This page explains what a shockwave quote should contain rather than quoting one, because prices are set by the clinic providing the treatment and vary widely across London. Everything below is about how to read a quote, what tends to be left out of one, and which questions settle the difference before you commit to a course.
The single-session figure is the wrong number
Shockwave is delivered as a course. Typically that is three to five sessions roughly a week apart, and a single session on its own is not a plan.
So a per-session price answers almost nothing. Two clinics can quote very similar session figures and produce completely different totals, because one has priced a course of three and the other a course of five. Ask what a full course comes to, and ask it in those words.
Then ask what happens at session four if the clinician thinks two more would help. A course that quietly extends is the most common way a treatment plan drifts past what you agreed to.
What a quote should itemise
A clear quote has five things in it. If any are missing, they are the questions to ask.
The initial assessment. Somebody has to examine the area, take a history and decide whether shockwave is a reasonable option before any machine is used. That appointment may be inside the course price or charged separately, and both are legitimate. What matters is knowing which.
The number of sessions included. Stated as a number, not as “a course”.
The review appointment. The honest point at which you find out whether the treatment helped is six to twelve weeks after the final session, because very little changes during the course itself. That review is a real appointment weeks after the last one you paid for, and it is the item most often absent from a quote.
The loading rehabilitation programme. Shockwave in United Kingdom musculoskeletal practice runs alongside a progressive loading programme rather than replacing one. Somebody has to prescribe those exercises, watch you do them and progress them. Whether that work sits inside the figure changes the total considerably.
What happens if it does not help. Guidance on musculoskeletal shockwave is cautious about efficacy, so the possibility that a course changes nothing is real and should be discussed openly. Ask what the plan is in that case and whether any further appointments to discuss it are chargeable.
Why two quotes for the same heel look nothing alike
Three things drive most of the spread.
Session count. Already covered, and the largest single factor.
What else is in the room. A clinic that bundles assessment, rehabilitation, progress reviews and the follow-up into one price will quote a bigger number than a clinic selling five treatment slots and nothing else. The bigger number may well be the better value. It is certainly the more comparable one, because the smaller quote leaves you buying the missing pieces separately.
The device and the setting. Clinics run different equipment and different protocols, and the difference between radial and focused devices also brings different consumables and session structures with it. This is a real input into price, though it is usually a smaller one than the two above.
What almost never explains the spread is the quality of the outcome, because nobody can promise you one. Treat a high figure presented as evidence of a better result with the scepticism it deserves.
The questions to ask before you pay
- What does a complete course come to, including everything?
- Is the initial assessment inside that, or on top?
- How many sessions is that, and what happens if you recommend more?
- Is the follow-up review six to twelve weeks after the last session included?
- Who prescribes and progresses my exercises, and is that time part of the price?
- What do we do if I finish the course and nothing has changed?
A clinic that treats with shockwave regularly will answer all six without difficulty. The answers also tell you a good deal about how the treatment is being delivered, which matters more than the arithmetic. A read of what a session involves makes those conversations easier to follow.
Private medical insurance changes the order
If you hold private medical insurance, the insurance question comes before the booking question rather than after it.
Cover for shockwave varies by insurer and by policy. Where a policy does cover it, the insurer will usually want a referral or an authorisation code in place before treatment starts, and a claim submitted after the fact can be refused on that basis alone. Getting the authorisation first also tends to establish how many sessions the insurer will fund, which is useful information to hold when you discuss the plan with the clinic.
Some policies fund the physiotherapy or podiatry that surrounds a course but exclude the shockwave sessions themselves. That is worth asking about explicitly rather than assuming a yes covers everything.
Where the NHS route sits
NHS availability varies locally, and the NICE position shapes it. Interventional procedures guidance IPG311, now HealthTech guidance HTG200, on refractory plantar fasciitis concludes that “current evidence on its efficacy is inconsistent” and that the procedure “should only be used with special arrangements for clinical governance, consent and audit or research”. The guidance on refractory tennis elbow, IPG313, now HTG201, says the same, and the Achilles guidance, IPG571, now HTG426, adds that the evidence is limited in quality and quantity. That is a meaningfully different footing from a straightforward recommendation.
In practice that means your GP or an NHS musculoskeletal service is the place to find out what is commissioned where you live, and the answer differs from one area to another. The route, the waiting times and the criteria are covered in the guide to shockwave therapy on the NHS.
A sensible order for the next steps
Get the diagnosis settled first. Shockwave suits some tendon problems and not others, and paying for a course before anyone has established that yours is a reasonable target is the expensive mistake. If a loading programme has never been tried properly, that conversation comes before this one.
Then check the insurance position, then get the full course quoted with everything itemised, and only then book. The overview of shockwave therapy sets out which conditions it is used for and what the published guidance actually says.
Frequently asked questions
How much does shockwave therapy cost?
Prices are set by each clinic and vary widely across London, so no single figure is meaningful. What drives the difference is the number of sessions quoted, whether the assessment and the review are charged on top, and whether the rehabilitation programme is included. Ask for the cost of a complete course.
How many shockwave sessions am I paying for?
A course is typically three to five sessions roughly a week apart, so the meaningful number is the course total rather than the single-session figure. Establish before you start whether the quote covers three or five, and what happens if the clinician recommends more than the plan included.
Is shockwave therapy covered by private medical insurance?
Cover varies by insurer and policy. Where it is covered, insurers usually require a referral or an authorisation code before treatment begins, and claims submitted afterwards can be refused. Contact your insurer before the first appointment rather than after it, and get the authorisation in writing.
Is shockwave therapy available on the NHS?
Availability varies locally. NICE guidance on musculoskeletal shockwave states the procedure should only be used with special arrangements for clinical governance, consent and audit or research, which shapes how NHS services offer it. Your GP or an NHS musculoskeletal service can tell you what is commissioned in your area.
What should a shockwave therapy quote include?
A clear quote states the initial assessment, the number of sessions, whether the follow-up review is charged separately, and whether the loading rehabilitation programme and any progress appointments are inside the figure. It should also say what happens if the course finishes and symptoms have not changed.