The therapeutic effects of shock waves on the musculoskeletal system (pain relief and healing) are based on a multitude of molecular and cellular mechanisms. Without going into detail, the main short-term effects are depletion of presynaptic substance P in C nerve fibers (resulting in pain relief) and improved blood circulation in the treated area (which is the basis for healing). The main long-term effects are blockade of neurogenic inflammation and improved tendon gliding ability (resulting in pain relief) as well as activation of mesenchymal stem cells and new bone formation (both essentially involved in healing).

No clinical study has been conducted on the combination shock waves and cryotherapy. However, Dr. Marc Rozenblat (Centre Coralis, Ozoir La Ferrière, France) reported at the 2008 ATRAD congress (Berlin, Germany) the combination of shock wave therapy using the Swiss DolorClast method and neurocryostimulation was successful in approximately 7000 cases.

Yes, being clinically proven is one of the pillars of the Swiss DolorClast method. Many randomized controlled trials (RCTs) demonstrating efficacy and safety of the Swiss DolorClast method on different indications have been published in the international peer-review literature. So far, 26 RCTs have been published on the Swiss DolorClast method, 15 of which have been listed in the PEDro database (search for “radial shock wave” at www.pedro.org.au)

This has not been tested in a clinical study. With regard to focused shock waves, no study listed in the PEDro database has tested the hypothesis that the application of 6,000 shocks in a single session is as effective as (or more effective than) the application of 2,000 shocks in three sessions.

ESWT has been developed to be conducted on athletes and non-athletes. The vast majority of RCTs on the Swiss DolorClast method were performed on non-athlete patients.

Yes, castor oil is better than standard contact gel according to Maier et al., 199910, “Castor oil decreases pain during extracorporeal shock wave application”. However, it is recommended to use the standard contact gel provided with the device.

References:
10) Maier M, Staupendahl D, Duerr HR, Refior HJ.: Castor oil decreases pain during extracorporeal shock wave application. Arch Orthop Trauma Surg 1999;119(7-8):423-427

The presence of metal implants or prostheses is not a contra-indication to the use of shock wave therapy.
In the case of a hip, lots of our DolorClast referrals have post-surgery hip replacement. Then, shock wave therapy is combined with normal rehabilitation exercising for treating trochanteric hip pain or related issues. However, we see surgeons recommend about 12 weeks with a treatment post surgery.

Clinical reference study: 
Extracorporeal shock wave treatment for pain following hip replacement
November 2008, Journal of Clinical Rehabilitative Tissue Engineering Research 12(48):9533-9536
https://www.researchgate.net/publication/289093922_Extracorporeal_shock_wave_treatment_for_pain_following_hip_replacement