Pulse Wave™ Focused Shockwave Therapy

Non-Invasive Relief That Activates Your Body's Own Healing

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Pulse Wave™
FESWT How Does It Work
95% Success Rate

95%+ Soft-Tissue Success

 

300+ Peer-Reviewed Studies

 

10+ Randomized, Double-blind RCT's

Relief Timeline:

Many feel improvement after the first session; most within 1-2 weeks.

 

Plan of Care:

Typically 4-8 treatments (1-2x/week for 4-8 weeks).

 

Downtime:

Return to daily activities right away; limit heavy exercise for 24-48 hours.

 

Insurance Coverage:

Not currently covered by insurance; we offer per-visit and discounted 3-pack pricing options.

Your Treatment Plan

  1. Consultation & Examination - The doctor examines your condition and discusses your goals.
  2. Personalized Protocol - We tailor session intensity and focus to the target tissue.
  3. Series of Sessions - Typically 4-8 treatments over 4-8 weeks.
  4. Re-evaluate - Track progress and adjust if needed.
Multi joint ortho SWT

Conditions We Treat

Focused Shockwave Therapy is effective for a wide range of musculoskeletal problems and injuries.

Tennis Elbow          Golfer's Elbow          Tendonitis

Patellofemoral Syndrome          Plantar Fasciitis

Carpal Tunnel        Labrum Injuries          Neuropathy

Rotator Cuff Injuries          Frozen Shoulder

Back Pain                Facet Pain                Neck Pain

Safety and Comfort

Focused Shockwave Therapy is very save with no known long-term adverse effects.

  • Mild treatment-time discomfort is possible
  • Temporary soreness, swelling, or tenderness may occur
  • Occasional bruising or tingling can happen

Most patients can  return to regular activity immediately.  We may advise avoiding heavy exercise for 24-48 hours.

Timeline
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TE
PF
OA
Ortho 5
FSWT Pain

Contraindications

  • Coagulation disorders or anticoagulant use
  • Active thrombosis, tumor, or carcinoma
  • Pregnancy
  • Polyneuropathy (eg., in diabetes)
  • Cortisone injection within 4-6 weeks at the site
  • Pacemaker or metal implant at treatment area
  • Children still in growth

Please avoid oral/topical anti-inflammatories before treatment

 

What Does the Research Say?

Effectiveness of Focused Shockwave Therapy versus Radial Shockwave Therapy for Non-calcific Rotator Cuff Tendinopathies: A Randomized Clinical Trial

Chengxin Li 1Zhizhuo Li 1Lijun Shi 2Peixu Wang 2Fuqiang Gao 3Wei Sun 3,✉

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PMCID: PMC7811429  PMID: 33506031

Conclusions

Both F-SWT and R-SWT are effective in patients with non-calcific rotator cuff tendinopathy. F-SWT proved to be significantly superior to R-SWT at long-term follow-up (more than 24 weeks).

 

Focused extracorporeal shockwave therapy for the treatment of low back pain: a systematic review

Dilyan Ferdinandov 1,2,3,*

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PMCID: PMC11390445  PMID: 39267973

Conclusion:   Focused ESWT is a modern physiotherapeutic method that can potentially treat a broad spectrum of conditions responsible for low back pain. Despite the small number of low-evidence studies, there is sufficient data on the effectiveness and safety of this therapeutic modality.

 

Efficacy of Extracorporeal Shock Wave Therapy for Lateral Epicondylitis: A Systematic Review and Meta-Analysis

Gaowen Yao 1Jing Chen 2Yanji Duan 1Xiao Chen 1,✉

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PMCID: PMC7106907  PMID: 32309425

Conclusion:   Based on the existing clinical evidence, extracorporeal shock wave therapy can effectively relieve the pain and functional impairment (loss of grip strength) caused by tennis elbow, with better overall safety than several other methods. However, owing to the limited quality and quantity of the included studies, more high-quality RCTs are needed to support the trend towards better functional outcomes with ESWT.

