Frequently Asked Questions

Shockwave therapy delivers high-energy sound waves from outside the body into targeted tissue. These controlled mechanical pulses trigger a biological response called mechanotransduction, where cells convert the mechanical stimulus into repair and pain-modulating signals. It's non-invasive, non-surgical, and requires no medication.

Yes, shockwave can be uncomfortable. Most people describe it as intense but tolerable. Your clinician starts at lower energy and increases gradually to your tolerance. Some soreness for up to 72 hours after the session is normal. The discomfort is brief and purposeful.

Focused shockwave concentrates energy at a selected depth, reaching deeper tissues with precision. Radial shockwave produces pressure at the skin surface and is more effective for superficial structures. They have different physical properties, and the right choice depends on what tissue needs to be treated. Unpain Clinic uses both.

A typical course is 3 to 5 sessions, spaced 1 to 2 weeks apart. Severe chronic or degenerative cases may require more. Expert consensus suggests significant clinical benefit begins around 6 weeks after starting treatment. Your clinician will recommend a plan based on your specific case.

An umbrella review found shockwave outperformed cortisone injections for pain outcomes, with a higher rate of patients achieving meaningful pain reduction. Unlike injections, shockwave is non-invasive and targets tissue repair biology, not just pain suppression. The best choice depends on your specific condition. We review this during your assessment.

Expert consensus estimates the effects of shockwave last approximately 10 months on average for tendon conditions, with a range of 6 to 12 months. Combining shockwave with targeted rehabilitation supports longer-lasting results. Your clinician will discuss realistic expectations for your case.

Shockwave outcomes are highly sensitive to the device type (focused vs radial), energy settings, targeting accuracy, and how it's combined with rehabilitation. Published research highlights protocol heterogeneity as a major reason for mixed results. If you only had radial shockwave for a deep-tissue problem, or if the treatment wasn't paired with rehab, that may explain the difference.

For most tendon and fascial conditions, expert consensus confirms no range-of-motion restrictions are needed after treatment. Light activity is generally fine. Your clinician will give you specific guidance based on your condition, and structured rehabilitation exercises are an important part of the overall plan.

Radial shockwave therapy delivers rapid mechanical pressure pulses from a handheld applicator into soft tissue. A compressed-air projectile strikes the applicator tip, creating a pressure wave that spreads outward through the tissue. Your cells detect this mechanical stimulus and convert it into biological signals that can reduce pain sensitivity and support tissue repair. It's non-invasive, requires no medication, and each session delivers thousands of pulses adjusted to your tolerance.

Radial shockwave is strongest at the applicator surface and decreases with depth, making it well-suited for broader, superficial-to-mid-depth tissue targets. Focused shockwave concentrates energy at a selected depth, enabling precise targeting of deeper structures. They have different physical properties. At Unpain, we use both and select the right type based on your condition.

Yes, it can be uncomfortable. Most people describe it as painful at times but tolerable. Your clinician adjusts parameters based on your feedback throughout the session. Local anesthesia is not used, partly because your feedback helps guide the treatment and partly because research suggests numbing may reduce effectiveness. Some tenderness for 1 to 2 days after is normal.

A typical course is 3 to 5 sessions, spaced 1 to 2 weeks apart. This is consistent with both ISMST guidelines and clinical practice at Unpain. Some longer-standing conditions may need more. Your clinician will recommend a plan based on your specific case and adjust as you progress.

Shockwave outcomes depend heavily on applicator selection, energy settings, targeting technique, and how the treatment is integrated with rehabilitation. Published research highlights protocol heterogeneity as a major driver of mixed results. If your previous treatment used a standard applicator without adjustment, or wasn't paired with rehab, that may explain the difference. We assess all of this during your visit.

Technically, radial devices generate pressure waves, not true shockwaves in the strict physical definition. The term "radial shockwave" is widely used in clinical practice. The International Society for Medical Shockwave Treatment distinguishes between the two. Both produce meaningful clinical effects through mechanotransduction, but they have different physical properties and tissue reach. Your clinician will explain which type is appropriate for your case.

Durability varies by condition and protocol. In at least one reviewed study, shockwave results were better than cortisone injection beyond 12 months, suggesting meaningful long-term effects are possible. Combining shockwave with targeted rehabilitation supports more durable outcomes. Your clinician will discuss realistic expectations for your case.

