Your first steps hurt
That sharp feeling under your heel in the morning can make the simplest routine frustrating.
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RADIAL PRESSURE WAVE THERAPY · STORZ MEDICAL
Radial Pressure Wave Therapy EPAT ®
Less time working around pain. More confidence moving again.
That sharp heel pain with your first steps. The elbow that interrupts golf. Back muscles that stay tight no matter how often you stretch. When pain keeps changing your plans, you deserve more than a one-size-fits-all answer.
At Cleveland Health Center, EPAT uses carefully directed radial pressure waves to address selected muscle, tendon and fascia problems without needles or incisions during the procedure. We start by finding out what is causing your symptoms, then discuss whether EPAT - or another option - fits your goals.
STORZ MEDICAL TechnologyNo IncisionClinical Assessment FirstUltrasound Evaluation
CLEVELAND HEALTH CENTER · EPATCare designed around your movement and comfort.
Individualized evaluation · STORZ Medical technology · Thoughtful treatment options
WE UNDERSTAND THE FRUSTRATION
What if the pain that keeps coming back could have another treatment option?
Pain is personal. It affects where you go, how you sleep, and how confidently you move. The right treatment starts with understanding how it is affecting your life.
You keep adjusting how you move
You shorten your walks or avoid the movements that irritate your Achilles tendon or knee.
Your favorite activities are becoming chores
Golf, pickleball, gardening, and workouts are harder with a sore elbow or tight, tender muscles.
EXPLAINED IN PLAIN ENGLISH
What is EPAT and how does it work?
EPAT stands for Extracorporeal Pulse Activation Technology. In simple terms, it uses controlled pressure pulses that travel through your skin into a sore tendon, muscle or band of connective tissue called fascia. A small handheld device delivers these pulses to the area being treated. There is no incision, injection or medication delivered by the EPAT procedure.
The pressure waves spread over a broader area, with their greatest energy close to the skin. Research suggests this stimulation can influence local pain signaling and tissue response, helping some people with ongoing tendon or heel problems improve over time.
PHOTO PLACEMENT 02 · CLINICAL EXAMClinical Exam
Dr. Gegaj evaluating a painful heel or elbow, with the patient visible.
WHY PATIENTS CONSIDER IT
Another option when pain keeps getting in your way
For carefully selected patients, the appeal is not complicated: a noninvasive treatment to consider alongside the right exercises, recovery plan and other medical care.
No needles in the EPAT procedure
Treatment is applied from outside the body. For the right condition, it may provide a less invasive option to discuss before an injection or surgery.
Designed around your actual pain
We look beyond where it hurts to understand the tendon or tissue involved, what makes symptoms worse, and which treatment is most appropriate.
Fits into an active lifestyle
Visits take place in the office, and the care team explains how to manage activity between appointments rather than leaving you guessing.
FIND YOUR CONDITION · INDIVIDUALIZED EVALUATION
What Conditions Can EPAT Radial Pressure Wave Therapy Help Treat?
You may know the frustration long before you know the diagnosis. Here are common problems we evaluate for EPAT, along with what they can feel like. Suitability depends on your examination and the evidence for your particular condition.
Plantar fasciitis and chronic heel pain
Sharp first steps in the morning or soreness after being on your feet. Persistent plantar heel pain is among the better-studied applications of pressure-wave treatment.
Achilles tendinopathy
A stiff, sore tendon at the back of your ankle makes walking uphill, running or getting moving uncomfortable.
Tennis elbow (lateral epicondylopathy)
Pain on the outside of the elbow when gripping a paddle, lifting a grocery bag, or using tools.
Golfer’s elbow (medial epicondylopathy)
Pain on the inside of the elbow with golf, gripping or repeated wrist movement.
Patellar tendinopathy / jumper’s knee
Discomfort just below the kneecap with stairs, squats, jumping or exercise.
Greater trochanteric pain syndrome
Pain at the outside of the hip, often worse with longer walks or sleeping on that side.
Rotator cuff tendon pain
A shoulder that aches when you reach overhead or lift something out of a cabinet. The cause determines whether radial treatment makes sense.
Shin splints (medial tibial stress syndrome)
An ache along the inner shin after walking, running or repeated impact. Stress fractures must first be considered when appropriate.
