Pain Relief
Shockwave Therapy in St. Augustine
Shockwave therapy delivers pulses of acoustic energy into a specific area of tendon or soft tissue to provoke a healing response in tissue that has stalled. At Spinal Solutions it runs on the OmniWave device, and it is reached for when a tendon or trigger point has stopped responding to hands-on care, rest and loading on their own.
- OmniWave device on site
- Sessions run by Nate Reinhardt
- No injections, no downtime
Why some tissue stops healing
Most soft tissue injuries follow a curve. Something gets overloaded, it becomes inflamed, the body repairs it, and within weeks it is tolerating work again. Tendon pain that is still there months later has usually come off that curve. The tissue is no longer acutely inflamed, but it has not remodelled properly either. It sits in a degraded state where it hurts under load and does not improve with more rest.
That is the specific problem shockwave is aimed at. Pulses of acoustic energy are delivered into the tissue to provoke a fresh biological response in an area that has gone quiet, so that loading it afterwards produces repair rather than more irritation. the MedlinePlus overview of tendinitis is a useful plain-language read on how tendon problems present and why the long-standing ones behave differently to a fresh strain.
Results vary, and nobody should promise otherwise. What we can say honestly is that the cases which respond best are the ones the exam identifies as tendon or soft tissue in origin, with a specific tender point, where hands-on care already helped and then stopped.
Where it sits in this practice
Shockwave is not a first move. It is the step after hands-on soft tissue work has plateaued, and it exists here because that plateau is a real and common place for people to get stuck.
Patients have been asking about it by name for a while, which is part of why the device is in the building. The other part is that the practice already treats the population it suits: golfers loading the same tissue every week, people back at work too soon after a car accident, and anyone whose shoulder or hip has been “nearly better” for six months.
What it is not for
If your pain travels down a leg or an arm along a nerve path, the driver is more likely a disc than a tendon, and the DRX9000 decompression table is the tool for that instead. If the tissue is acutely torn, it needs imaging before anything else. And if the exam says the problem is a joint that has stopped moving, an adjustment costs less and works faster.
Being told which of those you are is the whole point of examining you first.
Conditions we treat with this
How it compares to the alternatives
| Option | Best for | Worth knowing |
|---|---|---|
| Shockwave therapy | Tendon or soft tissue pain that has been there for months and stalled | Non-invasive and drug-free. Works over a short course of sessions, not one visit. |
| Hands-on soft tissue work | Recent tightness, trigger points and tissue that still responds to pressure | Cheaper, and the right first move. Shockwave is what we add when this has plateaued. |
| Rest and loading alone | An early strain that is still on a normal healing curve | Often all that is needed. Tendon pain past three months is usually the sign it is not. |
| Injections | Severe inflammatory pain needing short-term control | Managed by a medical provider, not here. We refer when that is the better path. |
Who this helps, and who it does not
Usually a good fit
- Tendon or soft tissue pain that has lasted months rather than weeks
- A specific, tender spot you can point to rather than a general ache
- Hands-on treatment helped at first and then stopped making a difference
- You would rather avoid injections or surgery while there is still a conservative option
Not the right treatment
- Pregnancy
- A bleeding disorder, or anticoagulant therapy without medical clearance
- Active infection, an open wound or a tumour in the treatment area
- Pain coming from a disc pressing on a nerve, which decompression addresses instead
If this is you, we will say so and point you somewhere better.
What to expect
- 01 We locate the exact spot
Shockwave is a targeted treatment, so the session starts by finding the precise tender point rather than treating a general region.
- 02 Gel, then the applicator
Conductive gel goes on the skin and the applicator is worked over the area. You feel a rapid tapping and a building pressure, and the intensity is set to what you can tolerate.
- 03 A short session
The treatment itself is brief. Nate Reinhardt runs the sessions and will talk you through what you are feeling before he starts.
- 04 Load it afterwards
Shockwave provokes a response in the tissue. The corrective loading that follows is what turns that response into a tendon that tolerates work again.
What it costs and how payment works
Shockwave sits inside a care plan rather than being sold by the session, and the number of sessions depends on what the exam finds, so we do not quote a course before we have examined you. New patients start with the $47 evaluation, which covers the consultation, orthopedic and neurological testing, digital imaging if it is clinically necessary, a full findings review, and a trial shockwave or red light therapy session where it is appropriate. We handle PIP and personal injury cases directly. Medicare Part B covers manual spinal manipulation to correct a subluxation and does not extend to shockwave, so that portion is covered by an in-house care plan or CareCredit financing.
Why have it done here
Very few clinics in St. Johns County have an acoustic wave device on site at all, and fewer still have it sitting next to a DRX9000 and a rehabilitation program. That matters because shockwave rarely works as a standalone purchase. Nate Reinhardt runs both the shockwave and the decompression side, so the person treating you does it every day rather than occasionally.
This sits inside our pain relief program, so if it turns out not to be what you need, the alternative is in the same building.
Book the $47 evaluationWhat patients say
5.0 from 166 Google reviewsWe hold 166 five-star reviews across every kind of care in this practice. Rather than pick one that is not about this treatment, here is the whole profile, unedited.
Where to find us
The clinic sits at 276 Paseo Reyes Dr in St. Augustine, Florida, just off U.S. 1 at World Golf Parkway, near the entrance to the Palencia neighborhood. Most people coming in for stubborn tendon and soft tissue pain drive in from across St. Johns County, and the office is a straight run up or down U.S. 1 from either end of it.
- Palencia
- World Golf Village
- Nocatee
- Ponte Vedra
- Julington Creek
- Downtown St. Augustine
Questions we get asked
Is shockwave therapy painful?
Most patients describe shockwave therapy as producing mild discomfort or pressure rather than significant pain. Our team will walk you through what to expect before beginning treatment. The intensity is adjustable, so if a setting is more than you want, it comes down.
How many sessions will I need?
It depends on the tissue involved and how long the problem has been there, which is why we do not quote a course before the exam. You get a recommended number of sessions and the cost at the findings review, before anything starts.
Is there any downtime?
No. You walk out and carry on with your day. Some people notice the area feels tender or warm for a day or two afterwards, which is an expected response rather than a setback.
What kind of shockwave is the OmniWave?
It is an acoustic wave device used on soft tissue and tendon pain. We are deliberately not classifying it further on this page, because the focused-versus-radial distinction is a real clinical difference and we would rather confirm the manufacturer's own specification than assert one. Ask us at your visit and we will show you the device.
Will it work if nothing else has?
Sometimes, and that is exactly the situation it exists for. It is not a guarantee, results vary, and a tendon that has been painful for years is a harder problem than one that has been painful for four months. The honest version is that the exam tells us whether you are the kind of case that tends to respond.
Can I have it alongside adjustments?
Yes, and most people do. The two address different things: the adjustment restores joint motion, the shockwave targets the tissue that has stopped healing. They are sequenced within the same plan rather than booked as separate courses.
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not a guess.
Reading on this, from us
Written by the doctors here, on the same treatment this page describes.
7 Conditions Shockwave Therapy Can Help With
From heel pain to jaw tension, here are seven conditions this practice generally considers for shockwave therapy, and why the exam decides case by case.
Read the articleSeptember 3, 2026How Shockwave Therapy Helps Stubborn Pain Heal
Tendon pain that outlasts normal healing time behaves differently than a fresh strain. Here is what shockwave therapy actually does about it, and what it does not.
Read the articleSeptember 3, 2026Radial vs. Focused Shockwave Therapy Explained
Radial and focused acoustic wave therapy are not the same thing. Here is the honest, non-branded explanation of how they differ and why the distinction matters.
Read the article