Shock wave therapy: Is focused or radial treatment best?

 It’s hard to put your best foot forward in life when every step brings you searing discomfort or even unbearable pain.

Even when you get a diagnosis, finding the best treatment for plantar fasciitis (heel pain) can be bewildering.

Fortunately, you can feel confident that modern technology has provided an increasingly common method of tackling problems with the underside of the heel bone.

What To Expect From This Article

For several years, shock wave treatments are a highly effective way to alleviate pain and substantially ‘kick-start’ the healing process.

However, that can still leave you feeling bewildered!

You will likely hear recommendations for Focused Extracorporeal Shock Wave Therapy and high praise for an alternative that you will see referred to as Radial Shock Wave Therapy for Plantar Fasciitis.

This article will help you to understand the differences between these two options to treat plantar fasciitis and the relative advantages of using a focused method. We will also give you an overview of what to expect when you undergo this treatment and answers for some of the frequently asked questions about shock wave therapy in general. 

What Is Shock Wave Therapy?

 Before exploring the differences between the two types of Shockwave Therapy

here’s a general overview of what this treatment involves.


Shock wave therapy is now standard practice in various medical fields, including orthopaedics, physiotherapy and sports medicine. Particularly as it provides a trusted, non-surgical intervention to address diverse Musculoskeletal problems.

The aim of this therapy is to alleviate pain without reliance on pain medication and to improve mobility. It also boosts cellular repair and regrowth because it stimulates cells to carry out natural processes faster!

The treatment works using an acoustic pressure wave, which travels to the injury site. This is firm pressure, applied in fast bursts to deliver energy pulses to the affected bone or tissue. This sound wave has been found to promote faster healing, including speeding up the natural regeneration and repair process and helping blood circulate to the affected site more efficiently.

The technology involved in shock wave therapy is highly advanced, delivering kinetic energy in carefully measured and controlled amounts via a transmitter created within an application tool.

The three perimeters used to vary how the low-density energy is applied: pressure amplitude, pulse duration, and impact.

The primary difference between Focused Extracorporeal Shock Wave Therapy and Radial Shock Wave Therapy for Plantar Fasciitis is the method of delivery. In other words, how this energy is dispensed to create a sustainable improvement.

When you seek help for heel pain at a London foot clinic, the first thing that will happen is testing to find its origin. This will confirm a diagnosis of Plantar Fasciitis (inflammation of the fascia). This is now a common issue for individuals of all ages and lifestyles!

Next, our Wimbledon foot specialist would decide the best treatment for this problem to bring lasting relief and improvement.

If shock wave treatment is the preferred way forward, there is a good chance the focused version would be used, but understanding the radial method is essential too. 

Radial Shock Wave Therapy

This method of administering shock wave therapy differs from the focused option, mainly due to its pressure amplitude, pulse duration and energy impact.

Radial treatments cover a larger area, with a slower pulse rate and softer energy but counterintuitive this can mean more discomfort.

Radial shock waves have their highest energy level at the source and then weaken as they travel into your body. hence there is high stimulation at skin level and for sites where the pain is below the skin like a foot/heel. therefore the radial type of shock wave therapy was historically largely the preferred alternative. Particularly if the medical issue were more widespread and superficial in nature.

Clearly, if you have Plantar Fasciitis, the inflammation is localised and emanating from within your heel’s fascia - a site a little deep than the preferred depth. This makes it a far more effective option to apply greater energy at a faster pulse rate using a focused shock wave application.

radial shock wave therapy

Focused Extracorporeal Shock Wave Therapy

As the name indicates, this method of treating heel pain is more site-specific and intense.

The technology used in focused shock wave therapy can involve different applicators, some of which can penetrate the energy wave as far as 12cm into human tissue.

It provides a faster pulse rate and a higher degree of kinetic energy. One advantage is that it offers a precise and effective way to treat inflammation in a specific location and a more exact version of shock wave therapy.

