Radial vs Focused Shockwave Therapy for Erectile Dysfunction

2022 ED Wave Therapy Q&A

Did you know there are two different types of Shockwave therapy devices? The two types of Shockwave therapy devices available today are Radial Shockwave Therapy and Focused Shockwave Therapy machines. But how do you know which kind of shockwave will work for you?

In this post, we’ll look at the differences between the two types of ED Wave therapy devices and provide links to the relevant accredited clinical studies to help you make an informed decision about Radial vs focused shockwave therapy for yourself. Let’s get this party started.

2022 Focused vs. Radial Shockwave Update

  • Radial Shockwave: Pressure waves also called soft or acoustic
  • Focused Shockwave: Hard shockwave often referred to as lithotripsy
  • Both radial and focused wave therapy have benefits.
  • Every patient we’ve treated with shockwave has stated a preference for Radial shockwave for ED.
  • Determining which type of shockwave therapy you may needed is an important part of the diagnosis. Regardless of which type of wave therapy is needed, Health Expressions can help you.
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Radial vs Focused Shockwave Therapy Video Explainer

Doctors are using different ED Wave Therapy devices because shockwave therapy for erectile dysfunction has become the hottest alternative treatment available since the introduction of Viagra. Many patients have become confused by advertisements claiming that Radial vs focused shockwave therapy for Erectile dysfunction only works with certain devices. The reality is that both of these medical shockwave devices have helped men, but some reports have also fallen short of their true potential.
Learn more about Shockwave Therapy

ED Wave Therapy Near You

Shockwave is a type of non-invasive treatment that uses high-frequency sound waves to accelerate the healing process in injured or diseased areas of the body. This type of therapy is commonly used for bone fractures, tendon injuries, and sports injuries. (Mayo Clinic, 2019)

Shockwave energy is a strong, quick pressure pulse that travels faster than the speed of sound. It is a clinical treatment that is used to treat a wide range of musculoskeletal issues. It was initially intended to break up kidney stones. The machine was redesigned to work on different parts of the body. Shockwave therapy is a non-invasive treatment that employs sound waves to assist men in regaining their ‘good vibrations.’ It is used for immediate pain relief and has proven to be increasingly effective in restoring men’s function.

Find Additional ED Wave Therapy Research Links here: https://healthexpressions.com/research/

Different Kinds of Shock Wave Therapy

There are 2 kinds of shockwaves:

  • Focused Shockwaves: Hard shockwave often referred to as lithotripsy
  • Radial Shockwaves: Pressure waves also called soft or acoustic

The wavelength of each machine is specific to the needs of the patient and specific to the conditions at hand. Both focused and Radial wave energies have a positive pushing phase and a negative recoil phase as the shockwave energy penetrates the tissue. Both radial and focused shockwave therapy offer a safer alternative to surgery. (C.Speed, 2013) And studies have concluded that both radial and focused shockwave therapy can benefit patients.  (Christoph Schmitz, 2015)



Radial and Focused Shock Waves Actions

The mechanism of action of shockwave treatment is to microscopically cause interstitial and extracellular biological responses through;

  1. Cellular activation
  2. Neuro-regeneration or “nerve-fix”

iii. Neovascularization or “New-arteries”

  1. Hyperstimulation for pain relief

It is difficult to explain how shockwave therapy works. In general, medical research has found that mechanical force has the ability to disintegrate hard tissues (Biomedicines, 2022) …


… in the same way that shockwaves are used in urology to ablate kidney stones, a procedure known as Lithotripsy. Radial shockwave and focused waves can both effectively treat hardening in penile arteries and veins, which is one of the primary causes of Organic Erectile Dysfunction, also known as arteriosclerosis.
The following is a step-by-step explanation of how focused and radial shockwaves work in arteriosclerosis tissues:

  1. First Step: Shockwave hits scar tissue
  2. Second Step: Shows shear at transition
  3. Third Step: Cellular regeneration is activated
  4. Fourth Step: The scar tissue is enveloped
  5. Fifth Step: Scar tissue is pulled out of shape
  6. Sixth Step: Scar tissue shatters or breaks apart

(Sex Med Rev., 2020)

Radial Shock Wave Therapy Explained

Radial shockwaves, also known as acoustic waves or pressure waves, are superior for those treatment areas of superficial – indications, including the common applications referred to as GAINSWave.


Radial shockwave therapy is the most common type of shockwave therapy used by hospitals and clinics today. It generates shockwaves that target the whole body. This type of shockwave therapy is used to treat a variety of conditions, including arthritis, tendinitis, carpal tunnel syndrome, tennis elbow and sciatica. Additionally, radial shockwave therapy is used to treat scoliosis, a condition in which the spine curves to one side.

