What is Shockwave Therapy?

shockwave therapy plantar fasciitis
Shock Wave Therapy is a non-invasive procedure often used to treat injured bones, joints, muscles, tendons and other soft tissues. With no need for painkillers, shock wave therapy can offer fast pain relief and aid recovery for a range of chronic conditions including:

How Does Shock Wave Therapy work?

Shockwave therapy is delivered directly onto the affected area via the use of a ‘generator’ or device, using low-energy acoustic waves that penetrate the skin and treat the immediate area. 

Most treatments are applied by a therapist using a hand-held device, which turns compressed air into low-energy sound waves. Light pressure is applied and the device is moved across the damaged areas that require treatment.

Shock wave therapy has two main ‘modes of action’ that can help with persistent pain.

Firstly, the shock waves work to ‘desensitise’ nerve endings which can immediately reduce pain in the local area. Secondly, the waves stimulate blood flow in the area, causing a small amount of localised inflammation.

In the days immediately following the treatment, the body naturally tries to heal the inflammation and in doing so, encourages the regeneration of cells, repairing damaged tissue and reducing pain.

shockwave therapy machine

Shock wave therapy can also help with issues relating to scar tissue. Because scar tissue is much denser – and much less elastic – than normal tissue, the sound waves can help break it down, improving mobility and reducing discomfort.

Similarly, the waves can be used to break down ‘disorganised’ tissue or any build-up. While these sound waves are radial, this should not be confused with the types of shock wave therapy that are typically available – ‘radial’ and ‘focused’.

Radial Wave Therapy is the most common type of shock wave therapy, although Focused Wave Therapy is growing in popularity due to the treatment options, depth and precision it can offer acute cases.

Below we explore some of the differences between Radial Shock Wave Therapy (RSWT) and Focused Shock Wave Therapy (FSWT), we must first understand what they are.

shockwave before after

What is Radial Shock Wave Therapy?

radial shockwave therapy

Radial Shock Wave Therapy consists of three parts –

– Ultrasonic Pulses

– Audio Acoustic Pulses

– Slow Shear Waves

These waves have their greatest energy at the source which weakens the farther it travels away.

Using compressed air, the projectile is accelerated to a high speed which decelerates when it’s held to the area being treated. This kinetic energy is then transmitted to the tissue and pushed outwards as a ‘radial wave’ across the affected area.

The point of ‘impact’ constitutes the highest pressure and highest energy density which eventually loses power the deeper they enter the body. For patients with more superficial, surface-level issues, radial shock wave therapy can give good results.

This tends to be for patients suffering from conditions to do with the Achilles tendon, plantar fasciitis or more specific issues such as tennis elbow.

What is Focused Shock Wave Therapy?

focused shochwave

Focused shock wave therapy – sometimes known as Focused Shockwaves – is able to provide more depth penetration for deeper tissue than radial waves, focusing its output into more localised, deeper areas. 

These types of waves are generated through the use of a coil, which creates magnetic fields when a current is applied. This generates a pressure wave that can move through the medium without any loss of energy in a focused zone.

Fortunately, the site of actual wave generation experiences a minimal impact, limiting the damage to surface skin and underlying soft tissues.

While radial waves are applied all over a local area, FSWT is only applied at defined points within the body, which can be adapted depending on the depth that is required.

This makes focused therapy much better for treating any issues that affect tissues deeper within the body – including tissues close to the bone or any denser build-up that may have accrued.

In some cases, focused shock wave therapy is used in conjunction with radial therapy – typically when a patient’s pain levels can’t tolerate radial wave therapy or could benefit from a hybrid approach.

Comparing Radial vs Focused Shock Wave Therapy

When comparing radial and focused shock wave therapy, the main considerations are penetration depth and localisation of the treatment. As you’d imagine, the greater the depth penetration of the waves, the easier it is to treat deep-lying issues in the tendons, muscle or bones. Similarly, depending on the size of the problem area, the type of therapy needed will typically change.
radial vs focused

Comparing Radial vs Focused Shock Wave Therapy

While radial waves are good at providing relief over a wider area and can treat low depth issues such as those on the Achilles or elbow, other conditions can require more focused treatments.

Radial waves are characterised by three key points

– they have lower maximum intensity,

– they have a divergent wave

– they deliver their maximum intensity to a ‘superficial’ area i.e low depth. This depth is usually around 3 – 4cm.

Focused shock waves allow for ‘adjustable’ penetration depending on where needs to be treated and are ideal for treating deeper problem areas such as hamstring, pelvic or hip issues.

Focused waves are characterised as having a higher maximum intensity, delivered as a convergent wave with an adjustable depth of focal area. This can range between 2 and 30cm.

The reason the waves are different is down to how the therapy is applied. While

– RSWT follows a pneumatic principle, using compressed air and transmitters to determine the wave shape

– FSWT follows an electroacoustic principle, using electromagnetism and coupling pads to apply deeper, focused and adjustable waves.

Is there a difference in pain levels?

Radial therapy is typically more painful because of the way it is applied. The vibrating nature of the radial treatment, plus the fact it is delivered over a larger area, means it is generally only used to treat chronic conditions. Focused therapy, on the other hand, can be used in more acute cases that are causing the patient more pain, as it is typically less painful itself.

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