How to Avoid Failure of Radial Pressure Waves and Focused Shock Waves Therapy in Plantar Heel Pain: Diagnostic, Technical, and Biomechanical Pitfalls
Review Article | Vol 6 | Issue 1 | January-June 2026 | page: 27-32 | Osvaldo Valle Toledo
DOI: https://doi.org/10.13107/jrs.2026.v06.i01.197
Open Access License: CC BY-NC 4.0
Copyright Statement: Copyright © 2026; The Author(s).
Submitted Date: 05 Mar 2026, Review Date: 20 April 2026, Accepted Date: April 2026 & Published: 30 June 2026
Author: Osvaldo Valle Toledo [1]
[1] Department of Orthopedic Surgery, Ankle and Foot Team, MEDS Clinic, Santiago de Chile, Chile.
Address of Correspondence
Osvaldo Valle Toledo,
Department of Orthopedic Surgery, Ankle and Foot Team, MEDS Clinic, Santiago de Chile, Chile.
E-mail: osvaldo.valle@meds.cl
Abstract
Mechanical wave-based therapies are a widely used and effective treatment for chronic plantar fasciopathy (PF); however, some patients do not achieve satisfactory clinical outcomes. Treatment failure is not necessarily related to the intrinsic efficacy of the method but is more frequently associated with modifiable clinical factors. This narrative review aims to analyze the most common causes of failure, focusing on diagnostic errors, inappropriate timing of treatment, inadequate technical application, and failure to address biomechanical abnormalities. Misdiagnosis is a major cause of therapeutic failure, as plantar heel pain may originate from multiple conditions other than PF, including tarsal tunnel syndrome, Baxter’s nerve entrapment, heel fat pad syndrome, calcaneal stress fractures, bursitis, tumors, and systemic inflammatory diseases. Technical factors, such as inappropriate energy delivery, incorrect targeting, and the use of local anesthesia, may also negatively influence outcomes. Furthermore, uncorrected gastrocnemius contracture and altered foot biomechanics contribute to persistent overload of the plantar fascia. Finally, both radial pressure waves and focused shockwaves appear to be more effective in chronic than in acute PF. A better understanding of these factors may improve patient selection and optimize treatment outcomes.
Keywords: Heel pain, Radial pressure waves, Focused shock waves, Plantar fasciitis
References
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| How to Cite this article: Toledo OV How to Avoid Failure | of Radial Pressure Waves and Focused Shock Waves Therapy in Plantar Heel Pain: Diagnostic, Technical, and Biomechanical Pitfalls | Journal of Regenerative Science | Jan-Jun 2026; 6(1): 27-32. |
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How to Read Radial Pressure Wave and Shock Wave Scientific Literature Without Perishing in the Attempt
Review Article | Vol 5 | Issue 2 | July-December 2025 | page: 42-46 | Daniel Moya, Mani Singh, Lauro Schledorn de Camargo
DOI: https://doi.org/10.13107/jrs.2025.v05.i02.183
Open Access License: CC BY-NC 4.0
Copyright Statement: Copyright © 2025; The Author(s).
Submitted Date: 08 Aug 2025 , Review Date: 27 Sep 2025, Accepted Date: Nov 2025 & Published: 30 Dec 2025
Author: Daniel Moya [1], Mani Singh [2], Lauro Schledorn de Camargo [3]
[1] Department of Orthopaedics, Hospital Británico de Buenos Aires, Argentina.
[2] Department of Rehabilitation and Regenerative Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, United States.
[3] Orthopedic Surgeon, LC Clinic Jundiaí – SP, Brazil .
Address of Correspondence
Daniel Moya,
Department of Orthopaedics, Hospital Británico de Buenos Aires, Argentina.
E-mail: drdanielmoya@yahoo.com.ar
Abstract
Publications on shock wave therapy have experienced exponential growth since the beginning of the 21st century. While this has had a positive effect by providing a wealth of information, it has also generated confusion and misunderstandings. It is essential that readers be aware of the significant discrepancies and serious errors, even within the basic sciences related to this therapeutic tool.