Foot and ankle tendon overuse
Persistent discomfort around the foot or ankle, including selected peroneal tendon problems.
Chronic muscular lower-back pain
Tight, tender muscles beside the low back that interfere with bending, standing or everyday movement; this does not treat a compressed nerve.
Myofascial trigger points and muscle knots
Sore, sensitive bands of muscle in the back, shoulders or other areas that may limit comfortable movement.
Selected other tendon overuse problems
Some ongoing tendon problems around the hip, thigh or lower leg may be considered after a focused examination.
These are conditions we can evaluate, not promises of benefit or automatic recommendations. Research varies by diagnosis. Your consultation helps determine which options are most appropriate.
BACK PAIN · A MORE PERSONALIZED START
Can EPAT Help With Back Pain?
If your lower back feels constantly tight, sore or tender to touch, part of the problem may be coming from the muscles and connective tissue surrounding your spine. For selected chronic muscular or myofascial pain, radial pressure waves may be an option alongside movement, strengthening and other conservative care.
The important first step is knowing where pain comes from. EPAT is not intended to correct a herniated disc, relieve severe spinal nerve compression, or replace urgent evaluation of new neurological symptoms. We examine the pattern of pain and use imaging or referral when needed.
The strongest back-pain combination evidence currently centers on ESWT plus physical therapy; research specific to radial EPAT is less conclusive. Read the clinical study ↗
PHOTO PLACEMENT · BACK PAINHelp patients see that you treat more than feet and knees.
Real CHC clinical image: evaluation of lower-back muscles and movement, not a graphic implying shock waves are aimed at spinal bones.
A CLEAR, PERSONALIZED EXPERIENCE
How EPAT Treatment Is Prepared & Delivered
Your treatment begins with a thoughtful evaluation—not with a device. Dr. Gegaj brings more than 15 years of musculoskeletal ultrasound evaluation and ultrasound-guided procedure experience. Ultrasound may help clarify the problem and guide related injections when clinically appropriate; it is not required for every shock wave or EMTT session.
We listen and examine
Tell us when pain began, what you have tried, and what you want to get back to. We examine the painful area and review prior testing.
We identify the right treatment area
If useful, musculoskeletal ultrasound helps us assess involved tendons and other soft tissues. Not every patient needs ultrasound.
We apply radial pressure waves
A clinician uses a handheld STORZ applicator and gel over the treatment area. You will feel repeated tapping or pressure; intensity can be adjusted.
We plan your next steps
We discuss how to adjust activity, whether rehabilitation should continue, and how your progress will be reviewed.
Ultrasound helps us evaluate some tendons, joints and soft tissues. It is a diagnostic tool and may be used to guide separate PRP or other injections; it does not mean every EPAT session is performed under live imaging.
PHOTO PLACEMENT 03 · TREATMENTTreatment
Close-up of radial handpiece, gel and correct placement on body.
PHOTO PLACEMENT 04 · PATIENT EXPERIENCEPatient Experience
Consented photo/video of patient describing the treatment experience, not a guaranteed result.
WHY CLEVELAND HEALTH CENTER
We treat the person—not simply the painful spot.
Dr. Florian Gegaj brings more than 15 years of experience with musculoskeletal ultrasound evaluation and image-guided procedures, as described by Cleveland Health Center. Ultrasound may help clarify whether a tendon, joint, bursa or another structure is responsible for your symptoms.
Our practice also offers STORZ Medical radial EPAT, focused ESWT, and EMTT, along with selected PRP and ultrasound-guided injection options. These are different tools—not a package everyone needs. We help you understand which, if any, fits the problem you are actually having.
We have seen encouraging clinical responses in our own patients. As with any medical treatment, results vary; we focus on selecting appropriate patients and measuring improvements that matter to them.
PHOTO PLACEMENT · CHC PHYSICIAN AND EQUIPMENTA real consultation feels more reassuring than a stock photo.
Use a photograph of Dr. Gegaj discussing symptoms, reviewing an ultrasound or explaining a treatment plan.
THREE DIFFERENT TECHNOLOGIES
EPAT, focused ESWT or EMTT—which is right for me?
