The global shockwave therapy device market was worth almost $83.7 million in 2018. Analysts expect it to reach over $130.4 million by 2026. This rapid growth means you’ve probably heard of shockwave therapy. Your patients have, too. When you’re ready to add this treatment option to your physical therapy practice, how do you find the best shockwave therapy device? Find out what you need to know to choose the best device for you and your patients.

What Is Shockwave Therapy?

Shockwave therapy, or extracorporeal shockwave therapy (ESWT), applies a series of energy pulses directly to the site of pain or injury through the patient’s skin.

Shockwave therapy is an effective treatment for musculoskeletal conditions that involve ligaments, tendons, and other connective tissue.

High Energy or Low Energy?

High energy shockwave therapy uses short pulses that break the sound barrier, which results in a shockwave. High energy shockwaves focus directly on the treatment site.

Low energy shockwaves are actually pressure waves. A radial pressure wave travels more slowly and doesn’t break the sound barrier like a “true” shockwave. Low energy shock waves are longer, slower, and less intense than high energy waves. They also spread over a wider treatment area.

The circumstances of each patient’s situation will determine whether high or low energy shockwave treatment is likely to get the best results. However, high energy shockwave therapy is more expensive and requires the use of anesthesia.

For most physical therapy applications, low energy is a better option. It’s more affordable, and it provides good results when treating a variety of conditions.

When to Use Shockwave Therapy

Some of the conditions that shockwave therapy can treat include:

  • Tennis elbow
  • Patellar tendonitis
  • Hip bursitis
  • Plantar fasciitis
  • Achilles tendonitis
  • Shin splints

The US Food and Drug Administration (FDA) has approved some of these applications, including for plantar fasciitis and tennis elbow.

Shockwave Therapy Sessions

Most patients will have 1 session a week for 3 to 6 weeks. Each session lasts for between 5 and 15 minutes, depending on the strength of the shockwaves and the part of the body receiving treatment.

Most patients will feel the benefits of shockwave therapy within the first 3 weeks. Other patients may take longer to start feeling results.

Be sure to discuss with your patients what they can expect from shockwave therapy sessions. They’ll feel more comfortable with the procedure. They’ll also be less likely to get discouraged if they don’t start to feel improvement right away.

Benefits of a Shockwave Therapy Device

You may want to add shockwave treatments to your physical therapy practice for a variety of reasons.

Shockwave therapy is especially useful in treating chronic conditions that haven’t responded to other treatments. A shockwave therapy device gives you another way to help patients with long-term pain and injuries.

Shockwaves are non-invasive. Shockwave treatments are often a good alternative to surgery.

For example, surgery for plantar fasciitis requires a recovery time of at least 3 weeks. Infection and nerve damage are some of the possible risks.

In contrast to surgery, the side effects of low energy shockwaves are mild. The treatment can cause mild discomfort. The patient may experience soreness, tenderness, and swelling after treatment. These reactions are temporary.

Low energy shockwave therapy doesn’t require the use of drugs or anesthesia. Patients can return quickly to most regular activities after treatment. Athletes can often continue training while undergoing a shockwave therapy regime.

An additional benefit for the therapist is that you can schedule more patients. A therapy session with traditional treatments like massage lasts at least 30 minutes. A low energy shockwave treatment takes 15 minutes or less.

Potential Challenges of Using Shockwave Therapy

One downside to shockwave therapy is that many insurance providers don’t cover it. They consider it to be investigational.

Medicare and Medicaid don’t cover ESWT either. They state that more research is necessary to determine its safety and effectiveness.

Low energy shockwave therapy devices have become more affordable, however. A small group practice or even an individual therapist can often afford one. The lower cost of the equipment means that more patients can pay out-of-pocket if their insurance doesn’t cover shockwave therapy.

What to Look for in a Shockwave Therapy Device

Several brands of shockwave therapy devices are on the market. Each brand usually has multiple models to choose from. Here are some factors to consider.

FDA Registration

Be sure that the device you’re considering is registered with the FDA. Devices can be registered as Class I, II, or III. The classification depends on the intended use of the device and its indications for use. Any risks the device may pose to patients or the user is a final factor in classification.

Focused or Radial?

A focused shockwave therapy device sends medium-to high-energy shockwaves to a specific target. You direct the pressure pulses with ultrasound or radiography.

A radial device transmits low- to medium-energy shockwaves over a larger surface area. Both types of devices have FDA approval.

A low energy radial device is usually the best choice for physical therapists. Low energy doesn’t require anesthesia, it provides effective treatment for many conditions, and the devices are often less expensive.

Power Levels and Frequency

A radial shockwave therapy device should have at least 1 to 5 pressure bars and a frequency range of at least 1 to 21 Hz. These ranges will give you enough power for low energy treatments.

Transmission Heads

You’ll need different transmission heads depending on the part of the body and the condition that you’re treating. Some treatment protocols recommend starting with a larger head and then using a smaller one after the patient has gotten used to the treatment.

Look for a device that includes several heads. You’ll have more treatment options.


The device should have a clear display that is easy to use. Many manufacturers offer touch screens. Be sure the display is large enough that you can read it comfortably.

You control some models remotely with an app for your smartphone or tablet. Your phone or tablet then becomes the display.

User-Friendly Interface

You want a device with an interface that’s easy to use. You shouldn’t have to go through specialized training just to use the device. Some manufacturers include pre-programmed therapy protocols, which makes the devices, even more, user-friendly.

Comfortable Grip

The handpiece that delivers the shockwave should be ergonomic. You’ll likely be using your shockwave therapy device frequently, so you want a grip that doesn’t cause any strain on your hand.

A slip-resistant coating, material, or texture is also a useful feature. Anti-slip design helps prevent the handpiece from falling out of your hand during treatments.


If you need a device that you can take with you, look for a portable model. Many manufacturers offer lightweight, compact devices that you could bring to a patient’s home, sporting events, or other sites outside of the treatment room.

Carrying Case

A case is especially important for a portable shockwave therapy device, but it’s useful even if you plan for the device to be stationary.

The case should be strong enough to protect the shockwave device. It should have room for all of the accessories like cables and additional transmission heads.


Check the manufacturer’s warranty. The conditions may be different for the controller unit and accessories like the handpiece and applicator head. Look for a warranty that covers at least 2 years.

The manufacturer should also give you an estimated minimum lifespan for the handpiece and applicator heads. A typical measurement is the number of pulses, for example, at least 2,000,000 pulses per handpiece.

Choosing a Brand of Shockwave Therapy Device

When you’re ready to choose a shockwave therapy device, you have a lot of choices. Many brands are on the market, and they all have several models available.

Consider how you’ll be using the device and features like the range of power levels, the display and interface, how the handle feels in your hand, and the carrying case. Be sure the manufacturer stands behind their device with a warranty. You should also verify that the device is registered with the FDA.

Finally, check reviews and testimonials. Product reviews are usually available online. You can also talk to other physical therapists. Your colleagues know what you’re looking for as a physical therapist and can give you their perspective.


Oceanus has been designing radial pulse shockwave devices since 2013. We offer two shockwave therapy devices for clinical use. They’re both registered with the FDA.

The PhysioPRO and PhysioPRO II are portable. They feature pre-programmed therapy protocols for a variety of conditions. The “plug & play” system makes them very user friendly. You can use your device almost immediately because it requires minimal set-up.

The PhysioPRO features a color touch screen display. You control the PhysioPRO II with an app for your smartphone or tablet.

We stand behind both devices with a warranty.

Contact us today to find out what our innovative products can bring to you and your patients.