Effectiveness of Extracorporeal Shock Wave Therapy and High-Intensity Laser Therapy in Shoulder Rehabilitation: A Narrative Review
Abstract
Shoulder disorders are among the most prevalent musculoskeletal conditions, often resulting in pain, limited mobility, and reduced quality of life. In recent years, non-invasive modalities such as Extracorporeal Shock Wave Therapy (ESWT) and High-Intensity Laser Therapy (HILT) have gained recognition in physiotherapy for their potential to accelerate tissue healing and provide symptomatic relief without the risks of pharmacologic or surgical intervention. This article presents a narrative review of peer reviewed literature published between 2020 and 2025, selected using structured searches in PubMed, Scopus, Web of Science, and Google Scholar. Studies were included based on predefined inclusion and exclusion criteria, with a focus on clinical outcomes, therapeutic mechanisms, and safety across various shoulder pathologies. The findings indicate that both ESWT and HILT show considerable promise in managing conditions such as rotator cuff tendinopathy, calcific tendinitis, adhesive capsulitis, and subacromial impingement. However, variability in treatment parameters, study quality, and outcome measures continues to hinder the development of standardized clinical guidelines. This review offers practical insight for clinicians and identifies critical gaps in the literature that should inform future research priorities, including protocol optimization and comparative effectiveness studies.
Keywords
Shoulder desorders Extracorporeal shock wave therapy High intensity laser therapy Rehabilitation
References
- Abdelhakiem NM, Saleh MSM, Shabana MMA, Abd EL Wahaab HA, Saleh HM. 2024. Effectiveness of a high intensity laser for improving hemiplegic shoulder dysfunction: A randomized controlled trial. Scientific Reports, 14: 7346. https://doi.org/10.1038/s41598-024-57453-9
- Aldardour A, Al Qudimat AR, Etoom M, Alnammaneh S, al Debes W, Khasaweneh L, Abd Alrazaq A, Mysore S, Al-Jarrah M. 2025. Extracorporeal shockwave therapy as a treatment option for shoulder impingement syndrome: A systematic review and meta analysis. Bulletin of Faculty of Physical Therapy, 30: 43. https://doi.org/10.1186/s43161-025-00300-3
- Demirel A, Arslan H, Gündoğdu İ. 2021. Effectiveness of ESWT and ultrasound therapy in the management of calcific tendinitis: A randomized clinical trial. Archives of Rheumatology, 36(2): 189–195. https://doi.org/10.46497/ArchRheumatol.2021.8129
- Hao J, Yao Y, Remis A, Sun Y, Zhu D, Wu S. 2024. Effects of high intensity laser therapy on subacromial impingement syndrome: A systematic review and meta analysis. Lasers in Medical Science, 39: 240. https://doi.org/10.1007/s10103-024-04190-0
- Ismail RM, Khalaf MMAEK, Fol HAEKE, Kamel NM. 2025. Effect of extracorporeal shock wave therapy on intercostobrachial neuralgia post mastectomy: A randomized controlled trial. Fizjoterapia Polska, 1: 282-288.
- Lee HW, Kim JY, Park CW, Haotian B, Lee GW, Noh KC. 2022. Comparison of extracorporeal shock wave therapy and ultrasound-guided shoulder injection therapy in patients with supraspinatus tendinitis. Clinics in Orthopedic Surgery, 14(4): 585–592. https://doi.org/10.4055/cios21191
- Liao YK, Wu CH, Özçakar L. 2025. Hemiplegic shoulder pain: A narrative review. Rehab Pract Sci, 2025(1): 1. https://rps.researchcommons.org/journal/vol2025/iss1/1/
- Mazin Y, Lemos C, Paiva C, Oliveira LA, Borges A, Lopes T. 2023. The role of extracorporeal shock wave therapy in the treatment of muscle injuries: A systematic review. Cureus, 15(8): e44196. https://doi.org/10.7759/cureus.44196
- Ranjithkumar N, Paul J, Alagesan J. 2025. Comparative effectiveness of extracorporeal shock wave therapy, low-level laser therapy and ultrasound in the treatment of rotator cuff tendinopathy. Biomed Pharmacol J, 18(1): 849-866.
- Salem MMI, Abdelaal AAM, El Fiky AAR, Ebid AA, Battecha KH, Thabet AAEM, Mousa G. 2024. High-intensity laser therapy versus shock wave therapy in the management of diabetic frozen shoulder. Pharmacophore, 15(2): 113–118. https://doi.org/10.51847/twO5acnaXy
- Sharahili TM, Alzahrani HA. 2025. Effect of radial extracorporeal shockwave therapy combined with evidence-based physical therapy for adhesive capsulitis of the shoulder: A randomized controlled trial. Saudi Medic J, 46(7): 816–824. https://doi.org/10.15537/smj.2025.46.7.20250213
- Xue X, Song Q, Yang X, Kuati A, Fu H, Liu Y, Cui G. 2024. Effect of extracorporeal shockwave therapy for rotator cuff tendinopathy: A systematic review and meta analysis. BMC Musculoskeletal Disorders, 25: 357. https://doi.org/10.1186/s12891-024-07445-7
Effectiveness of Extracorporeal Shock Wave Therapy and High-Intensity Laser Therapy in Shoulder Rehabilitation: A Narrative Review
Abstract
Shoulder disorders are among the most prevalent musculoskeletal conditions, often resulting in pain, limited mobility, and reduced quality of life. In recent years, non-invasive modalities such as Extracorporeal Shock Wave Therapy (ESWT) and High-Intensity Laser Therapy (HILT) have gained recognition in physiotherapy for their potential to accelerate tissue healing and provide symptomatic relief without the risks of pharmacologic or surgical intervention. This article presents a narrative review of peer reviewed literature published between 2020 and 2025, selected using structured searches in PubMed, Scopus, Web of Science, and Google Scholar. Studies were included based on predefined inclusion and exclusion criteria, with a focus on clinical outcomes, therapeutic mechanisms, and safety across various shoulder pathologies. The findings indicate that both ESWT and HILT show considerable promise in managing conditions such as rotator cuff tendinopathy, calcific tendinitis, adhesive capsulitis, and subacromial impingement. However, variability in treatment parameters, study quality, and outcome measures continues to hinder the development of standardized clinical guidelines. This review offers practical insight for clinicians and identifies critical gaps in the literature that should inform future research priorities, including protocol optimization and comparative effectiveness studies.