 

Effectiveness of shockwave therapy in the treatment of plantar fasciitis

Renan Gonçalves Leão 1Marina Mayumi Azuma 1Gustavo Henrique Carillo Ambrosio 1Flavio Faloppa 1Eduardo Shoiti Takimoto 1Marcel Jun Sugawara Tamaoki 1

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PMCID: PMC7006537  PMID: 32095104

Conclusion:   Shock wave therapy was effective for plantar fasciitis treatment according to the proposed protocol considering pain, function and quality of life. Level of Evidence Ic, Case-series Study.

 

Long Term Effectiveness of ESWT in Plantar Fasciitis in Amateur Runners

Joanna Kapusta 1,*Marcin Domżalski 2

Editor: Umile Giuseppe Longo

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PMCID: PMC9737564  PMID: 36498501

Conclusions: Extracorporeal shock wave therapy is an effective form of therapy for amateur runners. It reduces pain associated with plantar fasciitis that amateur runners may experience at rest, while walking, and during daily and recreational activity.

 

Comparative Effectiveness of Focused Extracorporeal versus Radial Extracorporeal Shockwave Therapy for Knee Osteoarthritis—Randomized Controlled Study

Nai-Yu Ko 1Chih-Ning Chang 1Chu-Han Cheng 1Hui-Kung Yu 2Gwo-Chi Hu 1,3,*

Editor: Paul B Tchounwou

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PMCID: PMC9332723  PMID: 35897371

Both groups showed significant improvement in secondary outcomes; however, the f-ESWT group yielded greater improvement in the VAS score, WOMAC score, and 6-minute walk test. Our results showed that f-ESWT was more effective than r-ESWT in improving pain and physical function in patients with knee osteoarthritis.

 

Effectiveness and Safety of Shockwave Therapy in Tendinopathies

Vasileios Dedes 1Apostolos Stergioulas 2Georgios Kipreos 2Ariadni Maria Dede 3Athanasios Mitseas 4Georgios I Panoutsopoulos 1

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PMCID: PMC6029898  PMID: 30061805

The results of the present study clearly indicate that shockwave therapy achieved a significant reduction in pain as well as a significant improvement in both the functionality and quality of life after the completion of the therapeutic intervention and the 4-week follow-up in patients suffering from plantar fasciitis, elbow tendinopathy, Achilles tendinopathy and rotator cuff tendinopathy. Significant pain reduction and improvement in functionality and quality of life were also observed in the control groups of each tendinopathy, but these findings were less pronounced than those in the group treated with shock waves.

 

Extracorporeal shock wave therapy mechanisms in musculoskeletal regenerative medicine

Claudio Lopes Simplicio aJoseph Purita bWilliam Murrell cGabriel Silva Santos d,Rafael Gonzales dos Santos dJosé Fábio Santos Duarte Lana d

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PMCID: PMC7275282  PMID: 32523286

ESWT works by the emission of acoustic waves (shockwaves) that carry energy and can propagate through tissues. Shockwaves can generate interstitial and extracellular responses, producing many beneficial effects such as: pain relief, vascularization, protein biosynthesis, cell proliferation, neuro and chondroprotection, and destruction of calcium deposits in musculoskeletal structures. The combination of these effects can lead to tissue regeneration and significant alleviation of pain, improving functional outcomes in injured tissue. Considering these facts, ESWT shows great potential as a useful regenerative medicine technique for the treatment of numerous musculoskeletal injuries.

 

Extracorporeal shockwave therapy for degenerative meniscal tears results in a decreased T2 relaxation time and pain relief: An exploratory randomized clinical trial

Shogo Hashimoto 1Takashi Ohsawa 1Hiroaki Omae 2Atsufumi Oshima 3Ryota Takase 1Hirotaka Chikuda 1

Conclusion: ESWT decreased the T2 relaxation time in the meniscus at 12 months post-treatment. ESWT also provided pain relief, but no differences were observed in clinical outcomes.