Yes. Systematic review evidence supports combining shockwave with exercise and loading for better outcomes. Shockwave can create a biological window where tissue becomes more responsive to rehabilitation. At Unpain, every shockwave treatment plan includes a rehabilitation component. We map this out during your first visit.

EMTT (Electromagnetic Transduction Therapy) is a non-invasive therapy that delivers brief, high-energy electromagnetic pulses into deep tissue. The pulses influence cell signalling pathways linked to inflammation and repair, supporting the body's natural healing processes.

Most people feel little to no sensation during EMTT. Some notice a mild warmth or faint pulsing. In highly inflamed areas, there may be slight discomfort, but it's typically tolerable. This is one of the reasons EMTT is well-suited for acute or sensitive cases.

Most treatment plans include 6 to 10 sessions, typically scheduled once or twice a week. Your clinician will recommend a specific course based on your condition and response.

They share roots, but EMTT is a higher-energy implementation designed to reach musculoskeletal targets. PEMF devices are typically lower-energy and intended for general wellness, while EMTT is a clinical therapy backed by randomized controlled trials.

Active electronic implants (pacemakers, cochlear implants, insulin pumps, neurostimulators) are a contraindication — you should not have EMTT. Passive metal implants or joint replacements should be discussed with your clinician so precautions can be reviewed.

Clinical trials show improvements maintained at follow-up assessments weeks after the last session. Long-term durability is supported when EMTT is combined with rehabilitation and lifestyle changes appropriate for your case.

Shockwave and EMTT work through different mechanisms — shockwave is mechanical, EMTT is electromagnetic/biochemical. They're complementary, and research shows combining them produces better outcomes than shockwave alone for some conditions.

EMTT has been studied in sham-controlled randomized trials, which is the gold standard for separating real effects from placebo. Results show meaningful improvements in pain and function over sham treatment, and preclinical research shows cellular-level effects consistent with a regenerative mechanism.

NESA is a non-invasive electrotherapy that delivers very low-intensity microcurrents through multiple electrodes placed on the body. The stimulation is designed to influence your autonomic nervous system, the control system that manages your stress response, sleep, and recovery. It's non-surgical, non-pharmaceutical, and the stimulation is typically imperceptible.

The sub-sensory stimulation is intentional. NESA works at a different level than therapies designed to create a noticeable sensation. A randomized controlled trial showed measurable vascular changes after a single session in subjects who felt nothing during treatment. At Unpain, we track your physiology before and after so you can see the data change yourself.

No. TENS uses higher-intensity stimulation to override pain signals locally, and the effect often fades when the device is turned off. NESA uses sub-sensory microcurrents through multiple electrodes to influence autonomic nervous system regulation. The mechanism, intent, and delivery are fundamentally different. We assess which approach is appropriate during your first visit.

Published NESA protocols typically involve 10 to 12 sessions delivered two to three times per week over several weeks. Some people notice changes sooner, particularly in sleep quality. Your clinician will recommend a plan based on your specific case and adjust as you progress.

Implantable pacemakers and other active electronic devices are a contraindication for NESA. This is a standard screening precaution across neuromodulation technologies. Your clinician will review your full medical history before recommending treatment.

NESA has been studied in placebo-controlled and randomized trial designs that show measurable physiologic changes. The broader field of non-invasive nerve stimulation for chronic pain shows a real, though modest, average effect on pain intensity across pooled analyses. The evidence base for NESA specifically is still growing, and we're transparent about where it stands during your assessment.

Some NESA studies include follow-up measurements months after treatment and suggest durability of improvements, though sample sizes are still limited. Because NESA is combined with active rehabilitation and self-management strategies at Unpain, the goal is to build lasting capacity, not just temporary relief. Your clinician will discuss realistic expectations for your case.

Sleep quality is the outcome most consistently reported in NESA studies, across populations ranging from children to older adults to athletes. Because sleep disruption and chronic pain are closely linked, improving one often supports improvement in the other. We track sleep alongside pain outcomes throughout your care.

The exercises are just the tool. What drives results is how they're selected, coached, progressed, and adjusted based on how your body is responding. Research consistently shows that outcomes depend on program design, quality of coaching, and adherence, not on the exercises themselves. Most people who say "I've tried the exercises and they didn't work" have never had a program built around their specific movement pattern, load history, and nervous system response. We map all of that out in your initial assessment.