Radial pressure waves use compressed air to accelerate at a high-speed and the transmitter is used to decelerate the speed.

The radial pressure waves are at the highest intensity and energy density at the transmitter surface and the pressure waves lose power the deeper they enter the body. This makes it a good treatment for when the targeted issues are just under the skin, including the delicate Penile tissues, where the arteries and veins are often visible and bulging on the penis.

Focused Shockwave Therapy

Focused shockwave therapy is a variation of shockwave delivery technology that uses high energy beams of sound to treat certain types deeper conditions. Electromagnetic or piezoelectric technologies are used primarily to generate focused shockwaves. It was designed to enter internal organs through the use of medical imaging techniques such as ultrasound. With enough power to penetrate deeply into bones, it necessitates the use of an anesthetic, and the application necessitates extreme caution not to apply too much pressure to any single tissue. In the United States, focused shockwave m treatment is most commonly used in orthopedic centers, but it is also used in equestrian or veterinary medicine.

When men are searching for the best ED Treatment, many land on a clinic based on location and pricing alone. But this month, Health Expressions Dr. Miller has noticed an upswing in the number of men asking about Radial vs focused shockwave therapy for Erectile Dysfunction.

“I hope that this blog, and our other blog posts can help men find answers to this question. But at Health Expressions, we can help men with more than Erectile dysfunction.  We also know that ED wave therapy, like GAINSWave,


is an effective non-surgical ED fix for a Curved Penis, or Peyronie’s Disease.”


Many come to us from over an hour away.  Why would anyone do that?

Because when it comes to your health you should choose your provider based on how you feel about that office.  Is the provider caring?  Are you just a number or are you someone that is treated as an individual with your own needs?

Our shockwave programs are individualized based on your painless blood flow test done on your initial visit.



How Much Shockwave Therapy for Erectile Dysfunction Is Needed?

Many providers base the number of visits required based on your symptoms from a questionnaire. Why is this important?

Because some have blood flow that is great, but their problem may be induced by another factor, in which case they may not be a candidate for treatment with us. Our treatments help restore blood flow, and the painless blood flow test gives us an initial baseline for what is needed. This test is also redone at the end of the sessions that are initially recommended. Why is this important? Because at the end of the recommended program it’s important that blood flow is at a certain level before the healing time is done. Without getting to a certain level of improved blood flow and then having a healing period before rechecking you may waste precious time. When you are trying to get results it’s important to follow recommendations.

We have had an occasional patient that prematurely stopped or paused treatment due to hectic schedules.  We understand- schedules can get crazy.  Everyone has a different clinical picture though, and unless that post blood flow test is done, how will you know that you have reached the full benefit of treatments and had blood flow fully restored?

Because we estimate plans based on clinical experience, we also have personalized all inclusive programs.  This means that our programs typically include the number of sessions required to get to full blood flow, so if needed we will extend and add sessions to get there.  What does that mean for you?  We know other offices are selling treatment packages that include a treatment number, then coming back to you to pay more if more sessions are needed.  We just don’t do that.  If we need to include more sessions in someone’s program we include that in an all inclusive program

Everything in life should be taken in moderation- this is also true of shockwave therapy.  Some shockwave devices and improper shockwave therapy technique can be harmful because it may cause bruising on that area when applied with high pressure, high frequency, and high focus. While both Focused Shockwave and Radial Shockwave are non-invasive treatment options to reduce pain and promote healing, the cells can only take in so much energy before they must release it. 

The shockwaves are acoustic waves that have specific physical characters including non-linearity, high peak pressure followed by low amplitude, short duration (10 sec) and short rise time. These characters produce a positive and negative phase of shockwave upon the area of treatment.

The positive phase produces direct mechanical forces, while the negative phase generates cavitation and gas bubbles that later burst inward at high speed, generating a second wave of shockwaves. In this therapy, we are using the low and medium energy levels (up to 0.28mJ/mm2 ). This can lead to the:

  • Mechanical deformation of cells
  • Possible tissue destruction at cellular level

 When too much energy is applied to one tissue with a high frequency or high-pressure shockwave, it can result in bruising in that area. Increased pain complaints may result as a result of this. Continuous shockwave application has been shown to have a negative effect on people with infections, so it’s critical that for certain patients with infections or delayed healing, taking your time and spacing treatments out weekly has a significant benefit in terms of allowing the healing process to keep up.