In a literature review, we discuss examples of the most frequent errors.
Critical reading is the surest way to avoid adopting false concepts.
Keywords: Shock wave, Radial pressure waves, Literature review, Critical reading
References:
1. Skaudickas D, Lenčiauskas P, Skaudickas A, Undžytė G. Low intensity extracorporeal shockwave therapy for chronic pelvic pain syndrome: Long-term follow-up. Open Med (Wars). 2023 Oct 28;18(1):20230832. doi: 10.1515/med-2023-0832. PMID: 37900960; PMCID: PMC10612526.
2. Hur KJ, Bae WJ, Ha US, Kim S, Piao J, Jeon KH, et al. Safety and efficacy of extracorporeal shockwave therapy on chronic prostatitis/chronic pelvic pain syndrome: a prospective, randomized, double-blind, placebo-controlled study. Prostate Int. 2024 Dec;12(4):195-200. doi: 10.1016/j.prnil.2024.06.003. Epub 2024 Jun 13. PMID: 39735201; PMCID: PMC11681323. Wang YR. Safety of low-intensity extracorporeal shock wave therapy — 2024. Revisión en PMC.
3. Huang N, Qin Z, Sun W, Bao K, Zha J, Zhang P, et al. Comparing the effectiveness of extracorporeal shockwave therapy and myofascial release therapy in chronic pelvic pain syndrome: study protocol for a randomized controlled trial. Trials. 2023 Oct 18;24(1):675. doi: 10.1186/s13063-023-07633-1. PMID: 37853420; PMCID: PMC10583345.
4. Wang YR, Feng B, Qi WB, Gong YW, Kong XB, Cheng H, Dong ZL, Tian JQ, Wang ZP. Safety of low-intensity extracorporeal shock wave therapy in prostate disorders: in vitro and in vivo evidence. Asian J Androl. 2024 Sep 1;26(5):535-543. doi: 10.4103/aja202448. Epub 2024 Aug 6. PMID: 39107962; PMCID: PMC11449405.
5. Labetov I, Vaganova A, Kovalev G, Shkarupa D. Extracorporeal shockwave therapy in treatment of chronic prostatitis/chronic pelvic pain syndrome: Systematic review and meta-analyses. Neurourol Urodyn. 2024 Nov;43(8):1924-1937. doi: 10.1002/nau.25524. Epub 2024 Jun 7. PMID: 38847290. Hegazy M. A randomized trial on low-intensity shockwave therapy (2024) — publicación en revista científica (Nature-linked).
6. Hegazy M, Sheir KZ, Gaballah MA, Elshal AM. A randomized controlled trial evaluating low-intensity shockwave therapy for treatment of persistent storage symptoms following transurethral surgery for benign prostatic obstruction. Prostate Cancer Prostatic Dis. 2024 Jun;27(2):305-311. doi: 10.1038/s41391-024-00820-4. Epub 2024 Mar 29. PMID: 38553627; PMCID: PMC11096095.
7. Ogbeivor C, AlMubarak H, Akomolafe T, Alkahtani H, AlMugizel H, Marin I, Aldosari H, Aldhwayan N, Mohamed G, Alobthani K. The effectiveness of radial shockwave therapy on myofascial pain syndrome: a two-armed, randomized double-blind placebo-controlled trial. BMC Musculoskelet Disord. 2025 Apr 24;26(1):413. doi: 10.1186/s12891-025-08659-z. PMID: 40275291; PMCID: PMC12023603.