Yes. Persistent musculoskeletal pain often involves changes in how the nervous system processes and amplifies signals, rather than ongoing tissue damage. Brain imaging studies show that chronic pain can change how the central nervous system works, independently of what shows up on an X-ray or MRI. Physiotherapy addresses the movement, load, and nervous system contributors directly. Many patients with "normal" scans respond well to a properly designed program. We review your imaging and history during the first visit.

This depends on how long the problem has been present, how many layers are contributing to it, and how your body responds to treatment. The evidence is clear that session count is not one-size-fits-all, and that matching the dose to the presentation matters more than a fixed number of visits. We will give you a realistic projection at your first assessment, with clear markers for what progress should look like and when we reassess the plan.

Mild post-session soreness is common and typically short-lived, particularly after new or progressed exercise loads and hands-on techniques. Research shows roughly 40 to 50% of patients experience this type of transient response after manual therapy. It's different from the pain you came in with, it usually settles within 24 to 48 hours. We explain what to expect and how to tell normal adaptation soreness from a sign that something needs adjustment. We discuss this with every patient during and after each visit.

The most common reasons we hear are: sessions were passive only (heat, ultrasound, TENS without meaningful exercise), the plan never changed, coaching was minimal, or the practitioner was managing too many patients at once to give proper feedback. Physiotherapy outcomes are strongly tied to program quality, progression, and the therapeutic relationship. We work exclusively one-on-one and reassess at every visit, so the plan is always current to where you actually are.

Yes. These technologies are available at our clinic and are used as adjuncts within structured physiotherapy plans, not as replacements for it. Shockwave, EMTT, and NESA neuromodulation each have clinical evidence supporting their use for specific presentations. When appropriate, they can help reduce pain and improve tissue conditions faster, which allows the exercise and coaching work to be more effective. Whether they're indicated for your case is something we determine at the initial assessment.

A chiropractor checks how your joints are moving, how your muscles are working, and where your body is compensating. If joints are stiff or restricted, the chiropractor uses their hands or a small instrument to gently move the joint so it functions more normally. At Unpain, every session is paired with exercise guidance and a defined plan. Your chiropractor will explain exactly what they find during your first visit.

Chiropractic care is widely considered safe when delivered by a qualified practitioner. Serious adverse events are rare. A large population-based study found that the rate of stroke after chiropractic visits was no higher than after visits to a primary care physician. Your chiropractor screens for vascular and other risk factors before any cervical treatment. We assess this during your first visit.

Most people feel minimal discomfort during an adjustment. The "crack" sound you may hear is joint cavitation, a normal release of gas within the joint. It is not bones breaking or moving "back into place." If you prefer a no-crack approach, instrument-assisted and low-force techniques are available. Your chiropractor will discuss your preferences before treatment begins.

It depends on your specific case. Research suggests meaningful improvements are often evident within the first 6 to 12 sessions over 4 to 6 weeks. Your treatment plan includes a defined endpoint and tapers in frequency as you improve. We do not believe in open-ended, indefinite care. We map this out clearly in your first visit.

Chiropractic care for musculoskeletal conditions is supported by dozens of randomized controlled trials and multiple systematic reviews. International guidelines including NICE and WHO include spinal manipulation as a recommended conservative option. Where the evidence is strongest, it supports chiropractic as part of a broader plan that includes exercise, not as a standalone cure. Your chiropractor will explain how the evidence applies to your case.

Three things. First, a thorough 60-minute assessment before any treatment starts. Second, a defined treatment plan with clear milestones, a timeline, and transparent pricing. Third, chiropractic integrated with exercise, soft tissue work, and technology-based treatments when your case needs it. No "adjust and go." No open-ended plans.

Yes. Guidelines recommend combining manual therapy with exercise for the best long-term results. At Unpain, chiropractic is part of a coordinated plan that may include physiotherapy, shockwave therapy, EMTT, and exercise rehabilitation. Your treatment team communicates directly so nothing falls through the cracks.

