So, I had a horse on loan that had a very painful back when he arrived and in fact was sore all over. Not excessively worked prior to getting me…in fact hardly worked at all. Back xray normal and a pretty much negative lameness exam. Vet mystified. Did 5 rounds of acupuncture with minimal improvement. Horse grumpy to ride and would not go forward. Did 2nd lameness exam - still nothing obvious. So, the vet decided he needed to develop some better topline and core strength and he was unable to work correctly in pain. What she ended up doing was Aquapuncture over back and hind end with Serapin, cortisone and Vit B12. Worked amazingly well. Repeated it 3 mths later just to be sure and have worked him pretty vigorously. His topline looks amazing and he is able to carry himself much more easily. Returned to his owner pain free. Not to sure about the effectiveness of PEMF or shockwave - would not be my first choices unless I had a scientist telling me exactly how it was going to work. Shockwave is not cheap. I am a fan of acupuncture over chiro but in the long run, if possible I always want a diagnosis and plan first - not just randomly trying things. Good luck!