is supported by evidence, appropriate for the diagnosis, and aligned with the patient's needs.
At DK Chiropractic, personalized assessment helps determine whether SoftWave therapy may be a reasonable part of a patient's pain management and recovery plan.
Explore Non-Surgical Pain Relief at DK Chiropractic in Honolulu
If persistent pain is affecting your ability to work, exercise, or enjoy everyday activities, learning about your treatment options can be an important first step.
At DK Chiropractic, Dr. Doo Hyun Kwak, DC, offers SoftWave therapy for appropriate patients seeking a non-invasive approach to musculoskeletal care.
Whether you are managing ongoing heel pain, tendon discomfort, or another musculoskeletal concern, Dr. Kwak can help evaluate whether SoftWave may fit your needs and whether additional medical evaluation is recommended.
DK Chiropractic welcomes patients from Honolulu, Ala Moana, Kakaako, Waikiki, and surrounding communities across Oahu.
Call (808) 551-4548 to schedule a consultation and learn whether SoftWave therapy may be appropriate for you.
Research References
Simental-Mendía, M., et al. (2024). Effect of extracorporeal shockwave therapy on plantar fascia thickness in plantar fasciitis: a systematic review and meta-analysis of randomized controlled trials. Archives of Orthopaedic and Trauma Surgery, 144, 3503–3516.
https://doi.org/10.1007/s00402-024-05464-6
Extracorporeal Shock Wave Therapy Versus Local Corticosteroid Injection for Chronic Lateral Epicondylitis: A Systematic Review with Meta-Analysis of Randomized Controlled Trials. (2024). Orthopaedic Surgery.
https://pubmed.ncbi.nlm.nih.gov/39198038/
Shockwave Therapy for Midportion and Insertional Achilles Tendinopathy: A Nail in the Coffin? A Systematic Review With Meta-Analysis. (2026). Journal of Orthopaedic & Sports Physical Therapy, 56(5), 282–299.
https://doi.org/10.2519/jospt.2026.13985
Medical Disclaimer: This article is intended for general educational purposes only and does not replace professional medical advice, diagnosis, or treatment. SoftWave therapy is not appropriate for every condition, and results vary. Patients considering surgery should discuss treatment alternatives with their treating physician or appropriate specialist.Explore Non-Surgical Pain Relief at DK Chiropractic in Honolulu
If persistent pain is affecting your ability to work, exercise, or enjoy everyday activities, exploring non-surgical treatment options may be an important first step.
At DK Chiropractic, Dr. Doo Hyun Kwak, DC, offers SoftWave therapy to help appropriate patients manage musculoskeletal discomfort and explore alternatives to invasive procedures.
Whether you're dealing with chronic heel pain, tendon discomfort, or other musculoskeletal concerns, our team is here to help you understand whether SoftWave therapy may be right for your needs.
Proudly serving patients in Honolulu, Hawaii and surrounding areas, DK Chiropractic is committed to providing personalized care focused on your comfort, mobility, and overall well-being.
Ready to explore your options? Contact DK Chiropractic at (808) 551-4548 to schedule a consultation with Dr. Doo Hyun Kwak, DC, and discover whether SoftWave therapy may be a suitable part of your treatment plan.
