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Radial versus Focused Shockwave Therapy

Posted by Vitality Team on 2019 Aug 14th

Shockwave Therapy is a relatively new form of treatment in the fields of orthopedic and rehabilitation medicine.

The effect of shockwaves was first documented during World War II. The lungs of castaways from merchant ships were noted to be damaged without any superficial evidence of trauma. This led to the discovery that shockwaves created by deep sea depth-charges were responsible for the internal injuries. This discovery created a great deal of interest and research into the biological effects of shockwaves on living tissue.

The use of a modified radial version of shockwaves to treat tendon related pain began in the early 1990s. The first medical treatment developed from this research was lithotripsy. This treatment allowed focused shockwaves to specifically target and essentially dissolve kidney stones without surgical intervention. Today, over 98% of all kidney stones are treated with this technology.

Therapeutic Radial Shockwaves are simply controlled pressure waves that are created when a ballistic projectile is accelerated and then impacted against a stop-plate inside a specially-designed hand-piece.

The primary effect of these shockwaves is a direct mechanical force that occurs at a cellular level as the wave’s energy passes through tissue. These waves cause a controlled impact on the tissue being treated. The result is a biological reaction within the cells of that tissue, which causes an increase in blood circulation through the injured site. This triggers the body to accelerate its natural healing processes. Radial shockwave treatments increase the metabolic activity around the site of pain or discomfort. It stimulates the re-absorption of irritative calcium deposits in tendons, accelerates the body’s natural healing process, and reduces pain.

Research indicates that the mechanical stimulation produced by shockwaves is capable of inducing positive reactive processes in the cellular structure of injured tissue. The most commonly observed reactions in tissue treated with Shockwave Therapy are:

  • Increased Metabolism
  • Expression of Substance P (a growth & pain mediator hormone)
  • Improvement of cellular tensile stability
  • Altered cell membrane permeability
  • Increased cell activity by Gene Expression
  • Overall improvement of cellular structure
  • Re-absorption of calcium deposits in tendons

  • Extracorporeal Shock Wave Therapy (ESWT) is a term most commonly associated with Focused Shockwave therapy, although many manufacturers and researchers also use this terminology to refer to Radial Shockwave Therapy. As the name implies, ESWT is simply extracorporeal shockwave or “outside of the body''. It can technically refer to any type of Shockwave Therapy.

    Focused Shockwave machines have inherent drawbacks. To create effective therapies, you need to be able to target both the exact areas that require treatment and the depth of the treatment being applied. This is often difficult, even with the use of visual references like ultrasounds. Therefore, many focused shockwave treatments become “hit and miss”.

    Research shows that for many conditions, Radial extracorporeal shockwave delivers results just as good or better than low-energy Focused therapy, with the added benefit of being more consistent in application and not requiring local anesthesia. Therefore, for the balance of this document we will focus on Radial Shockwave Therapy only.

    Clinical research has been ongoing for decades and the published data clearly shows that Radial Shockwave Therapy (RSWT) is a highly effective treatment option for many musculoskeletal conditions and injuries.

    Radial Shockwave Therapy works without the need for drugs, stimulates the body’s natural ability to heal itself, and, in some cases, can even help eliminate the need for invasive surgery.

    Shockwave therapy is used to treat many difficult orthopedic conditions, including:

  • Plantar fasciitis
  • Heel spurs
  • Patellar tendinitis (jumper’s knee)
  • Lateral epicondylitis (tennis elbow)
  • Medial epicondylitis (golfer’s elbow)
  • Thumb basal joint Arthritis
  • Tendinitis
  • Chronic Inflammation
  • Bursitis
  • Shin splints
  • Morton' s Neuroma
  • Stress Fractures
  • Osteoarthritis
  • Insertion Tendonopathy
  • Epicondylopathy radialis / Ulnaris
  • Achilles Tendonitis
  • Myofascial Pain Syndromes
  • Impingement Syndrome
  • Tendon calcifications
  • Patellofemoral Syndrome /Achillodynia
  • Tibialis anterior Syndrome
  • And more recently it has been found to have excellent results for common forms of Erectile Dysfunction

  • Radial Shockwave Therapy is very easy to learn for any hands-on medical professional. It is popular for use by podiatry, chiropractors, physiotherapists, massage therapists and other orthopaedic specialties.

    Vitality Depot offers two Radial Shockwave Therapy devices: The Zimmer enPuls 2.0 and enPuls Pro. Each of these units offer onboard protocols with visual instructions, through an easy-to-navigate full colour interface.