SWT can be performed before administering a cortisone injection. SWT treatment does not exclude the use of other kinds of treatments, which can be performed afterwards. Cortisone injections carry a high risk of side effects and should not be given more than 2-3 times.SWT is effective in the most difficult cases, where cortisone injections have not been able to produce therapeutic results. It is advisable to combine SWT with physiotherapy; the combination is highly effective.