 

EXTRACORPOREAL SHOCKWAVE THERAPY IN SHOULDER INJURIES: PROSPECTIVE STUDY

Victor Otavio Moraes DE Oliveira 1Juliana Munhoz Vergara 1Vicente Furquim DE Oliveira 1Paulo Henrique Schmidt Lara 1Luiz Carlos Nogueira 1Gustavo Gonçalves Arliani 1

Conclusion: Extracorporeal shockwave therapy proved to be efficient and safe in the treatment of shoulder pathologies, improving pain, range of motion and functional scores in all groups of patients evaluated in the study. Level of Evidence IV, Case series.

 

Extracorporeal shockwave therapy as a novel and potential treatment for degenerative cartilage and bone disease: Osteoarthritis. A qualitative analysis of the literature

Qiaodan Ji 1Pu Wang 1Chengqi He 2

 

The effect of extracorporeal shock wave therapy on the treatment of moderate to severe knee osteoarthritis and cartilage lesion

Yongming Xu 1Kun Wu 2Yu Liu 2Huan Geng 2Haochong Zhang 2Shuitao Liu 3Hongying Qu 4Gengyan Xing 2

Conclusions: The ESWT has potential in reducing pain and improving knee function, and the therapeutic effects may peak at 8 weeks after the completion of treatment.

 

What does the research say about focused shockwave and delayed-union and non-union fractures?

Research supports the use of focused shockwave for treating both delayed and non-union fractures, reporting it to be a reliable and safe modality (Mittermayr et al., 2021) with a success rate as high as 85% (Schleusser et al., 2020).

The Efficacy of Focused Extracorporeal Shock Wave Therapy and Ultrasound Therapy in the Treatment of Calcar Calcanei: A Randomized Study

Ivana Topalović 1Dejan Nešić 2Sindi Mitrović 3Vera Miler Jerković 4Ljubica Konstantinović 3

 

Patients treated with standard ultrasound therapy did not have a statistically significant reduction in the calcification size. In contrast, the patients in the experimental group treated with f-ESWT showed a substantial decrease in the calcification size.

 

Extracorporeal Shockwave Therapy as an Adjunctive Therapy for Frozen Shoulder: A Systematic Review and Meta-analysis

Ruihan Zhang *Zhenyu Wang *,†Ruishu Liu Nan Zhang *Jiaxun Guo *Yunxia Huang *

Conclusion:  ESWT seems to be beneficial to patients with frozen shoulder by alleviating pain and improving function.

 

Efficacy of Extracorporeal Shockwave Therapy in Frozen Shoulder

Babak Vahdatpour 1Parisa Taheri 1Abolghasem Zare Zade 1,✉Saeed Moradian 1

Conclusions:  The use of ESWT seems to have positive effects on treatment, quicker return to daily activities, and quality-of-life improvement on frozen shoulder.

 

The Role of Extracorporeal Shock Wave Therapy in the Treatment of Muscle Injuries: A Systematic Review

Yuriy Mazin 1,✉Carolina Lemos 2Carolina Paiva 3Luís Amaral Oliveira 1Andre Borges 4Tiago Lopes 1

 

ESWT was associated with less pain on VAS, better function, reduction of size of lesion on ultrasound evaluation, faster RTP and/or lower re-injury rate in patients with indirect and direct muscle injuries and muscular hematomas, a frequent secondary complication of muscle injuries. The evidence regarding the use of ESWT for these types of injuries is therefore promising.

 

Clinical evaluation of the efficacy of focused extracorporeal shock-wave therapy in patients with cervical spondylosis: A randomized control trial

Shuangyue Li 1Jie Liu 2Yan Wang 3Chan Zhu 1Yahong Tang 1Minghong Gu 1

Conclusion: The fESWT has shown promising therapeutic effects in the treatment of cervical spondylosis. It effectively reduces patient pain, improves cervical function, and enhances the quality of life, making it worthy of clinical promotion and applicationSh.