8. Hurt K, Svestkova O, Halaska M, Driak D, Rakovicova I, Musalek M, Krajcova A. Extracorporeal Shock Wave Therapy of Vulvodynia: A Feasibility Study. Actual Gyn. 2019;11:18-22
| How to Cite this article: Moya D, Singh M, Camargo LSD. How to Read Radial Pressure Wave and Shock Wave Scientific Literature Without Perishing in the Attempt. Journal of Regenerative Science. July-December 2025;5(2):42-46. |
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Pelvic Pain and the Use of Extracorporeal Shock Wave Therapy (ESWT)
Review Article | Vol 5 | Issue 2 | July-December 2025 | page: 39-41 | Romina Tang Candiotti
DOI: https://doi.org/10.13107/jrs.2025.v05.i02.181
Open Access License: CC BY-NC 4.0
Copyright Statement: Copyright © 2025; The Author(s).
Submitted Date: 25 Oct 2025, Review Date: 12 Nov 2025, Accepted Date: Nov 2025 & Published: 30 Dec 2025
Author: Romina Tang Candiotti [1]
[1] Pelvic floor unit. RENOVA MEDIC Medical Center, Lima, Perú.
Address of Correspondence
Armando Tonatiuh Ávila García,
Pelvic floor unit. RENOVA MEDIC Medical Center, Lima, Perú.
E-mail: romi.arw@gmail.com
Abstract
Chronic pelvic pain (CPP) is a heterogeneous condition affecting individuals of both sexes and may originate from urological, gynecological, gastroenterological, musculoskeletal, and neurological structures. Over the past three years (2023–2025), multiple clinical studies, reviews, and meta-analyses have evaluated the use of focused extracorporeal shock waves treatment (ESWT), low-intensity shock waves (Li-ESWT) and radial pressure waves (RPW), on specific CPP subtypes, particularly chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), pelvic floor myofascial pain, and vulvodynia/vestibulodynia. Recent evidence suggests benefits in pain reduction and functional improvement in the short and medium term, with a favorable safety profile; however, methodological limitations and protocol heterogeneity persist.
Keywords: Chronic pelvic pain syndrome, Shock waves, Pelvic floor myofascial pain, Chronic prostatitis, Vulvodynia, Vestibulodynia.
References:
1. Skaudickas D, Lenčiauskas P, Skaudickas A, Undžytė G. Low intensity extracorporeal shockwave therapy for chronic pelvic pain syndrome: Long-term follow-up. Open Med (Wars). 2023 Oct 28;18(1):20230832. doi: 10.1515/med-2023-0832. PMID: 37900960; PMCID: PMC10612526.
2. Hur KJ, Bae WJ, Ha US, Kim S, Piao J, Jeon KH, et al. Safety and efficacy of extracorporeal shockwave therapy on chronic prostatitis/chronic pelvic pain syndrome: a prospective, randomized, double-blind, placebo-controlled study. Prostate Int. 2024 Dec;12(4):195-200. doi: 10.1016/j.prnil.2024.06.003. Epub 2024 Jun 13. PMID: 39735201; PMCID: PMC11681323. Wang YR. Safety of low-intensity extracorporeal shock wave therapy — 2024. Revisión en PMC.
3. Huang N, Qin Z, Sun W, Bao K, Zha J, Zhang P, et al. Comparing the effectiveness of extracorporeal shockwave therapy and myofascial release therapy in chronic pelvic pain syndrome: study protocol for a randomized controlled trial. Trials. 2023 Oct 18;24(1):675. doi: 10.1186/s13063-023-07633-1. PMID: 37853420; PMCID: PMC10583345.
4. Wang YR, Feng B, Qi WB, Gong YW, Kong XB, Cheng H, Dong ZL, Tian JQ, Wang ZP. Safety of low-intensity extracorporeal shock wave therapy in prostate disorders: in vitro and in vivo evidence. Asian J Androl. 2024 Sep 1;26(5):535-543. doi: 10.4103/aja202448. Epub 2024 Aug 6. PMID: 39107962; PMCID: PMC11449405.
