Extracorporeal Shockwave has an analgesic effect through several mechanisms. Research has shown that it reduces nerve sensitivity, and hinders nerve conduction of pain causing nerve fibers. In addition, shock waves alter the composition of chemical mediators around nociceptors and mimic the effect of capsaicin by reducing substance-P concentration. Substance-P causes pain through a process known as nociception. A nociceptor is a sensory neuron that reacts to potentially damaging stimuli by signaling the spinal cord and brain causing the perception of pain and has proinflammatory effects.

Research shows that ESWT can help improve range of motion and mobility in those with musculoskeletal disorders. Shockwave therapy can produce a cavitation effect between tissues, causing intertissue release, promoting the separation and release of adhesive tissue. It may also improve range of motion because the therapy reduced pain by causing changes in the metabolism of cells and the penetrability of endothelial tissues. In addition, it may stabilize the tissues by stimulating and reactivating the healing process of soft tissue and their surrounding structures by creating new muscle fibers through facilitating the secretion of angiogenic substances around the affected region and increasing blood flow to the region.