You do not need to decide before calling us. Your diagnosis, tissue involved and safety history help determine what is reasonable to consider.
| Option | How it works | What patients should know |
|---|---|---|
| EPAT | Radial pressure pulses spread over a broader area closer to the surface. | Often discussed for heel pain and selected superficial tendon, muscle and fascia concerns. |
| Focused ESWT | Sound energy is concentrated into a selected target at a chosen depth. | May be considered for specific tendon or selected deeper tissue problems. |
| EMTT | High-energy magnetic pulses, rather than acoustic waves. | Comfortable, contact-free delivery; clinical evidence for many joint and tendon uses is still emerging. |
A single therapy may be enough for some conditions. For others, combining complementary approaches with exercise, rehabilitation or selected injections may be reasonable. We explain why each treatment would be included rather than simply adding procedures.
ONE CLINICAL TEAM · MORE THAN ONE OPTION
Why We Sometimes Combine Shock Wave Therapy, EMTT and PRP
Pain often has more than one contributing factor. A sore tendon, weak supporting muscles and an irritated joint can affect how you move. Having several treatment options available lets us build a more complete plan around your diagnosis and goals—without assuming everyone needs every therapy.
Address different parts of the problem
Radial pressure waves may be chosen for a broader superficial area, focused ESWT for a defined target, and EMTT for selected magnetic-pulse applications. Exercise, rehabilitation and activity changes remain important.
Consider PRP when appropriate
For certain tendon or joint conditions, a separate PRP injection may be discussed alongside shock wave therapy. Our XCELL PRP system and ultrasound-guided injection capabilities support individualized treatment planning.
Choose treatments for a reason
We review the diagnosis, studies, previous care and patient preferences before recommending one therapy, a planned combination, or a different route entirely.
What has combination research found?
Selected studies have reported encouraging results for specific combinations. A randomized study of tennis elbow examined ESWT plus PRP and exercise; a separate study of patellar tendinopathy found faster early pain improvement when ESWT was added to PRP. Another trial reported greater improvement for rotator cuff tendon pain with ESWT plus EMTT than ESWT with sham EMTT.
The important distinction is that these findings apply to particular conditions and study protocols. They do not prove that all combinations are better, or that adding treatments improves outcomes for every patient.
- 2025: ESWT + PRP + exercise for tennis elbow
- 2024: PRP with ESWT for patellar tendinopathy
- 2018: ESWT + EMTT for rotator cuff tendinopathy
PHOTO PLACEMENT · INTEGRATED THERAPIESYour real STORZ technologies, side by side.
Show actual radial handpiece, focused device and MAGNETOLITH—not a stock graphic.
PHOTO PLACEMENT · PRP + ULTRASOUNDPRP prepared and targeted with precision.
Real XCELL preparation photo or ultrasound-guided injection, with appropriate patient consent.
SIMPLE ANSWERS BEFORE YOU COMMIT
What to expect before, during and after treatment
During treatment
You may feel rhythmic tapping and some tenderness over the painful area. Tell us if the pressure feels too strong.
Later that day
Temporary soreness or mild redness can occur. Many people continue usual light activities, but your instructions depend on the condition.
Over the coming weeks
Improvements are often gradual. Tendons may take time to respond, so one visit is not necessarily enough to judge the outcome.
At follow-up
We look at what has changed: walking comfort, morning heel pain, grip strength, or your ability to exercise.
PREPARATION AND AFTERCARE
EPAT Protocol & Post-Treatment Instructions
These are general considerations. Your provider will give instructions appropriate for your diagnosis, treatment settings, medications and other health conditions.
Before
Bring any relevant imaging, mention recent injections, medications, bleeding conditions, pregnancy or other medical concerns.
After
Mild soreness can occur. Use the individual activity and symptom-management instructions provided by your clinician.
Activity
Your return to walking, running, pickleball, golf or strengthening depends on the structure treated; avoid assuming that “no incision” means unlimited activity.
Follow-up
We will explain how many appointments to consider and when to reassess. There is no one schedule that fits everyone.
Important: do not stop prescription medication—including blood thinners or anti-inflammatory medication—unless your prescribing clinician tells you to. Contact the office for unexpected or worsening symptoms.