5. Labetov I, Vaganova A, Kovalev G, Shkarupa D. Extracorporeal shockwave therapy in treatment of chronic prostatitis/chronic pelvic pain syndrome: Systematic review and meta-analyses. Neurourol Urodyn. 2024 Nov;43(8):1924-1937. doi: 10.1002/nau.25524. Epub 2024 Jun 7. PMID: 38847290. Hegazy M. A randomized trial on low-intensity shockwave therapy (2024) — publicación en revista científica (Nature-linked).
6. Hegazy M, Sheir KZ, Gaballah MA, Elshal AM. A randomized controlled trial evaluating low-intensity shockwave therapy for treatment of persistent storage symptoms following transurethral surgery for benign prostatic obstruction. Prostate Cancer Prostatic Dis. 2024 Jun;27(2):305-311. doi: 10.1038/s41391-024-00820-4. Epub 2024 Mar 29. PMID: 38553627; PMCID: PMC11096095.
7. Ogbeivor C, AlMubarak H, Akomolafe T, Alkahtani H, AlMugizel H, Marin I, Aldosari H, Aldhwayan N, Mohamed G, Alobthani K. The effectiveness of radial shockwave therapy on myofascial pain syndrome: a two-armed, randomized double-blind placebo-controlled trial. BMC Musculoskelet Disord. 2025 Apr 24;26(1):413. doi: 10.1186/s12891-025-08659-z. PMID: 40275291; PMCID: PMC12023603.
8. Hurt K, Svestkova O, Halaska M, Driak D, Rakovicova I, Musalek M, Krajcova A. Extracorporeal Shock Wave Therapy of Vulvodynia: A Feasibility Study. Actual Gyn. 2019;11:18-22
| How to Cite this article: Candiotti RT. Pelvic Pain and the Use of Extracorporeal Shock Wave Therapy (ESWT). Journal of Regenerative Science. July-December 2025;5(2):39-41. |
[Article Text HTML] [Full Text PDF]
Extracorporeal Shock Wave Therapy and Radial Pressure Wave Therapy in Carpal Tunnel Syndrome: A Narrative Review of Clinical Outcomes and Therapeutic Implications
Review Article | Vol 5 | Issue 2 | July-December 2025 | page: 32-38 | Armando Tonatiuh Ávila García, Karen Chacón Morales, Ana Lilia Villagrana Rodríguez, Daniel Miller Serano, Diego Alberto Rojo Orozco, Diana Hazel Araiza Quintana
DOI: https://doi.org/10.13107/jrs.2025.v05.i02.179
Open Access License: CC BY-NC 4.0
Copyright Statement: Copyright © 2025; The Author(s).
Submitted Date: 05 Aug 2025, Review Date: 18 Nov 2025, Accepted Date: Nov 2025 & Published: 30 Dec 2025
Author: Armando Tonatiuh Ávila García [1], Karen Chacón Morales [1], Ana Lilia Villagrana Rodríguez [1], Daniel Miller Serano [1], Diego Alberto Rojo Orozco [1], Diana Hazel Araiza Quintana [1]
[1] Department of Physical Medicine and Rehabilitation, Hospital Civil de Guadalajara “Fray Antonio Alcalde,” Guadalajara, Jalisco, México.
Address of Correspondence
Armando Tonatiuh Ávila García,
Department of Physical Medicine and Rehabilitation, Hospital Civil de Guadalajara “Fray Antonio Alcalde,” Guadalajara, Jalisco, México.
E-mail: atavila@hcg.gob.mx
Abstract
Background: Carpal tunnel syndrome (CTS) is the most common peripheral entrapment neuropathy and a frequent cause of pain, functional impairment, and reduced quality of life. Although conservative management remains the first-line approach for mild-to-moderate disease, optimal non-invasive treatment strategies continue to be investigated. Extracorporeal shock wave therapy (ESWT) and radial pressure wave therapy (RPWT) have emerged as potential therapeutic alternatives due to their biological effects on nerve regeneration, inflammation, and tissue healing.
Objective: The objective of the study is to synthesize and critically evaluate the current evidence regarding the efficacy and safety of ESWT and RPWT in the management of CTS.