 

The Effect of Extracorporeal Shock Wave Therapy on Pain Intensity and Neck Disability for Patients With Myofascial Pain Syndrome in the Neck and Shoulder: A Meta-Analysis of Randomized Controlled Trials

Ji Hyun Jun 1Geun-Young ParkChoong Sik ChaeDong-Churl Suh

Conclusions: Extracorporeal shock wave therapy is superior to other treatments in terms of alleviating the pain intensity and pressure pain threshold of patients with myofascial pain syndrome in the neck and shoulder at postintervention. In particular, focused extracorporeal shock wave therapy shows significant improvement in pain relief. However, radical extracorporeal shock wave therapy for myofascial pain syndrome treatment still remains unclear.

 

Focused extracorporeal shockwave therapy for youth sports-related apophyseal injuries: case series

Journal of Orthopaedic Surgery and Research volume 18, Article number: 616 (2023)

Conclusion:  ESWT is a potentially safe and effective treatment for apophyseal injuries. It may facilitate an early return to sport activities.

 

Efficacy and safety of extracorporeal shock wave therapy for orthopedic conditions: a systematic review on studies listed in the PEDro database

Christoph Schmitz †,*Nikolaus B M Császár Stefan Milz Matthias Schieker Nicola Maffulli §,¶Jan-Dirk Rompe ||John P Furia ††

 

ESWT has been proven as an effective and safe non-invasive treatment option for tendon and other pathologies of the musculoskeletal system in a multitude of high-quality RCTs. For plantar fasciopathy, non-calcific tendinopathy of the supraspinatus tendon and calcifying tendonitis of the shoulder RCTs on ESWT are the predominant type of RCT in PEDro and obtained the highest PEDro scores among all investigated treatment modalities for these conditions. The latter criterion was also achieved for Achilles tendinopathy and lateral epicondylitis, albeit in a smaller number of RCTs. Therefore, ESWT should be considered by medical doctors, therapists, patients and payers when discussing treatment options for certain musculoskeletal pathologies.

 

Extracorporeal shock wave therapy mechanisms in musculoskeletal regenerative medicine

Claudio Lopes Simplicio aJoseph Purita bWilliam Murrell cGabriel Silva Santos d,Rafael Gonzales dos Santos dJosé Fábio Santos Duarte Lana d

Extracorporeal shockwave therapy (ESWT) is a popular non-invasive therapeutic modality in the medical field for the treatment of numerous musculoskeletal disorders. This technique first emerged around the 1980s as extracorporeal shockwave lithotripsy and has been studied since then for its application towards orthopedics and traumatology. ESWT works by the emission of acoustic waves (shockwaves) that carry energy and can propagate through tissues. Shockwaves can generate interstitial and extracellular responses, producing many beneficial effects such as: pain relief, vascularization, protein biosynthesis, cell proliferation, neuro and chondroprotection, and destruction of calcium deposits in musculoskeletal structures. The combination of these effects can lead to tissue regeneration and significant alleviation of pain, improving functional outcomes in injured tissue. Considering these facts, ESWT shows great potential as a useful regenerative medicine technique for the treatment of numerous musculoskeletal injuries.

Effectiveness and Safety of Shockwave Therapy in Tendinopathies

Vasileios Dedes 1Apostolos Stergioulas 2Georgios Kipreos 2Ariadni Maria Dede 3Athanasios Mitseas 4Georgios I Panoutsopoulos 1

Conclusions:  Shockwave therapy significantly reduced the pain that accompanies tendinopathies and improves functionality and quality of life. It might be first choice because of its effectiveness and safety.

