How Focused Shockwave Therapy Can Help People With Knee Osteoarthritis

Knee osteoarthritis (OA) is a degenerative joint condition that affects millions of people worldwide. Pain, stiffness, and reduced mobility are hallmark symptoms that can significantly impact quality of life. Many sufferers explore multiple treatments—ranging from medications and physiotherapy to injections and surgery—to find lasting relief.

One option attracting attention from clinicians and patients alike is focused shockwave therapy (often abbreviated f-ESWT). This non-invasive approach uses concentrated acoustic waves to stimulate biological changes in and around the osteoarthritic joint. While it’s not a cure, current evidence suggests it may offer meaningful benefits in pain relief and function for many knee OA sufferers.

What Is Focused Shockwave Therapy?

Focused shockwave therapy is a specialised type of extracorporeal shockwave therapy (ESWT). Unlike radial shockwaves—which disperse energy over a broader area—focused shockwaves concentrate mechanical energy deeper and more precisely into targeted tissues, such as the cartilage interface and subchondral bone near the arthritic knee joint. The energy delivered can penetrate deeper structures and more directly stimulate the biological responses clinicians aim to influence.

Sessions are generally brief, non-surgical, and performed in outpatient settings by trained clinicians.

How Focused Shockwave Therapy May Affect the Arthritic Knee

Although scientists are still detailing every mechanism of action, research and clinical trials indicate that focused shockwave therapy helps in several ways:

1. Reduction of Pain

Pain relief is the most reported benefit. In clinical trials, knee OA patients treated with focused shockwaves experienced larger reductions in pain scores (measured on standard pain scales) compared with those receiving other forms of shockwave therapy or standard care.

This likely reflects a combination of local effects on nerve sensitivity and modulation of pain-related chemicals in the joint environment, such as neuropeptides that heighten pain perception.

2. Improved Function and Mobility

Improved pain control often translates into better physical function. Studies have shown that focused shockwave therapy can lead to meaningful improvements in walking ability, knee movement range, and validated functional scores used in osteoarthritis research.

These functional improvements are important because they reflect real-world benefits—such as walking longer distances, climbing stairs more comfortably, and performing everyday activities with less discomfort.

3. Quality of Life Benefits

Beyond objective measures, participants in clinical research reported improvements in knee-related quality of life after focused shockwave therapy. Simple daily tasks became easier, and overall satisfaction with knee health increased compared with controls in some trials.

4. Addressing Inflammation and Tissue Health

While human evidence is still emerging, laboratory and animal studies suggest that shockwave energy may help modulate inflammatory processes in the joint. For example, targeted shockwaves have been associated with reduced levels of certain inflammatory cytokines and a decrease in destructive biochemical activity within the joint.

There is also preclinical evidence that shockwaves can stimulate blood flow, growth factor release, and tissue remodelling—factors that may support cartilage and bone health over time.

What the Evidence Says

Systematic reviews and clinical studies show that extracorporeal shockwave therapy in general has beneficial effects for knee osteoarthritis—including pain reduction and improved function—compared with sham treatment or other interventions in many cases.

Although research directly comparing focused vs radial wave types is more limited, available randomised trials suggest that focused shockwave therapy may offer greater improvements in pain and physical function compared with radial shockwave therapy in people with knee OA under similar treatment parameters.

That said, some studies show mixed results in specific outcomes, and more high-quality research is recommended to confirm optimal dosing, number of sessions, and long-term benefits.

What to Expect With Treatment

Focused shockwave therapy is typically delivered over several sessions spaced over weeks. Each session lasts only a few minutes and is considered non-invasive; there are no injections or incisions involved.

Most patients tolerate the procedure well. Some report mild discomfort during application, and occasional transient soreness around the treated area is possible.

Ideal candidates are generally individuals with mild to moderate knee osteoarthritis who have persistent symptoms despite conservative care, and who are seeking non-surgical treatment options. It may be less effective for severe, bone-on-bone disease, where structural joint damage is advanced.

Is It Right for You?

Focused shockwave therapy is not a universal solution, but it can be a valuable component of a comprehensive knee OA management plan. It may be especially appropriate for people who:

• Are not ready or eligible for surgery

• Want to minimise reliance on medications

• Have pain and function limitations despite physiotherapy or lifestyle modification

Consultation with a clinician experienced in shockwave therapy is essential. They can assess your specific condition, imaging findings, and overall health to determine whether focused shockwave therapy is a suitable option.