Methods: A narrative review of the literature was conducted using PubMed, Scopus, and Web of Science databases. Studies evaluating the effects of ESWT and RPWT in patients with CTS were included, encompassing randomized controlled trials, observational studies, and systematic reviews. Outcomes of interest included pain intensity, functional status, and electrophysiological parameters.
Results: The available evidence suggests that ESWT and RPWT are associated with significant improvements in pain relief, functional outcomes, and nerve conduction parameters in patients with mild-to-moderate CTS. Both ESWT and RPWT modalities demonstrated clinical benefits, with improvements observed in Visual Analog Scale scores, Boston Carpal Tunnel Questionnaire outcomes, and electrophysiological measures. Across studies, ESWT and RPWT were generally well tolerated, with minimal and transient adverse effects. Comparisons with conventional treatments, including splinting and corticosteroid injection, indicate comparable or superior outcomes for ESWT and RPWT in selected patient populations.
Conclusion: ESWT and RPWT represent promising non-invasive treatment options for CTS, offering meaningful clinical benefits with a favorable safety profile. Although current evidence supports its use in mild-to-moderate disease, further high-quality randomized controlled trials are warranted to establish optimal treatment parameters and long-term efficacy.
Keywords: Carpal Tunnel Syndrome, Extracorporeal Shock Wave Therapy, Radial Pressure Wave Therapy, Median Nerve.`
References:
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| How to Cite this article: Richmond C, Thieu V, Singh M. Application of Extracorporeal Shockwave Therapy for Recalcitrant Patellar Tendinopathy Following Anterior Cruciate Ligament Reconstruction With Patellar Tendon Autograft. Journal of Regenerative Science. July-December 2025;5(2):32-38 |
[Article Text HTML] [Full Text PDF]
Application of Extracorporeal Shockwave Therapy for Recalcitrant Patellar Tendinopathy Following Anterior Cruciate Ligament Reconstruction with Patellar Tendon Autograft
Case Report | Vol 5 | Issue 2 | July-December 2025 | page: 28-31 | Connor Richmond, Vincent Thieu, Mani Singh
DOI: https://doi.org/10.13107/jrs.2025.v05.i02.177
Open Access License: CC BY-NC 4.0
Copyright Statement: Copyright © 2025; The Author(s).
Submitted Date: 19 Sep 2025, Review Date: 02 Nov 2025, Accepted Date: Nov 2025 & Published: 30 Dec 2025
Author: Connor Richmond [1], Vincent Thieu [1], Mani Singh [2]
[1] NewYork-Presbyterian Hospital, Columbia University Department of Rehabilitation and Regenerative Medicine & Weill Cornell Department of Rehabilitation Medicine
[2] Department of Rehabilitation and Regenerative Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, United States.
Address of Correspondence
Na Chen,
Department of Internal Medicine, Peking University Hospital, Beijing, China. E-mail: 18901267905@163.com; CN09558@pku.edu.cn.
Abstract
Purpose: Extracorporeal Extracorporeal shockwave therapy (ESWT) has been increasingly utilized for musculoskeletal pathology, including conditions such as patellar tendinopathy. More recently, there is growing evidence to support the use of ESWT following anterior cruciate ligament (ACL) reconstruction to support post-operative rehabilitation and optimize return to sport.
We report a case of a 21-year-old collegiate male athlete with a relevant history of Osgood–Schlatter disease who suffered from an acute ACL rupture and subsequently underwent ACL reconstruction (ACLR) using bone-patellar tendon-bone (BTB) autograft. His rehabilitation course was complicated by worsening anterior knee pain consistent with patellar tendinopathy. His symptomatic knee was treated with four sessions of ESWT using both focused and radial devices. He was able to return to play 1 month later with improvement in pain, quadriceps strength, and on-field sports-specific function.
ESWT may serve as an adjunct to conventional rehabilitation following ACLR, particularly in patients experiencing patellar tendon-related pain.
