Focal shock waves


  • What are shock waves?
  • Why is it performed?
  • What does it consist of?
  • Preparation
  • Care
  • Alternatives

What are focal shock waves?

Shock waves are high-powered acoustic waves that have mechanical and biological effects. They can be of two types:

  • Focal shock waves (FSWT): they are generated by electromagnetic induction and propagate linearly, i.e. they are directed towards a single point. They produce low energy dispersion and exert high pressure (between 100 and 1,000 bar).
  • Radial shock waves (RSWT): they are generated pneumatically and propagate divergently. They exert a low pressure (between 1 and 10 bars). They are applied superficially on soft tissues, activating microcirculation and tissue metabolism.

The characteristics of focal shock waves make them have a greater penetration into the tissues and act at the cellular level, which also causes greater discomfort at the time of application.

Why is it performed?

They are indicated in multiple pathologies and at different points of its evolution: acute, subacute and chronic; but being focused and very powerful, this type of waves are usually used for more aggressive treatments.

are especially indicated for the treatment of:

  • deep myofascial trigger points
  • chronic insertion tendinitis
  • deep local pain points
  • destruction of some types of kidney stones and pancreatic calculi
  • calcifications

What does it consist of?

Shock waves produce pressure changes in the tissues and through a physiological principle, called mechano-transduction, act at the cellular level.

These waves go through the soft tissues and originate micro-stimuli in the area to be treated, and from this mechanical energy the biological energy is produced by cellular stimulation, producing biochemical factors with an effect similar to growth factors. What these waves cause is the integration of neo vascularization or angiogenesis, leading to cell growth, formation of new tissue and tissue growth, initiating the healing process. In addition, there is a migration of the body’s own stem cells in the tissues treated with ESWT (Extracorporeal shock wave therapy), i.e., stem cells are attracted.

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The treatment itself is very simple and absolutely minimally invasive. Each session consists of 3 phases:

  1. The specialist will palpate to locate more precisely the area to be treated with shock waves.
  2. Next, gel is applied to the area to allow the shockwaves to pass through more efficiently.
  3. Finally, the shock wave applicator is used in the area. This is a device by means of which the specialist must press and apply the waves manually.

Preparation for focal shock waves

The shock waves, both radial and focal, do not require special preparation by the patient, since it is not an invasive treatment and no anesthesia is required.

Aftercare after the procedure

After shock wave sessions, patients are advised to avoid physical exercise for the next 48 hours, especially that which affects or involves the treated area.

Some people may experience slight pain after the session, which subsides within 2 to 4 hours.

Alternatives to this treatment

Some of the possible adverse effects of focal waves are subcutaneous hematomas, petechiae, erythema. For this reason, people taking anticoagulants or with blood clotting disorders (hemophilia, thrombosis) should not receive this type of therapy.

Therefore, some non-invasive alternatives may be hyaluronic acid infiltrations, platelet-rich plasma, the application of heat or cold, or hydrotherapy, among others.

Surgery until very recently was the only treatment alternative for some muscular or osteoarticular injuries, although there are non-invasive treatments, sometimes open surgery is necessary.