No. Our goal is to get you better and get you independent. Treatment frequency tapers as you improve, and exercise is layered in so your body can maintain the gains on its own. Research shows outcomes are not purely "all-or-nothing." There is a point of meaningful improvement, and a clear point where active treatment ends. We define that endpoint with you from the start.

This is the most common and fair question to ask. The short answer: no, but the picture is more nuanced than either "it's magic" or "it's all in your head." High-quality individual patient data meta-analyses, pooling results from nearly 21,000 trial participants, found acupuncture consistently outperforms both sham needling and no-treatment controls for chronic pain, with effects that persist at one-year follow-up. The difference compared to sham is modest; the difference compared to no treatment is larger. Both findings matter. We explain what this means for your specific case during the assessment.

Most people are surprised by how little they feel. The needles used are much finer than medical injection needles. Sensations vary by person and point location but are commonly described as mild aching, heaviness, tingling, or dull pressure. In TCM practice, a particular sensation called "de qi" is considered a sign of effective stimulation. Brief, sharp discomfort at insertion is possible but typically passes quickly. Minor bruising or soreness at the needle site afterward is common, and is considered normal, usually self-resolving within a day or two.

Musculoskeletal pain trials have used anywhere from 1 to 24 sessions, with a median of around 8, typically delivered about twice per week. The right number for your case depends on how long the pain has been present, how your nervous system is responding, and whether acupuncture is being used alongside other modalities. We will give you a realistic projection at the first visit, along with clear markers for what progress should look like and when we re-evaluate. We do not extend treatment beyond what the evidence and your response support.

Yes. Acupuncture is a regulated health profession in Alberta. The College of Acupuncturists of Alberta regulates the profession in the public interest, and practitioners must meet defined education and registration standards before practicing. When choosing an acupuncturist in Edmonton, you can verify their registration status through the College's public registry. Our practitioners' credentials and training are listed on the clinic booking page. We discuss what acupuncture training our team holds with you at the initial visit.

Feeling tired, relaxed, or mildly sore after a session is common and typically self-limiting. This is frequently reported in patient forums and is consistent with what the safety literature describes as normal post-treatment responses. Some people also notice a temporary increase in symptoms before improvement, which can reflect the nervous system processing the treatment. What's not normal: escalating heat, redness, or swelling at needle sites suggesting infection, or any new neurological symptoms. We discuss expected responses with every patient before and after each session.

Yes, and this is often how we use it. Acupuncture's strongest mechanisms target the nervous system, specifically pain modulation, descending pain inhibition, and central sensitization. Shockwave and EMTT are primarily aimed at tissue-level processes. When pain is persisting despite tissue-level treatment, acupuncture can address what those modalities cannot. Physiotherapy builds movement capacity and load tolerance. These approaches are not competing with each other. Whether combining them makes sense for your case is something we determine together at the initial assessment.

Therapeutic massage is goal-directed and assessment-driven. It targets specific soft tissue restrictions, nervous system patterns, and movement limitations connected to your symptoms. Relaxation massage is primarily about comfort and stress relief, which is valuable, but it isn't designed to address the underlying reasons why you're in pain. At Unpain, every session has a clinical purpose tied to your treatment plan.

Massage delivers structured sensory input to your soft tissues and nervous system. This can quiet pain signaling, reduce the muscle guarding your body uses to protect painful areas, and shift your nervous system out of the stress-driven state that amplifies pain. Research shows it can produce meaningful pain reduction versus no treatment and improve how you feel and function. We assess which of these pathways matters most for your case during your first visit.

Massage therapy has been studied in dozens of randomized controlled trials and synthesized in multiple systematic reviews and meta-analyses. That research shows real, measurable effects on pain, function, and nervous system regulation across musculoskeletal pain populations. The evidence is heterogeneous, meaning results vary by condition and approach, but massage is far from placebo-only territory. We'll be honest about where the evidence is strongest and where your case fits within it.

Some targeted work can produce a "productive discomfort," where you feel pressure but it stays within your tolerance and doesn't feel harmful. That's different from pain that makes you brace or hold your breath. Research doesn't support the idea that deeper always means better. Outcomes don't reliably scale with intensity, and the assumption that it needs to hurt to work is one of the most common misconceptions about clinical massage. Your therapist customizes pressure throughout the session based on your feedback.