The equipment used in this option looks different too and can appear like something from science fiction! That’s because focused shock wave therapy is often delivered using electro-crystals. Having the energy applied to a submerged membrane via this method means the energy level remains constant from the transmitter to the affected site.

Apart from the ability to target damaged tissue more precisely – and at a deeper level – there are other benefits to using focused extracorporeal shock wave therapy.

Some patients don’t tolerate the radial treatment very well and find the focused method more comfortable. Also, the applicator and other elements of the devices used for focused administration of shock waves tend to be more adjustable, and the relevant values of the treatment can be personalised to the patient more incisively. 

Common Questions About Shock Wave Therapy

When you seek advice, diagnosis and treatment for heel pain at our London clinic, your specialist can talk you through which of the above types of shock wave treatment is best suited to your medical condition.
However, whichever procedure you benefit from, you may well want a guide to shock wave treatment in general and insights on how it affects your body.
We are always happy to answer these queries in person, but here are some frequently asked questions.

  • Can shock waves damage healthy tissue?

    Safety concerns about the equipment that delivers energy into your bones and tissues are perfectly natural. Both of the above options for the treatment of foot pain have an impeccable safety record, and we only use the most advanced and evidentially effective equipment. The low-density energy applied is not a risk to any human cells. Instead, it delivers a magnetic force to your cells, which boost their ability to regenerate and repair. It also stimulates your circulatory system (blood) and helps to release the neurotransmitters (chemicals) that moderate pain. Focused shock waves have also been found to stimulate growth factors.

  • Can shock wave therapies be used on children and young people?

    One of the advantages of both focused extracorporeal shock wave therapy and the radial alternative is that they can address heel pain without surgery or painkilling drugs. This makes them a safe and reliable way to help younger patients who have severe foot pain.

  • Can focused shock wave therapy heal a sports injury?

    Repetitive strain on the heel fascia, or sudden trauma to this part of the foot, can result in plantar fasciitis. They are threatening the career of professional athletes and limiting the abilities of sports amateurs. Fortunately, shock wave therapy has been shown to be an effective, safe and sustainable way to alleviate this increasingly common medical issue.

  • Does it hurt when you get shock wave therapy?

    This treatment method is considered to involve less risk than surgery or the use of strong pain medications. It is painless to undergo shock wave therapy for foot issues, and the only thing you may feel is a little discomfort from the pressure of the applicator.

  • Does shock wave therapy have side effects?

    One of the main reasons this treatment option is so respected and preferred by experts in this field is that it avoids the complications and risks involved in surgical intervention or the use of strong painkillers. It is, therefore, a low-risk alternative to traditional ways to treat plantar fasciitis and other musculoskeletal issues. Patients often report an immediate improvement in their pain level. However, some do feel a slight soreness around the treatment site, which is low grade and temporary.

  • How long do shock wave therapy sessions last?

    The duration of the treatment session is short. In the hands of a skilled medical professional, we can deliver your focused extracorporeal shock wave therapy in as little as five minutes! How many sessions you need depends on the nature of your injury and your response to the initial treatment. The benefits of shock wave therapy are accumulative – with the healing development often escalating most effectively during three to five sessions. According to your medical issue and tolerance levels, these sessions will be spaced out to ensure that the whole process is comfortable and sustainably effective.

  • What physical activity can you d after shock wave treatment?

    As the pain relief felt after shock wave treatment is usually immediate and substantial, it is tempting to jump straight back into physical activity. However, the recommended rest period is 48 hours after each session. Beyond that, you need to discuss your individual lifestyle and exercise goals with your foot pain specialist to ensure your road to a full recovery is as smooth as possible. Can both types of shock wave therapy be used on one person? In some medical situations, a specialist foot pain clinic can use both of these shock wave treatments safely and effectively during different sessions to achieve long-term relief.

The London Foot Pain Clinic in Wimbledon has both types of technology – and the expertise needed to use them – to create a personalised treatment programme for our patients.

Read more: Shock wave therapy: Is focused or radial treatment best?