By Dr. Anthony Cutting, DC
How Do You Choose Between Shockwave And Laser?
If your shoulder still hurts after rest, exercises, or physical therapy, you may be wondering whether shockwave or laser therapy could help. We offer both at Active Chiropractic Meridian, and the first step is understanding what is causing the pain.
Before I recommend a treatment, I want to hear what you’ve already tried and what you’ve had to stop doing. Then we can discuss your options, whether your goal is sleeping on your side, lifting at work, or getting back to golf.
An examination helps determine whether shockwave therapy is suitable for you.
If you’re comparing the two treatments, here is what is worth knowing before you book an appointment or agree to a recommendation.
How The Two Treatments Work
Shockwave therapy uses pressure waves. Class IV laser uses light. In both cases, a clinician uses a handheld applicator over the area being treated.
You may also come across the terms focused shockwave and radial pressure wave. They describe different ways of delivering mechanical energy. The International Society for Medical Shockwave Treatment explains the distinction, which matters when comparing treatments or reading about a study.
Class IV is the laser’s safety classification. It doesn’t mean every Class IV laser is identical or that a stronger setting is the right choice for every problem.
You don’t need to become an expert in the equipment. You should be able to ask why a treatment is being recommended and get an explanation you understand.
The Cause Of Your Pain Matters More Than The Treatment Name
A shoulder that hurts when you reach overhead could involve a tendon problem, stiffness, arthritis, or pain coming from the neck. Those possibilities can lead to different recommendations, even when the painful spot seems similar.
That is why I start with an examination. I want to understand how the shoulder moves, what feels weak or painful, and how the problem began. Our shoulder pain page explains more about that process.
The same approach applies when you’re asking about an elbow, heel, or another painful area. A treatment that helped someone else’s shoulder may not be the right choice for yours.
Terms such as advanced, deep tissue, and high intensity tell you very little about whether a treatment suits your problem. Ask what the examination showed and how that led to the recommendation.
What The Research Can Tell Us
Research is more helpful when it addresses the problem you actually have.
For example, a 2026 review compared high-intensity laser with shockwave therapy for tennis elbow. Laser performed better on some measures of arm function over the first few months. The review did not find a clear difference between the treatments for several other measures, including pain and grip strength, and longer follow-up was needed.
That gives us information about tennis elbow. It doesn’t settle which treatment to use for a painful shoulder or Achilles tendon, or prove that every laser or shockwave device will produce the same results.
When we discuss a treatment, I want you to understand what we hope it will help, how strong the supporting research is, and what other options you have. There may be reasonable choices beyond the two devices you originally came in to ask about.
What If Your Scan Shows Calcium Deposits?
Some people start researching shockwave after a scan shows calcium in a shoulder tendon. This is called calcific tendinopathy.
You may have seen claims that shockwave will break up the deposits and solve the pain. The research calls for more caution. The UK’s NICE guidance on shockwave for calcific shoulder tendinopathy recommends its use only in research because the evidence for effectiveness is inadequate. That guidance applies to the UK; it helps show why a treatment promise deserves a closer look.
If calcium appears on your report, bring the report to your appointment. We can discuss what the finding means alongside your symptoms and examination. The scan is one part of understanding the shoulder.
Where Treatment Fits Into Your Recovery
The device is only one part of the recommendation. You also need to know how care will help you work toward the things that are difficult now.
At Active Chiropractic Meridian, care may include rehabilitation, movement-based care, soft-tissue treatment, chiropractic care, shockwave therapy, or Class IV laser. You won’t automatically need every service we offer. Each recommendation should have a clear purpose.
Suppose carrying groceries is what bothers your elbow. I want to hear whether you can carry a bag farther, whether you still have to switch hands, and how the elbow feels later that day. Those details help us understand whether daily life is getting easier.
The same idea applies to reaching a shelf, sleeping on your shoulder, or getting back to golf. Tell me what you miss doing. That gives us a practical way to talk about progress.
What To Discuss Before Treatment
Before treatment starts, we need to review your health history, medications, recent procedures, and the area being treated. Ask about anything that concerns you, including what the treatment may feel like and what you should expect afterward.
For shockwave, ISMST describes safety restrictions that depend on the technique and treatment area. Laser treatment has its own equipment-specific safety requirements. This screening needs to happen with your clinician, rather than through a checklist you work through alone.
You should also have a clear explanation of costs, scheduling, alternatives, and when the recommendation will be reviewed. If you leave unsure why a particular treatment was suggested, ask us to go through it again.
Contact your clinician if symptoms worsen or change unexpectedly. Increased pain is not proof that treatment is working. A sudden injury with new weakness or a major loss of movement needs prompt medical assessment.
How We Check Whether Care Is Helping
Before starting, agree on what you hope to improve and when you will check in about it.
You might ask:
- What do you think is causing my pain?
- Why are you recommending this treatment?
- What changes should we watch for at home or during my usual activities?
- When will we review how I’m doing?
- What happens if I don’t improve?
I want you to understand the recommendation, including its limits. If something isn’t helping, we need to reconsider it. That could mean changing the approach, revisiting the diagnosis, or involving another provider.
You shouldn’t feel that you have to keep repeating the same treatment without knowing why.
Start With An Evaluation
You don’t have to decide between shockwave and laser before coming in. Bring your questions, any relevant reports, and the details of what you’ve already tried.
I will listen, examine the problem, and explain what I find. If one of our treatments seems appropriate, we can discuss why. If another provider or a surgical opinion would be more helpful, I’ll tell you that too.
To discuss the services available at Active Chiropractic Meridian, contact the office or call 208-593-2001. We are at 2145 E. Fairview Ave, Suite 140, Meridian, ID 83642.
FAQs
Is shockwave therapy the same as laser therapy?
No. Shockwave uses pressure waves, while laser uses light. Both involve an applicator over the treatment area, which can make them look similar in photographs. The examination helps determine whether either is a suitable option for you.
Does Class IV mean laser therapy works better?
No. Class IV is a safety classification. It doesn’t tell you how well a laser will work for your particular problem. The condition being treated and how the laser is used both matter.
Should everyone have both treatments together?
No. We offer both, but that doesn’t mean you need both. We should be able to explain the purpose of each treatment we recommend and how we will check whether it is helping.
What if my main goal is returning to golf or lifting?
Tell us. Knowing what you want to return to helps us understand the problem and discuss progress in useful terms. Bring examples of the movements that hurt, when the pain starts, and what you’ve had to stop or change.