What are the differences between focused and radial shockwave therapy?

There are currently two major types of shockwave therapy, namely focused and radial shockwave therapy.

With focused shockwaves, the depth of the focus can be adjusted in order to help more accurate tracking of the injury location and give targeted treatment on tissues with varying degrees of injuries. Compared to conventional ultrasound that can only reach a depth of about 20 to 30mm, focused shockwave therapy can adjust the focus and reach a depth of up to 60mm. As the depth is sufficient to pass through the deep tendon and accurately focus on the injured tissues, the therapy is therefore especially effective for treating deep muscle pain. In general, chronic inflammation of the tendons takes a longer time to recover. Focused shockwave can effectively treat various tendon strains and long-term sports injuries and shorten the entire recovery process. Meanwhile, as focused shockwaves give a higher output of energy, they can help to improve serious conditions such as poor fracture healing and osteonecrosis. Patients may experience soreness or painful sensations at the affected areas during the treatment, but no pain would be felt in unaffected areas.

Since radial shockwaves do not have the focusing feature, the depth of treatment cannot be adjusted. Meanwhile, since less energy is generated, a larger vibration force is released on the skin and superficial muscles. Hence, radial shockwaves are more suitable for treating the tendon injuries of the extrinsic layer. The overall skin surface generally feels some pain during treatment.

What kinds of disorders can shockwave therapy treat?

Shockwave therapy is mainly used for relieving the following pains:

  • Plantar fasciitis / plantar fasciopathy
  • Knee pain / patellar tendinopathy
  • Tennis elbow / Golfer's elbow and wrist / finger tendonitis (i.e. trigger finger, De Quervain’s Syndrome)
  • Low back pain / sciatica / piriformis syndrome
  • Adhesive capsulitis / Tibial margin syndrome
  • Other chronic fasciitis

Apart from improving chronic tendonitis, calcific tendinitis and muscle strains, focused shockwave therapy can also relieve muscle pain in many parts of the body, including shoulder and neck, upper limbs, lower back, hip joint, knee joints, ankle joints, etc.

Meanwhile, radial shockwave therapy is suitable for the treatment of superficial pain, such as myofascial pain that involves damages of soft tissues.

Are there any side effects or contraindications in receiving shockwave therapy?

Patients may feel pain, muscle tension or swelling of the affected area for one or two days. There may be mild redness and swelling or bruising on the surface of the skin. Fortunately, such conditions usually subside very quickly and do not cause any permanent damage to the body. Generally speaking, radial shockwave therapy is more likely to cause swelling or subcutaneous bleeding. 

It is important to note that the following individuals are not suitable for shockwave therapy, including infections, tumors or wounds around the pain site, pregnant women, patients using pacemakers, and patients with bleeding disorders. As misuse of shock waves may injure soft tissue, the therapy should be performed by trained medical personnel. Last but not least, the direction of treatment should be determined according to the cause of different pain and the patients’ conditions.

Last Updated: Jan 2020
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