Research commonly uses courses of weekly sessions over 4 to 8 weeks for therapeutic goals, with frequency depending on the presentation and how you're responding. Most people notice meaningful change within the first 4 to 6 sessions when the approach is matched to their case. We give you a clear plan after the first visit, with expected milestones and a defined endpoint, not an open-ended "come forever" commitment.

There are several common reasons massage doesn't produce lasting results: the wrong therapist style for the patient, no assessment, pressure mismatched to the tissue, or massage used in isolation without addressing the broader drivers of pain. If previous massage helped temporarily but didn't hold, that's information, not a verdict. We use the first session to understand what's actually driving your symptoms and whether a different approach or combination of approaches would produce a better result.

Yes, and in many cases it's how it works best. Real-world musculoskeletal care is frequently multimodal. Massage can reduce pain sensitivity and guarding enough to make chiropractic treatment more comfortable and exercise rehab more effective. At Unpain, our practitioners communicate directly so your care is coordinated. We decide together, based on your case, when combination makes sense and when massage alone is sufficient.

No. Our approach has a defined endpoint. As your pain sensitivity decreases and movement improves, the emphasis shifts toward active work, home care, and building the capacity to stay well on your own. Some people choose maintenance sessions after completing their plan, much like a tune-up, but that's a choice, not a requirement. We tell you clearly when the clinical case for regular sessions is complete.

ddrobotec is a robotic resistance training system that uses a screen-guided, game-like interface to prompt specific lower-limb movements and measure your performance in real time. Unlike a standard leg press or gym machine, it captures thousands of data points per session: force, speed, power, and coordination accuracy. A regular machine tells you how much weight you lifted. ddrobotec tells you how well your nervous system and muscles worked together to do it. We walk you through what this means for your specific case at your assessment.

Structured exercise programs consistently show improvements in pain and physical function across chronic pain populations, according to multiple large evidence reviews. The improvements are often described as small to moderate on average, with meaningful variation by individual. ddrobotec-specific clinical trials have not yet been published, so the evidence base here is the broader literature on structured resistance and feedback-based training. We'll tell you during your assessment whether your case is a strong candidate for this approach, and how it fits into your overall plan.

Sessions feel like resistance exercise: muscle effort, exertion, and sometimes coordination challenge. Many patients find the game-like interface keeps their attention on completing tasks rather than on discomfort. Some people experience mild delayed muscle soreness in the day or two after their first few sessions, which is normal and expected. Your clinician adjusts intensity throughout based on your real-time output data. You are always in control of the session.

Most structured resistance training programs in the research literature involve 2 to 3 sessions per week over several weeks to months. Early strength and neuromotor changes tend to show up within the first few weeks. Structural adaptations take longer. How many sessions you need depends on your starting point, your goals, and how you respond to training. We design a program specific to your case after the initial assessment, and adjust it based on your performance data as you progress.

Yes, with appropriate assessment and load progression. Resistance training for older adults is well-supported by evidence, and major position statements from organizations like the National Strength and Conditioning Association recommend 2 to 3 sessions per week with individualized load modifications for those with comorbidities or lower starting capacity. ddrobotec's adjustable resistance allows us to begin conservatively and progress based on your actual performance data. We screen for any conditions that would require physician clearance before starting.

Standard physiotherapy exercises are often prescribed without real-time measurement of how well you're actually performing them. ddrobotec adds objective data: every session captures your force output, speed, coordination accuracy, and power, and that data drives how your program progresses. For patients who have done exercises without measurable improvement, this shift from guesswork to measurement often changes what's possible. At Unpain Clinic, ddrobotec typically works alongside our physiotherapy and other modalities rather than replacing them. Your clinician will explain exactly how it fits your case at the assessment.

It depends on your current range of motion and pain levels. If you're in significant pain that restricts your ability to complete the required movement patterns safely, we may address tissue-level pain first using other modalities before beginning ddrobotec training. This is a clinical judgment made at your assessment. The goal is to make sure your first sessions are productive and safe, not to push through pain that isn't ready for loading.

Strength and neuromotor adaptations built through structured training do persist after training ends, but like all physical capacities, they require maintenance. Part of your program at Unpain Clinic includes building toward independent exercise habits and home-based activity so the gains you make in the clinic translate into your daily life. We discuss maintenance strategies with you as part of your overall plan.