First, let’s introduce what focused shockwave therapy is.
Focused Extracorporeal Shockwave Therapy (F-ESWT) is an advanced non-invasive treatment technology that uses high-energy sound waves to focus energy precisely onto specific areas deep within the body.
Definition and Characteristics of Shock Waves
A shock wave is a high-energy mechanical wave, characterized by:
- Rapid pressure surge: Pressure rises from zero to a peak value (up to hundreds of bar) in an extremely short time (milliseconds).
- Non-periodic: Unlike ordinary sound waves, shock waves are non-periodic.
- High penetrability: Energy attenuates little in the medium, allowing it to penetrate superficial tissues and reach deep lesions.
Main therapeutic mechanism
The therapeutic effects of shock waves primarily stem from their biological and mechanical stress effects within tissues:
- Analgesia: Immediate pain relief. The shockwave strongly overstimulates pain nerve endings, causing nerve signal transmission blockage or attenuation, thereby reducing pain.
- Inflammation relief and tissue regeneration: Reduces local inflammation and edema, stimulates stem cell and osteoblast activity, and promotes the regeneration of damaged tendons, ligaments, and bone tissue.
- Cavitation: Releases adhesions. The shockwave generates microbubbles in the tissue fluid. The rapid expansion and collapse of these bubbles create cavitation stress, which helps to release tissue adhesions and break down calcified deposits.
- Angiogenesis: Accelerates healing. Stimulates the release of growth factors (such as VEGF), promotes the formation of new microvessels, improves local blood circulation and nutrient supply, and accelerates tissue repair.
Next, we will introduce the two different technologies of focused shock waves separately:
Piezoelectric focused shock wave (Piezoceramic F-ESWT)
Technical Principles
- Wave generation mechanism: Based on the piezoelectric effect. Applying voltage to a large number of high-precision piezoelectric ceramic elements (crystals) causes them to expand and contract instantaneously, directly generating shock waves in the water medium.
- Focusing mechanism: Self-focusing. The piezoelectric crystals are arranged on a spherical or ellipsoidal concave surface, and the shock waves generated by all wave sources naturally converge to the geometric focus $F2$.
- Energy characteristics: Features stable energy output and fine energy level adjustment. Its shock wave rise time is short, and it typically has a high frequency output capability (up to 25 Hz).
Clinical advantages and applications
- Low pain: Due to its relatively gentle energy rise and small but uniform energy density distribution, it is highly tolerable for patients, and many treatments do not require anesthesia.
- High precision: It can precisely define the focal point, making it particularly suitable for treating deep trigger points or tissues requiring fine-tuning.
Indications:
- Soft tissue pain: Deep tendinitis, calcific tendinitis, plantar fasciitis, muscle contractures, trigger point treatment.
- Regenerative medicine: Promotes angiogenesis and stimulates osteoblast and mesenchymal stem cell migration.
*Special applications: Linear focused piezoelectric shock waves can be used to treat vascular erectile dysfunction (ED), ensuring uniform energy output throughout the corpus cavernosum.
Technical parameters
- Maximum energy flux density: Approximately 0.65 mJ/mm² (high energy range).
- Focusing depth: Up to 65 mm (6.5 cm) or deeper.
- Output frequency: 1-25 Hz
Electromagnetic Focused Shock Wave (F-ESWT)
Technical Principles
- Shock Wave Generation Mechanism: Based on the principle of electromagnetic induction. A high-voltage pulsed current passes through a coil, generating a strong magnetic field. The rapidly changing magnetic field pushes a metal diaphragm near the coil (or directly induces a current in the water), thus generating a shock wave.
- Focusing Mechanism: Reflector-Focusing. The generated shock wave needs to be reflected by a parabolic or ellipsoidal reflector to focus the energy at the focal point F2.
- Energy Characteristics: Wide energy range, extremely high peak pressure, and the strongest energy level potential among all shock wave types. Extremely stable output energy and long focal length.
Clinical advantages and applications
- High penetrating power: Capable of generating pressure waves approximately 100 times stronger than other types, possessing extremely strong penetrating power, allowing for safe and reliable treatment of deep areas.
- Wide treatment range: The focal area is typically large, which helps improve the error tolerance and accuracy of target localization (especially for moving targets).
Indications
- Urology (ESWL): Extracorporeal shock wave lithotripsy (ESWL) effectively and non-invasively breaks up hard kidney stones, ureteral stones, and bladder stones.
- Orthopedics: Nonunion fractures (pseudoarthrosis), avascular necrosis of the femoral head, osteophyte inflammation, and other conditions requiring high-energy stimulation.
- Deep Tissue Therapy: Deep musculoskeletal diseases, severe calcifications, etc.
*F-ESWT also treats erectile dysfunction.ED Treatment
Technical parameters
- Energy flux density: Achieves higher energy density, suitable for high-energy treatment needs.
- Focal length/depth: Longer focal length design, suitable for deep treatment with high penetration.
- Stability: Stable lifespan and stable output energy of the electromagnetic generator.
Comparison of piezoelectric and electromagnetic methods in rehabilitation therapy
Piezoelectric focused shock wave (Piezoceramic F-ESWT)
| Application | Why Piezoelectric | Application in treatment scenarios |
| Focused features | High precision, small focal size, and self-focusing. Energy is precisely concentrated in the defined focal area, enabling accurate location and treatment of deep trigger points. | Deep muscle trigger points, deep fasciitis. |
| Energy control | The energy level adjustment is precise and stable. It allows for small-amplitude, multi-level energy regulation, making it more suitable for patients sensitive to pain and those requiring gentle stimulation. | Tendinitis following the acute phase, or early or mild joint inflammation. |
| Patient comfort | Low noise and low pain. The equipment operates with minimal noise, and the shockwave rise is relatively gentle, making it well-tolerated by patients and usually requiring no anesthesia. | Suitable for pain-sensitive clients, improving treatment adherence. |
| Specific applications | Linear-focused piezoelectric shock waves are suitable for large-area, uniform stimulation (such as muscles or fascia bundles) and can be used for large-area muscle strain or relaxation. | Relaxation and relief of chronic muscle strain, stiffness and spasms. |
Electromagnetic Focused Shock Wave (F-ESWT)
| Application | Why Electromagnetic? | Application in treatment scenarios |
| Energy properties | It boasts extremely high peak pressure and strong penetrating power. It can generate immense pressure, allowing high energy to penetrate to the deepest tissues for deep treatment. | Treatment of hard, deep-seated lesions, such as refractory calcifying tendinitis and deep bone lesions. |
| Focused features | The focal area is typically large. This helps improve the tolerance for positioning errors when treating deep lesions, ensuring that energy covers the target area. | Areas requiring significant energy stimulation, such as deep Achilles tendon lesions and greater trochanter bursitis. |
| Treatment effect | The powerful mechanical stress effect is particularly effective in breaking down severe calcification and stimulating bone regeneration. | Delayed fracture healing and lesions requiring strong impact to restart the healing process of chronic inflammation. |
| Pain/Procedure | The pain level is relatively high, and medical staff may need to better guide the patient to tolerate it during treatment. | Suitable for customers who seek efficient and powerful treatment and can tolerate some discomfort. |
If your clients primarily focus on deep muscle trigger points and soft tissue relaxation, and have a low pain tolerance, then piezoelectric shockwave therapy would be a more comfortable and precise choice.
If your clients require treatment for severe calcification, intractable tendinopathy, or demand the highest energy output from the device, then electromagnetic shockwave therapy will offer more powerful and deeper therapeutic capabilities.