Keywords
Shoulder desorders Extracorporeal shock wave therapy High intensity laser therapy Rehabilitation
References
- Abdelhakiem NM, Saleh MSM, Shabana MMA, Abd EL Wahaab HA, Saleh HM. 2024. Effectiveness of a high intensity laser for improving hemiplegic shoulder dysfunction: A randomized controlled trial. Scientific Reports, 14: 7346. https://doi.org/10.1038/s41598-024-57453-9
- Aldardour A, Al Qudimat AR, Etoom M, Alnammaneh S, al Debes W, Khasaweneh L, Abd Alrazaq A, Mysore S, Al-Jarrah M. 2025. Extracorporeal shockwave therapy as a treatment option for shoulder impingement syndrome: A systematic review and meta analysis. Bulletin of Faculty of Physical Therapy, 30: 43. https://doi.org/10.1186/s43161-025-00300-3
- Demirel A, Arslan H, Gündoğdu İ. 2021. Effectiveness of ESWT and ultrasound therapy in the management of calcific tendinitis: A randomized clinical trial. Archives of Rheumatology, 36(2): 189–195. https://doi.org/10.46497/ArchRheumatol.2021.8129
- Hao J, Yao Y, Remis A, Sun Y, Zhu D, Wu S. 2024. Effects of high intensity laser therapy on subacromial impingement syndrome: A systematic review and meta analysis. Lasers in Medical Science, 39: 240. https://doi.org/10.1007/s10103-024-04190-0
- Ismail RM, Khalaf MMAEK, Fol HAEKE, Kamel NM. 2025. Effect of extracorporeal shock wave therapy on intercostobrachial neuralgia post mastectomy: A randomized controlled trial. Fizjoterapia Polska, 1: 282-288.
- Lee HW, Kim JY, Park CW, Haotian B, Lee GW, Noh KC. 2022. Comparison of extracorporeal shock wave therapy and ultrasound-guided shoulder injection therapy in patients with supraspinatus tendinitis. Clinics in Orthopedic Surgery, 14(4): 585–592. https://doi.org/10.4055/cios21191
- Liao YK, Wu CH, Özçakar L. 2025. Hemiplegic shoulder pain: A narrative review. Rehab Pract Sci, 2025(1): 1. https://rps.researchcommons.org/journal/vol2025/iss1/1/
- Mazin Y, Lemos C, Paiva C, Oliveira LA, Borges A, Lopes T. 2023. The role of extracorporeal shock wave therapy in the treatment of muscle injuries: A systematic review. Cureus, 15(8): e44196. https://doi.org/10.7759/cureus.44196
- Ranjithkumar N, Paul J, Alagesan J. 2025. Comparative effectiveness of extracorporeal shock wave therapy, low-level laser therapy and ultrasound in the treatment of rotator cuff tendinopathy. Biomed Pharmacol J, 18(1): 849-866.
- Salem MMI, Abdelaal AAM, El Fiky AAR, Ebid AA, Battecha KH, Thabet AAEM, Mousa G. 2024. High-intensity laser therapy versus shock wave therapy in the management of diabetic frozen shoulder. Pharmacophore, 15(2): 113–118. https://doi.org/10.51847/twO5acnaXy
- Sharahili TM, Alzahrani HA. 2025. Effect of radial extracorporeal shockwave therapy combined with evidence-based physical therapy for adhesive capsulitis of the shoulder: A randomized controlled trial. Saudi Medic J, 46(7): 816–824. https://doi.org/10.15537/smj.2025.46.7.20250213
- Xue X, Song Q, Yang X, Kuati A, Fu H, Liu Y, Cui G. 2024. Effect of extracorporeal shockwave therapy for rotator cuff tendinopathy: A systematic review and meta analysis. BMC Musculoskeletal Disorders, 25: 357. https://doi.org/10.1186/s12891-024-07445-7
Details
| Primary Language | English |
|---|---|
| Subjects | Health Services and Systems (Other) |
| Journal Section | Review |
| Authors | |
| Publication Date | September 15, 2025 |
| Submission Date | August 7, 2025 |
| Acceptance Date | August 26, 2025 |
| Published in Issue | Year 2025 Volume: 8 Issue: 5 |
