Radial Pressure Wave
What Is Radial Pressure Wave Therapy?
Radial Pressure Waves (RPW) are acoustic waves that generate a cellular response in the tissue. They help reduce pain, activate connective tissue (collagen) production, temporarily increase blood flow, and help in the treatment of common tendinitis conditions in the shoulder, elbow, hip, knee, ankle, and foot.
What Does RPW Feel Like?
You will feel a rapid thumping sensation and mild pain when the applicator passes over dysfunctional tissues. Patients report feeling minimal discomfort when the sound head passes over healthy tissues. Pain levels vary by patient, treatment location, and tissue sensitivity. The more energy into the tissue per treatment, the better, but we prefer to choose settings that keep the pain level below “6/10” throughout treatment. Post-treatment soreness is not uncommon and might last a couple of hours.
How Long is a Treatment Session?
Treatment takes only 5-10 minutes. The most effective treatment is always paired with a comprehensive rehabilitation program, so your therapist may first need to perform a full examination to issue proper home exercises. RPW sessions can also be added onto traditional therapy visits and do not require a doctor’s order.
How Many Treatments Will I Need?
Generally, 4-8 sessions to expect a significant treatment effect. Maximum improvement can even occur weeks after the final treatment, owed to the sequence of cellular events jump-started by RPW.
How Much Does It Cost?
Each session is $50 for one body part and $75 for two body parts. Sessions are spaced 5-10 days apart. No insurance will pay for RPW but it is commonly HSA/FSA eligible.
Does It Work?
Many high-quality studies show RPW to be more effective than therapy alone, corticosteroid injections, sham treatments, or manual therapy, particularly in long-term follow-ups.
Achilles Tendinopathy:
Feeney KM. The effectiveness of extracorporeal shockwave therapy for midportion Achilles tendinopathy: a systematic review. Cureus. 2022 Jul 18;14(7):e26960.
Washington State Health Care Authority Health Technology Assessment 2017. “Extracorporeal shock wave therapy (ESWT) for musculoskeletal conditions”
Lateral Hip Pain:
Ramon, S, Russo, S, Santoboni, F, et al. Focused shockwave treatment for greater trochanteric pain syndrome: a multicenter, randomized, controlled clinical trial. J Bone Joint Surg Am. 2020;102(15):1305-1311.
Dr. Craig Martin. Effectiveness of Extra Corporeal Shockwave Therapy (ESWT) in Treating Greater Trochanteric Bursitis A Rapid Systematic Review. Evidence-Based Practice Group WorkSafeBC. February 2024
Lateral Epicondylitis (Tennis Elbow):
Çetin BV, Sepetçi Ö, Yazar İ, et al. Comparison of local massage, steroid injection, and extracorporeal shock wave therapy efficacy in the treatment of lateral epicondylitis. Jt Dis Relat Surg. 2024 Apr 26;35(2):386-395.
Liu WC, Chen CT, Lu CC, et al. Extracorporeal shock wave therapy shows superiority over injections for pain relief and grip strength recovery in lateral epicondylitis: a systematic review and network ,eta-analysis. Arthroscopy. 2022 Jun;38(6):2018-2034.e12.
Yao G, Chen J, Duan Y, Chen X. Efficacy of extracorporeal shock wave therapy for lateral epicondylitis: A systematic review and meta-analysis. Biomed Res Int. 2020:2064781.
Yoon SY, Kim YW, Shin IS, et al. Does the type of extracorporeal shock therapy influence treatment effectiveness in lateral epicondylitis? A systematic review and meta-analysis. Clin Orthop Relat Res. 2020 Oct;478(10):2324-2339.
Heel Pain/Plantar Fasciitis:
Gollwitzer H, Saxena A, DiDomenico LA, et al. Clinically relevant effectiveness of focused extracorporeal shock wave therapy in the treatment of chronic plantar fasciitis: a randomized, controlled multicenter study. J Bone Joint Surg Am. 2015; 97(9):701-708
Asheghan M, Hashemi SE, Hollisaz MT, et al. Dextrose prolotherapy versus radial extracorporeal shock wave therapy in the treatment of chronic plantar fasciitis: a randomized, controlled clinical trial. Foot Ankle Surg. 2021 Aug;27(6):643-649.
Lai TW, Ma HL, Lee MS, et al. Ultrasonography and clinical outcome comparison of extracorporeal shock wave therapy and corticosteroid injections for chronic plantar fasciitis: A randomized controlled trial. J Musculoskelet Neuronal Interact. March 2018.
Gollwitzer H, Saxena A, DiDomenico LA, et al. Clinically relevant effectiveness of focused extracorporeal shock wave therapy in the treatment of chronic plantar fasciitis: a randomized, controlled multicenter study. J Bone Joint Surg Am. 2015; 97(9):701-708
Yin MC, Ye J, Yao M, et al. Is extracorporeal shock wave therapy clinical efficacy for relief of chronic, recalcitrant plantar fasciitis? A systematic review and meta-analysis of randomized placebo or active-treatment controlled trials. Arch Phys Med Rehabil. 2014 Aug;95(8):1585-93.
Proposed Mechanisms of Action in Situ:
Simplicio, CL, et. al. Extracorporeal shock wave therapy mechanisms in musculoskeletal regenerative medicine. Journal of Clinical Orthopaedics and Trauma 11 (2020) S309eS318
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