Non-invasive pressure-wave therapy
EPAT shockwave therapy.
EPAT stands for extracorporeal pulse activation technology, which means the pressure waves are made outside the body. A hand-held applicator sends low-frequency waves through the skin to a painful tendon or to the place where a tendon attaches to bone. There are no needles and no anesthesia. Sessions last 25 to 30 minutes and happen weekly.
EPAT
What is EPAT?
EPAT delivers low-frequency radial pressure waves. Radial means the waves spread outward from the tip of a hand-held applicator. Compressed air generates the waves, and ultrasound gel on your skin carries them into the target tissue. That tissue can be a tendon, the place where a tendon attaches to bone (the enthesis), or the sheet of connective tissue called fascia.
EPAT works through mechanical stimulation. The pressure waves are thought to increase blood flow to the area and prompt the release of growth factors. They are also thought to lower substance P, a chemical that carries pain signals, and to support the body's own repair signaling. EPAT does not replace damaged tissue, and it cannot guarantee a result.
Where it's used
Long-standing tendon pain and pain where tendons attach to bone.
We most often use EPAT for pain that has lasted at least 6 weeks despite rest, rehab, or changes in activity.
Plantar fasciitis
Long-standing heel and arch pain.
Achilles tendinopathy
Pain in the Achilles tendon, either where it attaches to the heel bone or in the middle of the tendon.
Tennis elbow
Pain on the outer side of the elbow (lateral epicondylitis) that has continued despite rest and bracing.
Patellar tendinopathy
Pain at the point where the patellar tendon attaches to the kneecap, often called jumper's knee.
Rotator cuff
Tendon pain in the shoulder's rotator cuff, with or without calcium deposits.
Trochanteric pain
Pain on the outer side of the hip (greater trochanteric pain syndrome), which involves the gluteal tendons.
Hamstring origin
Pain where the hamstring tendon attaches near the sit bone, seen in runners, cyclists, and people who sit for long periods.
Case-by-case
Other long-standing tendon or musculoskeletal pain, which we evaluate individually.
How it works
What to expect during a visit.
Each session is a short visit at the clinic. You don't need to prepare, and there is no recovery time. We plan the sessions as a series and assess your response after the last one.
Targeted exam
We find the painful structure and check that it sits at a depth, and in a kind of tissue, that the pressure waves can reach.
Treatment
We apply ultrasound gel to the treatment site and set the energy level for the condition and for what you can tolerate. We then deliver pulses through the hand-held applicator across the target area. You may feel discomfort during this step, and it stops as soon as the applicator stops.
Return to activity
There is no recovery time, and you can return to normal activity right away. Sessions repeat weekly.
Session schedule.
Most patients have 4 to 6 weekly sessions over 4 to 6 weeks, and we assess your response after the last session. Maintenance sessions are uncommon and depend on the case.
The device
How the device works.
EPAT uses a pressure wave generated by compressed air that spreads outward from the applicator. Focused shockwave systems work differently: they concentrate higher peak pressure at one focal point.
The EPAT applicator, held in the clinician's hand throughout the session. Compressed air generates the pressure wave, and the wave spreads outward from the tip.
Talking it through
How we decide whether EPAT fits.
EPAT is used for long-standing pain in a tendon or where a tendon attaches to bone. It isn't the right tool for a recent injury, arthritis inside a joint, or damage deep in the tissue, and we talk through other options with you.
What we look at together
- Tendon or fascia pain that has lasted at least 6 weeks
- Symptoms that continue despite physical therapy, activity changes, and other conservative care
- Wanting a non-invasive option before considering injections
- Plantar fasciitis, Achilles tendinopathy, tennis elbow, patellar tendinopathy, or rotator cuff tendinopathy
- Time for 4 to 6 weekly sessions
Frequently asked
EPAT questions.
How is EPAT different from the shockwave therapy I've heard about? +
EPAT is a radial pressure wave system. The energy spreads outward from the applicator and reaches targets from the surface to a moderate depth. Focused shockwave therapy uses a different mechanism that concentrates energy at a deeper focal point. We use EPAT for the conditions listed above.
How soon will I notice a change? +
Some patients notice a change by the third or fourth session, and others later. Changes can continue for 6 to 12 weeks after the final session.
Can I combine EPAT with PRP? +
Yes, and we often do. EPAT works through mechanical pressure waves and PRP through growth factors from your own platelets, and the two are thought to act on overlapping repair signaling. When tendon pain has not fully eased with EPAT alone, combining the two is a common approach. We decide together, case by case.
Does insurance cover EPAT? +
Coverage is variable. Some commercial plans cover EPAT for plantar fasciitis with documented failure of conservative care; most do not. We provide transparent pricing per session and supply HSA/FSA reimbursement documentation where applicable.
Related therapies
Related treatments.
Schedule a call
Find out whether EPAT fits your pain.
Dr. Glowney examines you and recommends what fits: sometimes that's EPAT alone, sometimes EPAT with PRP, and sometimes a different path entirely.
720-550-6175