EPAT for chronic tendon pain
A non-invasive option for tendon pain that hasn’t settled with rest, activity change, or physical therapy. No needles, no downtime, and about ten minutes a session.
Acoustic waves, not needles
EPAT — extracorporeal pulse activation technology, more commonly called shockwave therapy — delivers low-intensity acoustic waves through the skin in rapid pulses. The goal is to increase blood flow to a stubborn patch of tendon and prompt the body’s own healing response in tissue that has stopped making progress on its own.
There’s no incision, no needle, and no anesthetic. It’s an option worth considering when a tendon problem has hung around despite doing the sensible things first.
I’ll be straightforward about the evidence: shockwave therapy helps a meaningful share of patients with chronic tendon pain, and it doesn’t help everyone. Response varies by person and by problem, and I’d rather you know that going in than be promised a result nobody can guarantee.
Chronic tendon problems
- Tennis elbow and golfer’s elbow
- Rotator cuff and shoulder tendinopathy
- Gluteal tendinopathy and greater trochanteric pain on the outside of the hip
- Patellar and other tendon pain around the knee
- Chronic tendon pain that hasn’t settled with rest, activity change, or physical therapy
What a session involves
$300 per session · 3–6 sessions, a week apart
Most courses run $900 to $1,800 depending on how many sessions you need. Insurance doesn’t cover EPAT, but it is eligible for FSA and HSA funds.
- A gel is applied and the applicator is moved over the area in a circular motion
- Each session takes about 5–10 minutes
- Sessions are spaced a week apart — at least 3, and up to 6
- No needles, no anesthetic, no downtime — you leave and carry on with your day
- Some soreness afterwards is common and usually settles within a few days with ice
Sessions are delivered by our physician assistant at the Washington, D.C. office, after an evaluation to confirm EPAT is a sensible option for your particular problem. If it isn’t, we’ll tell you what would be — including PRP or one of the other non-surgical options.
See whether it fits your problem
Tell us where the pain is and how long it’s been going on. We’ll get you evaluated and let you know honestly whether EPAT is a reasonable option for you — or whether something else would serve you better.
Questions patients ask
What is EPAT?
EPAT — Extracorporeal Pulse Activation Technology, also called shockwave therapy — uses low-intensity acoustic waves delivered through the skin in rapid pulses. The aim is to increase blood flow to a stubborn area of tendon and stimulate the body’s own healing response. It is non-invasive: no incision, no needle, and no anesthetic.
What does it cost, and is it covered?
Each session is $300. A typical course is at least 3 sessions and up to 6, spaced about a week apart — so most courses run $900 to $1,800. Insurance does not cover EPAT, but it is eligible for FSA and HSA funds.
How long before I notice anything?
It varies. Some patients notice a difference early in the course, others not until several weeks in, and it can take up to about four weeks for relief to begin. Many patients see the most change after the third session. Some do not respond, and that is worth knowing before you start rather than after.
Does it hurt?
Most patients find it uncomfortable rather than painful, and it is brief. Some soreness in the treated area for a few days afterwards is common and usually settles with ice and compression.
Who performs the treatment?
EPAT sessions are delivered by our physician assistant in the Washington, D.C. office, following an evaluation to confirm it is a reasonable option for your problem.
How does it compare with PRP?
They are different tools for overlapping problems. EPAT is non-invasive and delivered over several short sessions; PRP is an injection given once or twice. EPAT is generally aimed at chronic tendon problems, while PRP is used for joints as well as tendons. Which one makes sense depends on what is actually causing your pain, which is the point of the evaluation.
Find out whether EPAT is worth trying for your tendon pain
Schedule a consultation with Dr. Harb to discuss your hip or knee and build a plan to get you back to the activities you love.