The Evidence Behind Shockwave Therapy in Pelvic Rehab: Faculty Spotlight on Stacey Roberts, PT, RN, MSN

Few modalities have generated as much clinical conversation in the last five years as low-intensity extracorporeal shockwave therapy. Once reserved for kidney stones and elite sports medicine clinics, shockwave has now crossed into pelvic health, with growing applications for chronic pelvic pain, erectile dysfunction, genitourinary syndrome of menopause, and stress urinary incontinence. For clinicians considering whether to add this tool to their practice, the first question is always the same. Does the research support what the marketing claims?

Stacey Roberts, PT, RN, MSN has built her teaching career around answering that question with rigor. Her Herman & Wallace remote course, Shockwave Treatment, gives pelvic rehab clinicians a clear-eyed look at the evidence, the device landscape, and the clinical protocols that actually work.

Why the Research Matters

The evidence base for shockwave therapy in pelvic health is deeper than many clinicians realize, and it is growing quickly. Three studies in particular have shaped the conversation.

First, the landmark randomized, double-blind, placebo-controlled trial by Zimmermann and colleagues, published in European Urology in 2009, established shockwave as a viable treatment for male chronic pelvic pain syndrome.1 Men who received four weekly sessions of perineal shockwave showed statistically significant improvements in pain, quality of life, and urinary symptoms compared to sham controls, with effects sustained at twelve weeks. This study is still cited today as the foundational clinical trial for shockwave in the pelvis.

Second, a 2021 systematic review and meta-analysis by Zeng and Ye in Translational Andrology and Urology pooled data from six controlled trials covering more than three hundred patients with chronic pelvic pain syndrome.2 The analysis confirmed that low-intensity extracorporeal shockwave therapy produced meaningful improvements in total National Institutes of Health Chronic Prostatitis Symptom Index scores, pain subscores, urinary function, and quality of life at twelve weeks post-treatment. The authors concluded that shockwave has a reproducible clinical effect and warrants continued investigation as a first-line conservative intervention.

Third, a 2022 randomized, double-blind, placebo-controlled study by Kim and colleagues in the World Journal of Men's Health applied multi-focal low-intensity shockwave weekly for eight weeks in men with category III chronic prostatitis.3 The treatment group showed significant improvements in symptom index scores, erectile function, and pain compared to placebo, with no reported adverse events. This study helped establish that the benefits extend beyond pain relief into sexual function, which has important implications for patients dealing with post-prostatectomy concerns, pelvic floor hypertonicity, and partner intimacy issues.

Taken together, these studies move shockwave from anecdote to evidence. They also raise the bar for clinical application. As Stacey emphasizes in her course, not all devices produce true shockwaves, not all protocols deliver equivalent doses, and not all patients are appropriate candidates.

What Sets This Course Apart

Where shockwave marketing tends to oversimplify, the Herman & Wallace course focuses on precision. Stacey walks participants through the physics of focused versus radial devices, the differences between electrohydraulic, electromagnetic, and piezoelectric shockwave generation, and how each influences tissue depth and clinical indication. She unpacks the research terminology so clinicians can read a study and immediately know whether the device tested was a true shockwave or a radial pressure wave, a distinction that matters enormously when translating findings to clinical practice.

The course also covers case studies, treatment protocols for common pelvic health indications, and practical business considerations for clinicians weighing whether to invest in a device for their practice.

About Stacey Roberts

Stacey Roberts, PT, RN, MSN has been a physical therapist specializing in outpatient orthopedics and sports medicine since 1990. She has been analyzing shockwave research extensively since 2020 to develop clear and concise therapeutic applications and protocols for pelvic health, sexual health, and musculoskeletal patients. Stacey is the owner of New You Health and Wellness, a cash-based clinic where she integrates wellness, hormone health, and musculoskeletal care. She is a co-principal investigator on an IRB-approved study related to shockwave and dyspareunia, and she joined the Herman & Wallace faculty in 2021.

Learn From Stacey Roberts

Shockwave Treatment: Therapeutic Interventions in Pelvic Health & Demystifying the Research

May 3, 2026

Remote Course via Zoom

Register here: https://hermanwallace.com/continuing-education-courses/shockwave-treatment/remote-course-may-3-2026

References

1. Zimmermann R, Cumpanas A, Miclea F, Janetschek G. Extracorporeal shock wave therapy for the treatment of chronic pelvic pain syndrome in males: a randomised, double-blind, placebo-controlled study. Eur Urol. 2009;56(3):418-424. doi:10.1016/j.eururo.2009.03.043
2. Zeng X, Ye Z. Low-intensity extracorporeal shock wave therapy for male chronic pelvic pain syndrome: a systematic review and meta-analysis. Transl Androl Urol. 2021;10(4):1543-1556. doi:10.21037/tau-20-1423
3. Kim KS, Choi YS, Bae WJ, et al. Clinical efficacy of multi-focal low-intensity extracorporeal shockwave therapy in the treatment of chronic prostatitis/chronic pelvic pain syndrome: prospective-randomized, double-blind, placebo-controlled study. World J Mens Health. 2022;40(2):298-305. doi:10.5534/wjmh.210078
4. Vahdatpour B, Alizadeh F, Moayednia A, Emadi M, Khorami MH, Haghdani S. Efficacy of extracorporeal shock wave therapy for the treatment of chronic pelvic pain syndrome: a randomized, controlled trial. ISRN Urol. 2013;2013:972601. doi:10.1155/2013/972601
5. Marszalek M, Berger I, Madersbacher S. Low-energy extracorporeal shock wave therapy for chronic pelvic pain syndrome: finally, the magic bullet? Eur Urol. 2009;56(3):425-426. doi:10.1016/j.eururo.2009.06.026