The big question that is always raised by clinicians and patients is “Radial shockwave or Focused shockwave” – and it’s a great question that we shall answer.
In short – radial “shockwave” therapy is a pressure wave that radiates out into the tissue – Like a shotgun, good a close range, but not very accurate.
Focused shockwave therapy produces a true shockwave by directing energy into a specific point – Like a sniper, very accurate and great at short and long distances.
What many people do not know is focused came first. However, at the time the research was developing, the size and cost of the machines were prohibitive and did not make commercial sense for manufacturers.
Off the back of this, radial shockwave therapy was born. A cheaper machine to make with a simple way of producing mechanical energy in a compact design. From then, radial shockwave therapy has become the most common type of shockwave therapy used in most MSK clinics.
However, in the last 5-8 years, focused shockwave therapy is growing in popularity. This is due to the machines becoming smaller and more affordable, but also the awareness has grown. Clinicians know more about how focused shockwave therapy has more treatment options, depth, precision, and patient comfort as well as its’ use for acute cases.
Why has awareness improved?
The education and awareness of the differences between radial and focused shockwave have been heavily pushed by Physiquipe in the UK. As part of our mission to challenge the standards in MSK rehabilitation, we recognised a gap in the knowledge of the clinician. We have worked hard with organisations such as Johns Hopkins, to improve clinicians’ awareness of shockwave.
As a result, we have now provided focused and radial shockwave to 7 international elite sports teams, over 30 elite sports clubs/institutions and hundreds of clinics. Not to mention over 300, tailored, education sessions on shockwave.
This is why we are rapidly becoming one of the UK’s most trusted and reputable shockwave specialists.
The differences between the technologies
Focused and radial shockwave therapy come under the shockwave umbrella and there are different variations within that – check out this blog here for the variations of shockwave therapy.
Radial shockwave therapy – wide treatment area at a superficial level
Radial shockwave is extremely effective for chronic tendinopathy particularly. Apart from plantar fasciitis, tennis/golfer’s elbow and some superficial muscles injuries, radial shockwave therapy is limited to these indications.
Radial shockwave treatment:
- Superficial and non-specific
o Approx. maximum effect to 3-4 cm depth - Low energy
o Most systems max. out at 4-5 bar of pressure - Low impulse
o Energy is better delivered at lower frequencies (5-8Hz)
There are 2 ways to create a radial shockwave. Compressed air or electromagnetic forces propel a projectile inside a tube which collides with a transmitter.
The highest point of energy is at the transmitter, on the surface of the skin, and the energy weakens the further it travels. The energy is transmitted to the tissue via a medium (ultrasound gel) where it travels outwards into the tissues.
The energy delivered loses power as it is absorbed and reflected by the tissues the further travels. For deeper indications radial shockwave therapy may not have much effect, whereas, if the target tissue is superficial (inside 4cm depth), radial shockwave therapy can provide positive results.
There are a variety of transmitters, that can come with radial shockwave therapy machines which can get very confusing, and it depends on what you want to treat.
We have done our research and recommend 15mm and 20mm transmitters, however, there are other transmitters available. You can speak to one of our specialists to find out what is best for you.
Focused shockwaves therapy – precision shockwave treatment at targeted depths
A focused shockwave works by directing energy into one particular point, the focal zone. All of the energy is delivered here and bypasses healthy tissue around it.
Focused shockwave therapy has a more profound physiological effect on a variety of tissues and can be used for acute and chronic injury.
Focused shockwave therapy treatment
- Can target specific depths
o Between 0cm-10/12cm (depending on the system)
o Find out more about how you can control depth here. - Delivers a consistent pulse of energy
o Limited energy loss through absorption - High and low energy
o Enabling you to alter treatments for desired outcomes
There are 4 variations of focused shockwave and each has a limitation, but all focused shockwave therapy machines work – if you get that focal zone hitting the target tissue.
All the systems vary in what energy they can provide and in most cases, the energy level affects what frequency you can deliver the energy at. E.g. as you increase the energy output, the frequency drops. This is one of the considerations you must look into before investing as this can impact treatment outcomes, find out what else you should consider here.
One of the most profound things about focused shockwave therapy is that you cannot feel it on healthy tissues, and it replicates the pain or symptom on problematic tissues. This engages the patient and involves them in the treatment where they can guide you to their “pain points” and from there, engagement in their rehab can be much higher.
How much does this all cost?
The average radial shockwave system is around the ÂŁ6,000-ÂŁ8500 mark. But some go up and beyond ÂŁ12,000. For anything below ÂŁ5000, the likelihood is, you will be buying another one shortly after.
For focused shockwave therapy you are looking at ÂŁ21,000-ÂŁ25000 with some in excess of ÂŁ30,000.
One of the things many suppliers will not communicate is their ongoing costs. This could be as high as ÂŁ1000+ every 1 million shocks.
Servicing is also another thing to be aware of. These systems will need to be serviced but in some cases, the therapy source and the machine are charged separately!
Also, the numbers above are all excluding VAT!
Can I use both radial and focused shockwave therapy?
Recently, some have been encouraging the use of both in the clinic and if finance is no issue, then absolutely, get both!
It does make sense in many ways as, when compared, they offer different benefits. However, let’s be realistic, not everyone can afford to do this, so what should you do?
If you are comfortable spending £20,000+ on a machine (approx. £500 a month) then focused shockwave is a strong candidate. There is always that risk, however, that it doesn’t kick off like you think.
So, it may be safer to start with a radial system at about the ÂŁ6,000 mark to build your experience and your shockwave service. Low overheads, keep cash flow nice, and you can always trade-in via our futureproof guarantee.
Lots to think about, but that is where our specialists come in. We have worked with hundreds of clinicians around the country, and advice is always free.
Get in touch to learn more!
