Focused Shockwave Therapy: How Does It Work and Who Can It Help?

Focused shockwave therapy is a non-invasive treatment that is increasingly being used for persistent tendon, muscle, joint and bone-related problems. It can be particularly useful when an injury has failed to improve with conventional treatment and is limiting activity or affecting everyday life.

What is focused shockwave therapy?

Focused shockwave therapy uses high-energy acoustic waves to deliver mechanical energy into a specific area of the body. Unlike radial shockwave therapy, which delivers energy more broadly from the treatment head, focused shockwaves can concentrate energy at a particular depth.

This means the treatment can be directed more precisely towards the affected tissue, including deeper tendons, ligaments, joints, bone and other soft tissues.

How does focused shockwave therapy work?

When the acoustic wave enters the tissue, it creates a mechanical stimulus that can influence cellular activity and the surrounding tissue environment. This process, known as mechanotransduction, may trigger a number of biological responses.

Research suggests that shockwave therapy may:

• Stimulate cellular processes involved in tissue repair

• Influence the formation of new blood vessels

• Affect pain signalling and sensitivity

• Encourage tissue remodelling

• Improve the tissue's ability to adapt to mechanical loading

Importantly, shockwave therapy isn't simply about masking pain or "breaking down scar tissue". Its effects are thought to involve a combination of mechanical, biological and neurological responses.

What conditions can focused shockwave therapy help?

Focused shockwave therapy has been investigated for a variety of musculoskeletal conditions, including tendinopathy, plantar fasciitis, persistent soft-tissue injuries and some bone-healing problems.

It may be particularly worth considering when symptoms have become persistent and haven't responded sufficiently to exercise, manual therapy or other conservative approaches.

Focused vs radial shockwave therapy

Focused treatment uses acoustic waves, whereas radial uses pressure waves, and they deliver energy differently. Focused shockwaves can concentrate energy at a selected depth, whereas radial shockwaves disperse energy more superficially.

The most appropriate treatment depends on the condition, the location of the problem and the individual patient.

Combining shockwave therapy with rehabilitation

Shockwave therapy is not necessarily a stand-alone solution. For many conditions, the best approach is to combine treatment with progressive exercise, appropriate loading and rehabilitation.

The aim is not simply to reduce pain, but to improve the tissue's capacity to tolerate load and return to normal function.