Quality Standards and Techniques for the Application of Focused Shockwaves and Radial Pressure Waves in Musculoskeletal Disorders

Review Article | Volume 1 | Issue 1 | JRS December 2021 | Page 9-12 | José Eid, Daniel Moya DOI: 10.13107/jrs.2021.v01.i01.007

Author: José Eid [1], Daniel Moya [2]

[1] Médico Assistente do corpo clínico do Hospital Hcor São Paulo, Brazil.

[2] Department of Orthopaedic, Servicio de Ortopedia y Traumatología, Hospital Británico de Buenos Aires.

Address of Correspondence:
Dr. José Eid, MD.
Médico Assistente do corpo clínico do Hospital Hcor São Paulo, Brazil.
E-mail: j.eid@uol.com.br


Focused shockwaves and radial pressure waves are safe and effective if used correctly. Nevertheless, poor results and complications have been described due to missdiagnosis and technical errors. The aim of this review is to introduce the basic principles of quality and technical recommendations for each method.

Keywords: Shock waves, Radial pressure waves, Quality standards


  1. Delius M, Brendel W. Historical roots of lithotripsy. J Lithotr Stone Dis 1990;2:161-3.
  2. Moya D, Ramón S, Schaden W, Wang CJ, Guiloff L, Cheng JH. The role of extracorporeal shockwave treatment in musculoskeletal disorders. J Bone Joint Surg Am 2018;100:251-63.
  3. Loske AM. Medical and Biomedical Applications of Shock Waves. Cham, Switzerland: Springer International; 2017. p. 19-42.
  4. Novak P. Physics: F-SW and R-SW. Basic information on focused and radial shock wave physics. In: Lohrer H, Gerdesmeyer L, editors. Multidisciplinary Medical Applications. Heilbronn: Buchverlag; 2014. p. 28-49.
  5. Consenso de la Federación Ibero-Latinoamericana de Ondas de Choque e Ingeniería Tisular Sobre las Bases Físicas de las Ondas de Choque Focales y de las Ondas de Presión Radial. Available from: https://onlat.net/?page_id=2497 [Last accessed on 2021 June 09].
  6. Eid J. ISMST Consensus Statement Terms and Definitions. https://www.shockwavetherapy.org/fileadmin/user_upload/dokumente/PDFs/Formulare/Consensus_MBRadial_pressure_wave_2017_SS.pdf [Last accessed on 2021 June 09].
  7. European Commission DG Health and Consumer. Medical Devices: Guidance document. Classification of medical devices. MEDDEV 2. 4/1. Available from: https://pdf4pro.com/download/medical-devices-guidance-document-6fa97.html [Last accessed on 2021 June 09].
  8. Digest Guidelines for Extracorporeal Shockwave Therapy. Available from: https://www.shockwavetherapy.org/fileadmin/user_upload/ISMST_Guidelines.pdf [Last accessed on 2021 June 09].
  9. Kibler WB. Value on the front end: Making the effective diagnosis for optimal treatment. Arthroscopy 2017;33:493-5.
  10. Moya D, Ramón S, Guiloff L, Terán P, Eid J, Serrano E. Malos resultados y complicaciones en el uso de ondas de choque focales y ondas de presión radial en patología musculoesquelética [Poor results and complications in the use of focused shockwaves and radial pressure waves in musculoskeletal pathology]. Rehabilitacion (Madr) 2021;2021:00031-1.
  11. International Society for Medical Shockwave Treatment. Consensus Statement on ESWT Indications and Contraindications. Available from: https://www.shockwavetherapy.org/fileadmin/user_upload/dokumente/PDFs/Formulare/ISMST_consensus_statement_on_indications_and_contraindications_20161012_final.pdf [Last accessed on 2021 June 09].
  12. Wright JG. Revised grades of recommendation for summaries or reviews of orthopaedic surgical studies. J Bone Joint Surg Am 2006;88:1161-2.
  13. Ramon S, Español A, Yebra M, Morillas JM, Unzurrunzaga R, Freitag K, et al. Current evidences in shockwave treatment. SETOC (Spanish Society of Shockwave Treatment) recommendations. Rehabilitacion (Madr) 2021;55(4):291-300.
  14. Wang CJ, Huang HY, Yang K, Wang FS, Wong M. Pathome-chanism of shock wave injuries on femoral artery, vein andnerve. An experimental study in dogs. Injury. 2002;33:439-46.
  15. Buchbinder R, Ptasznik R, Gordon J, Buchanan J, Prabaharan V, Forbes A. Ultrasound-guided extracorporeal shock wave therapy for plantar fasciitis: A randomized controlled trial. JAMA. 2002;288:1364-72.
  16. Njawaya MM, Moses B, Martens D, Orchard JJ, Driscoll T, Negrine J, et al. Ultrasound guidance does not improve the results of shock wave for plantar fasciitis or calcific achilles tendinopathy: A randomized control trial. Clin J Sport Med 2018;28:21-7.
  17. Charrin JE, Noel ER. Shockwave therapy under ultrasonographic guidance in rotator cuff calcific tendinitis. Jt. Bone Spine 2001;68:241-4.
  18. Sabeti-Aschraf M, Dorotka R, Goll A, Trieb K. Extracorporeal shock wave therapy in the treatment of calcific tendinitis of the rotator cuff. Am J Sports 2005;33:1365-8.


How to Cite this article: Eid J, Moya D | Quality Standards and Techniques for the Application of Focused Shockwaves and Radial Pressure Waves in Musculoskeletal Disorders. | Journal of Regenerative Science | December 2021; 1(1): 9-12.

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