In case of erectile dysfunction, the application of too much shockwaves in that area causes penile skin degradation and further exacerbates one’s erection issues. In severe cases, patients treated with focused shockwave devices have complained of blood in their urine and worst pain feeling in abdominal area. The best offense is a good defense- so talk with your doctor right away if you are having significant pain during a a shockwave treatment.  Shockwave therapy, when done correctly by a qualified shockwave provider, does not hurt.

Shockwave therapy sessions can last anywhere from 10 to 30 minutes, depending on the size and severity of the condition. Shockwave is a non-invasive healing tool that provides immediate pain relief and long-term pain reduction. If too many shockwaves are applied at once, any side effects usually appear soon after the initial treatment. The following are some of the possible side effects of shockwave therapy:


  • Redness on the specific area where too much shockwaves applied.
  • Swelling on the specific area
  • Increased pain in that area due to bleeding under the skin (bruising) because of high pressure or high frequency shockwaves.
  • Formation of hematoma on specific tissue sites where too many waves are applied.


In the fight against erectile dysfunction low intensity extracorporeal shockwave therapy (LI-ESWT) is a relatively new treatment method. If medium or high frequency shockwaves are used in this treatment, or if too many low intensity shockwaves are used for erectile dysfunction treatment, the following side effects may occur:

  • Bruising of penile skin
  • Penile skin infection
  • Painful erection
  • Blood in urine due to too many shockwaves applied
  • Pain or difficulty during sexual intercourse, due to any above condition.

If you experience these or any side effects during shockwave therapy, contact your provider for help modifying your treatment plan.

Focused vs Radial Shockwave Therapy for Pain Relief

Radial shockwave therapy is considered a low-intensity shockwave device that targets the peripheral nervous system. In other words, it’s designed to treat pain, not neurological problems.

On the other hand, focused shockwave therapy (FSWT) is a high-intensity shockwave system that only a few clinics have access to. These clinics have dedicated rooms that are purpose-built for the equipment and are certified to use it- at least they’re supposed to be. Focused shockwave therapy devices should only be operated under direct ultrasound visualization to ensure the pin-point focused Sonic explosions focused shockwave is known to deliver does not cause damage.

Focused shockwave therapy is a specific form of shockwave therapy that uses focused beams of ultrasound to target and treat deep-seated, chronic pain conditions. It’s much more intense and targeted than regular shockwave therapy.

This blog post is not meant to say that Focused Shockwave is not a valuable medical tool. Many of our international colleagues combine radial and focused shockwave therapy based on specific patient indications. Some patients have had great success with FSWT, while others have suffered severe side effects.

To learn more about whether this form of shockwave therapy is right for you and your curved penis, ED, or other pain conditions, contact Health Expressions to book a free consultation.

The indication and contra-indication for shockwave therapy are described as:

Indications for Shockwave Therapy Treatment

Contra-Indications to Shockwave Therapy Treatment

●       Tendinopathies

●       Over major blood vessels and nerves

●       Plantar Fascitis

●       Open wounds

●       Adhesive Capsulitis

●       Joint Arthroplasty (Replacement)

●       Avascular necrosis of long bone heads

●       Any blood clotting disorder

●       Osteoarthritis of Knee

●       Cancerous tissues

●       Erectile Dysfunction (Recently developed this treatment but most expensive)

●       Any other infection of related organs


Question 3: One reference to an actual report of patient having damage from too many shockwaves in one area- if discoverable?


Shockwave therapy significantly reduced the pain intensity that accompanies tendinopathy or plantar fasciopathy and improves functions and quality of life. It is fast with little to no down time and most side effects of the treatment are temporary and resolve with rest. Shockwave treatment is valuable healing tool that is non-invasive and give immediate pain relief or pain reduction. It might be first choice of treatment now a days because of it’s effectiveness and safety. No such case is referred through an actual report having damage from too many shockwaves in one area.

Why most successful Shockwave treatment?

Extracorporeal Shockwave Therapy (ESWT) is one of the most widely research rehabilitation modalities used in physiotherapy treatment purpose, with increased number of scientific studies added each year.

The majority of research proved the effectiveness of extracorporeal shockwave and shows successful treatment rates up to 90%.



  • NCBI:

 US national library of medicine, National institute of health (biological effects of extracorporeal shockwaves, shockwave treatment of erectile dysfunction, effectiveness and safety of shockwave therapy)

  • Physiopedia:

(ARTICLE: extracorporeal shockwave therapy)

Google Scholar Articles:

  • Extracorporeal shockwave therapy in musculoskeletal disorders.
  • Extracorporeal shock-wave therapy in the management of chronic soft-tissue conditions.
  • Extracorporeal shock wave therapy (ESWT) for wound healing: Technology, mechanisms, and clinical efficacy.

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