Extracorporeal shockwave therapy (ESWT)
Extracorporeal shockwave therapy delivers acoustic energy through the skin to a treatment area, without surgery, injections, or anesthesia. "Extracorporeal" simply means the energy is generated outside the body and transmitted in.
ESWT is a broad category. Devices within it vary substantially in how the energy is generated, how it's focused, and what FDA clearances they carry — which is exactly why "shockwave" alone doesn't tell a provider much.
Electrohydraulic shockwave generation
SoftWave TRT generates its acoustic waves electrohydraulically: an electrical discharge creates a rapid expansion that produces a pressure wave, which is directed toward the treatment area through a parabolic reflector.
The result is a broad, unfocused treatment field — different from devices that concentrate energy into a narrow focal point, and mechanically different from the pneumatic, ballistic-impact mechanism used in radial pressure-wave devices.
FDA clearance — stated precisely.
"FDA cleared" and "FDA approved" are not interchangeable terms. SoftWave TRT is cleared, not approved — the correct and current terminology for a device that has gone through the FDA's 510(k) pathway.
Musculoskeletal / pain-related clearance
SoftWave TRT holds FDA 510(k) clearance for activation of connective tissue, temporary increase in local blood circulation, and temporary relief of minor muscle and joint pain, stiffness, and muscle spasm. This is the clearance basis most relevant to chiropractic, sports medicine, orthopedic, and similar musculoskeletal practices.
Wound-care clearances
SoftWave TRT also holds separate FDA clearances for the treatment of diabetic foot ulcers and superficial, partial-thickness second-degree burns. These clearances are typically relevant to wound-care settings rather than musculoskeletal practices, and are noted here for completeness, not as a claim about what your practice would treat.
SoftWave vs. focused shockwave vs. radial pressure-wave devices.
This isn't about attacking other equipment — it's about giving you the vocabulary to evaluate any shockwave technology on its actual mechanism, not just the word on the brochure.
| Technology | Energy source | Treatment field | Typical use case |
|---|---|---|---|
| SoftWave (electrohydraulic ESWT) | Electrohydraulic discharge, reflector-directed | Broad, unfocused | Musculoskeletal pain, connective tissue, wound care (per specific clearances) |
| Focused shockwave | Electromagnetic, piezoelectric, or electrohydraulic | Narrow focal point at depth | Deeper, more targeted lesions |
| Radial pressure-wave devices | Pneumatic / ballistic impact | Radial, dissipating from the applicator tip | Superficial soft-tissue applications |
A $5,000 radial device and a $75,000 electrohydraulic device are both sometimes marketed as "shockwave therapy." Mechanically and clinically, they are not the same category of equipment — and that's the comparison worth making before evaluating price.
What a treatment session typically looks like.
Brief sessions
Individual treatments are typically short compared to many other clinical services, which is part of why scheduling patients into concentrated blocks works well operationally.
No downtime
No incision, injection, or anesthesia is involved, and patients generally resume normal activity immediately.
Multi-visit plans
Treatment plans are determined by the provider's clinical judgment and the condition being addressed — commonly structured as a series of visits rather than a single session.