Shock wave therapy, or extracorporeal shock wave therapy (ESWT), is a non-invasive medical treatment used to treat various musculoskeletal conditions, particularly those involving connective tissues such as tendons and ligaments. Its wave is delivered into the treatment area with two types of machine generators. These generators give two kinds of ESWT: 1) Focused and 2) Radial. Here's a brief overview:

1. **Mechanism**: Shock wave therapy uses high-energy sound or acoustic waves to induce microtrauma in the tissue. This microtrauma initiates a biological response in the treated area, which includes increased blood flow and the stimulation of cell regeneration and healing processes.

2. **Conditions Treated**: Shock wave therapy is typically used for conditions like plantar fasciitis, tennis elbow, shoulder tendinitis, Achilles tendinitis, and other chronic tendinopathies. It's also used in some cases for bone healing and other orthopaedic conditions.

3. **Procedure**: it should be noted that there are two types of shock wave therapy wave generators, although the procedure is the same as the client's experience. During the treatment, a device generates shock waves directed to the affected area through the skin. A trained therapist can adjust the intensity and frequency of the waves. Usually, the procedure is done in a series of sessions and does not require anaesthesia.

4. **Benefits**: The main benefits include pain reduction and improved mobility in the affected area. It is a non-invasive option compared to surgery and usually has minimal side effects.

5. **Side Effects**: Some patients may experience temporary soreness or swelling in the treated area, but severe side effects are rare.

6. **Effectiveness**: Research has shown varying levels of effectiveness, often dependent on the specific condition being treated. Shock wave therapy, whether the focused or radial type, is generally considered a viable option when traditional treatments like physical therapy or medications have not been successful.

It's important to note that a trained healthcare professional should administer shock wave therapy, and it may not be suitable for all individuals, such as those with certain medical conditions or pregnant women.

Shock wave therapy uses high-energy sound or acoustic waves to induce microtrauma in the tissue. This microtrauma stimulation is similar to what happens when we exercise and impose demands on body tissues that we want to improve. 

This microtrauma initiates a biological response in the treated area, which includes increased blood flow and the stimulation of cell regeneration and healing processes.

This is typically required due to healing stagnation which is common in tendon tissues or tissues with anatomically less blood supply.

Think of the pale bits in an anatomy diagram.

When pain causes are ongoing, like the sports you play or the fact you stand for a living. It means healing gets delayed.

If healing doesn't happen within eight weeks, the blood supply reduces, and healing stagnation happens, which slows the healing response and blood supply; ESWT restarts your natural healing process in certain areas of the body when it stagnates.