QUESTIONS WORTH ASKING
Frequently asked questions about EPAT
Will EPAT hurt?
You may notice tapping or pressure and extra tenderness near the painful spot. We can adjust the treatment intensity and talk you through what you are feeling.
How soon might I feel better?
Some people notice changes early, while others improve gradually over several weeks. Not everyone experiences meaningful relief.
Can I have EPAT if physical therapy did not help?
Persistent symptoms after rest or rehabilitation are a common reason to discuss EPAT. Your provider may recommend continued strengthening alongside treatment.
Is this the same as focused ESWT?
Not exactly. EPAT uses radial pressure waves that spread across a broader, more superficial area. Focused ESWT directs acoustic energy toward a smaller target at a selected depth.
Will I need several appointments?
Often treatment involves a series of visits, but the appropriate number and spacing depend on the diagnosis, your response and the clinician’s recommendations.
Can I travel to CHC for EPAT?
Yes. We welcome people from throughout Florida, elsewhere in the United States and internationally. Contact us before planning travel, particularly if multiple visits may be needed.
Can EPAT be used for lower-back pain?
Sometimes. It may be considered for selected muscular or myofascial lower-back pain, especially alongside exercise and rehabilitation. It is not a treatment for every cause of back pain.
What is the difference between EPAT and focused shock wave therapy?
EPAT sends radial pressure waves into a relatively broad, surface-oriented area. Focused ESWT concentrates true shock waves at a selected target and depth. Your provider can recommend the appropriate option.
Does EPAT involve a needle or surgery?
No. EPAT itself uses a handpiece on the skin. If your care plan also includes PRP, that is a separate injection-based treatment and requires its own evaluation and consent.
Is shock wave or EMTT treatment covered by insurance?
Coverage varies by plan and procedure; some advanced therapies may be self-pay. Please contact our team for current pricing and coverage guidance before your visit.
CENTRAL FLORIDA · WELCOME FROM EVERYWHERE
Advanced care, wherever you call home.
Located in Central Florida, Cleveland Health Center welcomes patients from The Villages and Wildwood, throughout Florida, from other states and from around the world. Whether you live nearby or are planning a trip for care, we want your first step to feel straightforward.
If you are traveling, contact our scheduling team before making plans. We can discuss what records or imaging may be helpful and whether your condition might require several visits or follow-up.
PHOTO PLACEMENT 05 · TEAMTeam
Dr. Gegaj and equipment in an authentic CHC treatment room.
EXPERIENCE INFORMED BY MEDICAL RESEARCH
What Does the Evidence Say About EPAT?
For persistent plantar heel pain and several long-standing tendon conditions, radial pressure waves are supported by clinical studies and professional consensus. Research on muscle pain and low-back trigger points is promising but less settled. The goal is to match treatment to the specific problem—not to assume that every painful area will respond.
We will explain what has been studied for your condition, what is still uncertain and how this option compares with other reasonable approaches. Your care plan should fit your medical needs—not a marketing promise.
If back pain comes with new bowel or bladder problems, saddle numbness, significant or worsening leg weakness, fever or serious trauma, seek urgent medical assessment rather than scheduling an elective therapy session. Back-pain safety reference ↗
LET’S TALK ABOUT YOUR OPTIONS
Take the next step toward moving more comfortably.
If heel, tendon or muscle pain is limiting your days, let us help you understand what is causing it and whether EPAT belongs in your treatment plan.
Request an Evaluation →FOR PATIENTS WHO WANT TO LEARN MORE
Trusted sources
- Mayo Clinic — clinical indications, expectations and safety
- STORZ MEDICAL — difference between radial and focused waves
- STORZ MEDICAL — step-by-step shockwave treatment
- Mayo Clinic — focused versus radial shock waves and indications
- ISMST — indications, terminology, safety and clinical judgment
- 2026 chronic low-back pain systematic review
- 2026 randomized EMTT trial, including lumbar pain
- ESWT + PRP tennis elbow randomized study
- PRP + ESWT patellar tendon randomized study
- ESWT + EMTT rotator cuff randomized study
Clinical review required before publication: Dr. Florian Gegaj, MD. Confirm final indications, patient preparation, activity guidance, device-specific safety, treatment combinations, and any practice outcome statements.