When May EPAT Be Considered for Musculoskeletal Concerns?

Extracorporeal Pulse Activation Technology, also known as EPAT, is a form of Shockwave Therapy. The procedure uses a handheld medical device to deliver controlled acoustic pressure waves to a selected musculoskeletal area.

Before treatment, the physician reviews the patient’s diagnosis and identifies the appropriate treatment location. A coupling gel is generally applied to the skin, and the EPAT applicator is moved over the selected area. The treatment settings may be adjusted according to the condition, treatment location, and patient comfort.

Patients may feel tapping, pulsing, pressure, or temporary discomfort during the session. EPAT may be included within a broader care plan involving activity modification, physical therapy, home exercise, medications, supportive devices, or other physician-directed options.

EPAT should not be described as regenerating tissue, creating new blood vessels, repairing damaged structures, or guaranteeing pain relief. It is one possible treatment option that requires an accurate diagnosis and careful patient selection.

EPAT may be considered for carefully selected patients with certain persistent tendon and soft-tissue conditions. The decision depends on the diagnosis, severity and duration of symptoms, examination findings, previous care, and current available evidence.

Conditions for which EPAT may be considered include:

• Plantar fasciitis
• Achilles tendinopathy
• Patellar tendinopathy
• Tennis elbow
• Golfer’s elbow
• Calcific shoulder tendinopathy
• Selected persistent tendon conditions
• Certain sports-related musculoskeletal concerns

Having one of these conditions does not automatically mean that EPAT is appropriate. Joint, tendon, ligament, muscle, bone, and nerve concerns may produce similar symptoms and require different treatment plans.

At Mullally Sports & Family Medicine, Dr. Timothy Mullally, DO, and our team complete a comprehensive evaluation before recommending EPAT or another care option.

The goals of EPAT are personalized according to the patient’s diagnosis, symptoms, functional limitations, lifestyle, activity level, and priorities.

Possible treatment goals may include:

• Reducing pain and discomfort
• Improving mobility and physical function
• Increasing tolerance for work or daily movement
• Supporting participation in physical therapy or exercise
• Helping patients gradually return to recreational activities
• Complementing activity modification or home exercise
• Providing a non-invasive treatment option when appropriate

These goals are not guaranteed outcomes. Some patients may experience changes in pain, mobility, or activity tolerance, while others may have a limited response.

Progress is reviewed during follow-up evaluations, and the overall care plan may be continued, adjusted, combined with another option, or replaced according to the patient’s response.

Research continues to evaluate EPAT and other forms of Shockwave Therapy for different musculoskeletal conditions. Findings vary according to the diagnosis, device type, treatment settings, patient-selection criteria, comparison treatment, and study design.

Current literature does not support applying one expected outcome to every patient, condition, or procedure. Evidence may be more developed for certain tendon and soft-tissue conditions and limited or still evolving for others.

Dr. Timothy Mullally, DO, explains how the current evidence relates to the patient’s diagnosis, medical history, examination findings, imaging when appropriate, previous treatments, functional needs, and goals.

The potential risks, limitations, recovery considerations, costs, areas of uncertainty, and alternative treatment options are discussed before EPAT is recommended. No specific degree or duration of improvement can be guaranteed.

There is no exact number or frequency of EPAT sessions that applies to every patient or condition. The recommended schedule depends on the diagnosis, treatment area, symptom duration, condition severity, medical history, previous care, and individual response.

Follow-up assessments may review:

• Pain frequency and intensity
• Mobility and range of motion
• Strength and activity tolerance
• Ability to work or complete daily tasks
• Participation in exercise or recreation
• Response to physical therapy or home exercise
• New, persistent, or changing symptoms

Based on these findings, the physician may recommend continuing EPAT, changing the schedule, adding supportive care, or considering another treatment option.

Receiving additional sessions does not guarantee greater improvement or longer-lasting changes.

The cost of EPAT varies according to the treatment area, diagnosis, proposed schedule, evaluation requirements, follow-up plan, and insurance policy.

Factors that may influence the overall expense include:

• The number of sessions recommended
• The area being addressed
• The complexity of the condition
• The initial physician evaluation
• Diagnostic imaging when appropriate
• Follow-up appointments
• Other care included in the treatment plan
• Insurance coverage and patient responsibility

Patients should contact their insurance company to ask whether EPAT is covered, whether prior authorization is required, and what deductibles, copayments, or exclusions may apply.

Mullally Sports & Family Medicine can explain the anticipated practice charges before treatment begins. Final coverage decisions are made by the insurance company and cannot be guaranteed.

At Mullally Sports & Family Medicine, Dr. Timothy Mullally, DO, and our team focus on identifying the source of the patient’s symptoms before recommending EPAT. Each plan is based on the patient’s diagnosis, medical history, previous treatments, physical examination, imaging findings when appropriate, functional limitations, and goals.

EPAT may be considered alone or as part of a comprehensive care plan. Our team explains the procedure, treatment goals, possible risks, limitations, expected schedule, costs, current evidence, and alternative options so patients can make informed decisions.

Standard disclaimer

Treatment recommendations are individualized according to the patient’s diagnosis, medical history, goals, and current available medical evidence. EPAT is not appropriate for every patient or condition. Your physician will discuss the potential goals, risks, limitations, expected recovery, costs, and alternative treatment options before recommending care. No specific outcome can be guaranteed. For more information, contact us or schedule an appointment online. We are conveniently located at 11275 Delaware Pkwy Suite A, Crown Point, IN 46307. We serve patients from Crown Point IN, Winfield IN, Schererville IN, St. John IN, Cedar Lake IN, Munster IN, Lowell IN, DeMotte IN, as well as other Northwest Indiana locations.