 

Efficacy of high energy, focused ESWT in treatment of lumbar facet joint pain - a randomized sham-controlled trial

Tomas Nedelka 1 2 3Jakub Katolicky 2 4Jiri Nedelka 2Paul Hobrough 5Karsten Knobloch 6

Conclusions: High-energy focused ESWT is a safe and effective non-invasive therapy for chronic lumbar facet joint pain, showing sustained improvements in pain, function, and neuropathic symptoms. MRI findings support its biological effect on joint-related bone marrow edema. ESWT represents a promising alternative to interventional pain procedures.

 

EFFICACY OF FOCUSED SHOCKWAVE THERAPY IN PATIENTS WITH MODERATE-TO-SEVERE CARPAL TUNNEL SYNDROME: A PRELIMINARY STUDY

Pimpisa VONGVACHVASIN 1Thitiporn PHAKDEPIBOON 2Waree CHIRA-ADISAI 2Punpetch SIRIRATNA 2

Conclusion:   Focused extracorporeal shockwave therapy plus conservative treatment effectively provided short-term improvement in symptoms, hand function, and nerve conduction in patients with moderate-to-severe carpal tunnel syndrome compared with conservative treatment alone.

 

Effectiveness of focused extracorporeal shock wave therapy in the treatment of carpal tunnel syndrome

A randomized, placebo-controlled pilot study

Christina Gesslbauer 1Michael Mickel 1Othmar Schuhfried 1Dominikus Huber 1Mohammad Keilani 1Richard Crevenna 1

Conclusion:   Focused extracorporeal shock wave therapy is an effective and noninvasive treatment method for mild to moderate carpal tunnel syndrome.

 

Extracorporeal Shock Wave Therapy in Dupuytren’s Disease

Serkan Aykut 1,✉Canan Aydın 2Kahraman Öztürk 1Fatih Arslanoğlu 3Cem Yalın Kılınç 4

Conclusion:   We can suggest that ESWT in the early term can be preferred over costly injections and surgical intervention options as it increases the quality of life and delays the recurrence of contractures.

 

The Effect of Shock Wave Therapy on Improving the Symptoms and Function of Patients with Dupuytren's Contracture

Parisa Taheri 1Najmeh Salek 1Maryam Mousavi 1Razieh Maghroori 1

Conclusion:   It can be concluded that shock wave therapy can be effective in improving the symptoms and function of patients with Dupuytren's Contracture.

 

Comparison Between Extracorporeal Shock Wave Therapy and Intra-articular Hyaluronic Acid Injections in the Treatment of First Carpometacarpal Joint Osteoarthritis

Francesco Ioppolo 1Fabiana Saracino 1Rosaria Sabrina Rizzo 1Giampaolo Monacelli 2Danilo Lanni 1Luca Di Sante 1Angelo Cacchio 3Valter Santilli 1Teresa Venditto 1

Conclusion:   The use of ESWT in patients with first CMC joint osteoarthritis leads to a reduction in pain, an improvement in pinch test performance that persists for at least 6 months, and a decrease in hand disability up to the 6-month follow-up visit.

 

Application of extracorporeal shock wave therapy in nervous system diseases: A review

Juan Guo 1Hong Hai 1Yuewen Ma 1

ESWT is a form of mechanotherapy with a peak pressure of about 1,000 times more than ultrasound therapy (27). ESWT can be classified into focused ESWT (fESWT) and radial ESWT (rESWT) based on the wave patterns used (28). In general, a focused extracorporeal shock wave (fESW) is generated electrohydraulically, electromagnetically, or piezoelectrically, followed by converging it into a focal tissue zone (29). As an acoustic wave, fESW is characterized by its high pressure of more than 1,000 bar (100 MPa), an extremely short rise time (<10 ns), a short duration (<10 ms), and a broad frequency spectrum (16–20 MHz) (3032). Unlike fESW, radial extracorporeal shock wave (rESW) does not possess the shock wave characteristics of a short rise time, a high peak pressure, and non-linearity. Some scholars even call “rESW” “radial pressure waves” because rESW uses the energy generated from compressed gas to drive the bullet body to the treated tissue area in a pulsed manner

 

Chapter Three - The Use of Shock Waves in Peripheral Nerve Regeneration: New Perspectives?