Keywords: Patellar Tendinopathy; Anterior cruciate ligament reconstruction; Focused shock waves, Radial pressure waves
References:
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| How to Cite this article: Richmond C, Thieu V, Singh M. Application of Extracorporeal Shockwave Therapy for Recalcitrant Patellar Tendinopathy Following Anterior Cruciate Ligament Reconstruction With Patellar Tendon Autograft. Journal of Regenerative Science. July-December 2025;5(2):28-31. |
[Article Text HTML] [Full Text PDF]
Visual Analysis of Research Progress and Trends in Extracorporeal Shock Wave Therapy for Coronary Heart Disease
Original Article | Vol 5 | Issue 2 | July-December 2025 | page: 20-27 | Na Chen
DOI: https://doi.org/10.13107/jrs.2025.v05.i02.175
Open Access License: CC BY-NC 4.0
Copyright Statement: Copyright © 2025; The Author(s).
Submitted Date: 25 Oct 2025, Review Date: 12 Nov 2025, Accepted Date: Nov 2025 & Published: 30 Dec 2025
Author: Na Chen [1]
[1] Department of Internal Medicine, Peking University Hospital, Beijing, China
Address of Correspondence
Na Chen,
Department of Internal Medicine, Peking University Hospital, Beijing, China. E-mail: 18901267905@163.com; CN09558@pku.edu.cn.
Abstract
Purpose: Extracorporeal shock wave therapy (ESWT) has emerged as a promising non-invasive intervention in cardiovascular disease (CVD) management, with increasing research interest over the past two decades. This study aimed to systematically analyze the research progress, hotspots, and development trends in ESWT for CVD using bibliometric methods, providing a comprehensive overview for subsequent research.
Methods: Literature related to ESWT and CVD was retrieved from the Web of Science Core Collection database, covering the period from 1999 to August 2025. The search strategy was defined as TS=([Shock wave OR Extracorporeal shock wave therapy OR ESWT] AND [Cardiovascular disease OR Coronary artery disease OR Myocardial ischemia OR Heart failure]). After excluding non-English studies, proceeding papers, retracted publications, and early access articles, 465 valid articles were included. Bibliometric analysis was performed using VOSviewer and CiteSpace software, focusing on publication trends, country/institution contributions, author collaborations, journal distributions, keyword co-occurrence, and cited references.
Results: A total of 465 publications involving 3019 authors from 1001 institutions across 55 countries were included, with 15,556 citations from 3104 sources. The annual number of publications has shown a steady growth trend since 2017. The United States (133 documents, 53.3 average citations) was the most influential country, followed by China (82 documents) and Germany (47 documents). Tohoku University (20 documents, 56.1 average citations) and Mayo Clinic (11 documents, 79.7 average citations) were leading institutions. Hiroaki Shimokawa and Hon-Kan Yip (18 documents each) were the most productive authors. Heart Rhythm (15 documents, 44.8 average citations) and Circulation (9 documents, 140.2 average citations) were core journals in this field. High-frequency keywords included “heart failure” (56 times), “coronary artery disease” (44 times), and “mortality” (41 times), with “outcome” being recent burst terms (2023–2025). The top-cited reference was a 2004 study on ESWT improving ischemia-induced myocardial dysfunction in pigs (87 citations).
Conclusion: ESWT for CVD is a rapidly developing research field, with the United States leading in academic influence. Current research focuses on myocardial ischemia, heart failure, and therapeutic efficacy/safety, while future trends may involve exploring mechanisms related to extracorporeal shock wave action and expanding clinical applications in comorbidities.
Keywords: Extracorporeal shock wave therapy, Cardiovascular disease, Bibliometrics, CiteSpace, VOSviewer
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| How to Cite this article: Chen N . Visual analysis of research progress and trends in extracorporeal shock wave therapy for coronary heart disease. Journal of Regenerative Science. July-Decemnber 2025;5(2):20-27 |