Author links open overlay panelThomas Hausner *  , Antal Nógrádi * §

ESWT appears to have differential effects on peripheral nerves and has been proved to promote axonal regeneration after axotomy.

 

Effect of extracorporeal shock wave therapy on nerve conduction: a systematic review and meta-analysis

Liuxin Yang 1Xuan Li 1Shuhan Li 1Jiao Yang 1Dianhuai Meng 1

Conclusion:      ESWT had some excitatory effect on peripheral nerves, especially on sensory nerve studies. Although the efficacy of this treatment was superior to that of the control group, and the combined treatment with PT was more effective than PT alone.

 

Long-term effect of shock wave therapy on upper limb hypertonia in patients affected by stroke

P Manganotti 1E Amelio

Conclusions: ESWT reduces hypertonia of the wrist and finger muscles for > or =12 weeks after treatment.

The effect of extracorporeal shock wave on joint capsule fibrosis based on A2AR-Nrf2/HO-1 pathway in a rat extending knee immobilization model

 1,2,3 1,2 1,2 1,2 1,2,
Conclusions: In conclusion, this study provides evidence that ESWT reduces the total number of cells and collagen deposition in the joint capsule, thereby improving joint capsule fibrosis caused by long-term immobilization. These findings highlight the therapeutic potential of ESWT in the management of joint contracture and offer valuable insights into the underlying mechanism of action.

The effectiveness of extracorporeal shockwave treatment in subacromial impingement syndrome and its relation with acromion morphology

Conclusion: ESWT was found to be effective in the treatment of impingement syndrome both for pain and functional outcome in the early period regardless of acromion morphology.

Changes of articular cartilage and subchondral bone after extracorporeal shockwave therapy in osteoarthritis of the knee

Ching-Jen Wang1,2 Corresponding address*, Jai-Hong Cheng1*, Wen-Yi Chou2, Shan-Ling Hsu1,2, Jen-Hung Chen2, Chien-Yiu Huang1,2

Conclusion:  ESWT is effective in the prevention on the initiation of ACLT and MM induced osteoarthritis of the knee in rats. We expanded our previous study and detail described the pathological changes in articular cartilage and subchondral bone. ESWT showed the site-sensitive and location-specific with the best results when ESWT are simultaneously applied to medial distal femur and proximal tibia.

 

Enhancement of hyaline cartilage and subchondral bone regeneration in a rat osteochondral defect model through focused extracorporeal shockwave therapy

modulation of transforming growth factor-beta and bone morphogenetic proteins-2, -3, -4, -5, and -7 expression

Conclusion:  ESWT promoted the effect of TGF-β/BMPs, thereby modulating the production of extracellular matrix proteins and transcription factor involved in the regeneration of articular cartilage and subchondral bone in an OCD rat model.

The effect of shock wave treatment at the tendon-bone interface-an histomorphological and biomechanical study in rabbits

Conclusion: Shock wave treatment significantly improves the healing rate of the tendon-bone interface in a bone tunnel in rabbits. The effect of shock waves appears to be time-dependent.

The effect of extracorporeal shockwaves on cartilage end-plates in rabbits: a preliminary MRI and histopathological study

Conclusion: Our findings indicate that ESWT caused dose-dependent changes in the intervertebral end-plate. This study constitutes a preliminary evaluation of shockwave therapy to the intervertebral area in an animal model. High-dose ESWT may stimulate angiogenesis at cartilage end-plates in rabbits.

The Effect of Extracorporeal Shock Wave Therapy

CY Wen, CH Chu, KT Yeh, PL Chen
Conclusion:  The preliminary results suggested that regeneration of articular cartilage defects might be promoted by ESWT, due to the release of growth-inducing substances such as basic fibroblast growth factor, insulin-like growth factor-I and transforming growth factor-+β.