On this page we'll answer these questions about extracorporeal

shockwave therapy in general:

What is Extracorporeal Shock Wave Therapy (ESWT)?
What is Shockwave Biosurgery?
What is the origin of ESWT?
What conditions can you treat with ESWT?
When is ESWT considered as a treatment for these sorts of conditions?
When can't you use ESWT?
How effective is ESWT?
How fast does ESWT work?
How safe is ESWT?
How does ESWT work?
How do the physics of ESWT promote tissue healing?

We'll also discuss some of the differences between the various forms
of shockwave therapy on the market today:
 Are there different forms of ESWT?
What's the difference between the different forms of ESWT?
Which is the best version of shockwave therapy?
What form of shockwave therapy do you use?
How do I know which version of ESWT is being offered at a facility?
Where can I find the best, most up-to-date form of ESWT available?

-------------------------------------

What is Extracorporeal Shock Wave Therapy?

Extracorporeal Shock Wave Therapy, (or ESWT), is a new technology using shockwaves to
treat chronic, painful conditions of the musculoskeletal system. A shockwave is an intense,
but very short energy wave traveling faster than the speed of sound. The word "Extra-
corporeal" means "outside the body" and refers to the fact that the shockwaves are generated
outside the body.

What is Shockwave Biosurgery?

Extracorporeal shockwave therapy (ESWT) is sometimes alternatively known as

shockwave biosurgery, though ESWT isn't surgery as the word is usually defined or
understood in North America.

What is the origin of ESWT?

The basic science behind ESWT is analogous to lithotripsy, the

technology that uses acoustic shockwaves to break up kidney
stones without surgery. The technique of using shockwaves to
break up kidney stones has been around for a nearly a quarter
century now, and in the process of treating thousands and
thousands of patients, it was found that many people undergoing the
procedure had other unrelated aches and pains disappear. It was at
this point that scientists began to consider that shockwaves may
have an effect to heal other sorts of tissues.

Specialized machines were then developed specifically with the idea

of using these shockwaves on other parts of the body, and this is the
origin of ESWT.

The type of shockwave therapy we use, then, is specialized to

The Piezoson 100
specifically help treat musculoskeletal conditions. Extracorporeal Shock Wave Therapy (ESWT)
Unit
What conditions can you treat with ESWT?
 Extracorporeal Shock Wave Therapy can be used to treat a
wide variety of musculoskeletal conditions--particularly those
involving where major connective tissues attach to bone.

Complaints involving attachment points for tendons and

ligaments in major joints like the shoulder (such as the rotator
cuff), elbow (epicondylitis or tennis elbow), hip, and knee
(tendinitis or "jumper's knee) are common sites for ESWT.

One of the areas most frequently treated with ESWT,

however, is the foot. This is our specialty. Some conditions
in the foot that have been treated with ESWT include:

Plantar Fasciitis or Fasciosis (Strained Arch)

Achilles Tendinitis or Tendinosis
Calcific Tendinitis or Tendinosis
Connective Tissue Pain and degeneration
Muscle Pain and Injuries
Joint Injuries
Morton's Neuromas

And as ESWT encourages bone healing, it has been used to

help treat:

Stress Fractures
Avascular Necrosis (A dead portion of bone)
Slow-healing bone (Delayed unions)
Non-healing bone (Non-unions)
There are also urological conditions that respond to ESWT,
such as Peyronie's Disease.

Research presented at the 2005 International Conference on ESWT in Vienna and the 2006
International Conference in Rio de Janeiro demonstrated that ESWT is also being studied for
use for a wide variety of other conditions as disparate as skin ulcers and other chronic
dermatological lesions, infections, angina, arthritis, reflex sympathetic dystrophy (RSD), and
certain neurological conditions.

When is ESWT considered as a treatment for these sorts of conditions?

Shock Wave Therapy is generally considered when the following criteria are met:

 When patient has a diagnosis that is considered to be responsive to ESWT.

 When simpler and less expensive treatment alternatives have failed or aren't
appropriate for some reason.

 When surgery or other more invasive treatments are alternatives.

  When the patient fully understands the procedure.

 When there are no known contraindications to the procedure.

When can't you use ESWT?

ESWT is not typically used in the presence of bone tumours, certain metabolic bone
conditions, and certain nerve or circulation disorders. ESWT isn't typically used in pregnant
patients and locations of an open growth plate, (where the bone is still growing). It's not
currently used in areas where an infection is present, (though there is some early research
suggesting ESWT may actually help with infection). It also shouldn't be used in conditions or
locations where gas or air is present in the body, (rare in the locations where ESWT is
typically used)--or for other conditions as determined by your doctor.

How effective is Focused ESWT?

The answer to this question depends upon which study you read, what methods were used in
the study, how "success" is measured in the study, the patients selected to be included in the
study, the condition being treated, and the machine being used.

While there are some studies (usually quoted by an insurance company trying to find a way to
justify not paying for ESWT treatment) that suggest that shockwave hasn't been proven to be
effective, the vast majority of recent studies suggest that shockwave is highly effective. For
example, over 70 studies were presented at the 2006 international shockwave seminar in
Brazil, and over 80 were presented the year before in Vienna--and this doesn't even include
the numerous published findings in the medical literature.

Assuming you have an injury appropriate to extra-corporeal shockwave technology treatment,

most recent independent studies suggest somewhere between a 65% and a 95% "success"
range, with values around 80% being the most commonly cited number. And it's important to
note that most of these studies have success rates as determined by the patient, himself, in
terms of pain and function.

We find that our results with the highly accurate piezoelectric technology, are at least this
successful. The most important factor in getting a good result with ESWT appears to be in
selecting appropriate patients most likely to benefit from this technology. However, we can't
predict which patients will respond successfully to ESWT and which ones won't.

How fast does ESWT work?

We find that many patients get an initial degree of improvement almost immediately following
treatment. This effect is usually (but not always) temporary, and is associated with an
anesthesia effect from the hyperstimulation of the tissue from the ESWT.

It takes several days for injuries to begin to heal, and many patients see an improvement
before the end of the second week. Depending upon your diagnosis, the healing process may
take several weeks or even months to be completed, but pain relief often precedes the
completion of the healing process.

How safe is ESWT?

The basic technology involved with extracorporeal shockwave technology has been used for
decades now on quite literally millions of people. The technology has been used most
extensively in Europe, particularly the German-speaking countries, where this technology
originates. In all its use, ESWT of the musculoskeletal system has been found to have
virtually no serious side-effects. In fact, even mild side effects like tingling, aching, redness,
or bruising are relatively rare, modest and short-lived.

Further, effects like these appear to be more common with higher energy treatments,
particularly those from earlier generations of ESWT technology than that which we use. We'll
discuss more about the different ESWT technologies below.

How does ESWT work?

Simply put, extracorporeal shockwaves stimulate certain components within the body so the
body is able to heal. And ESWT is able to accomplish this even in chronic cases, when the
body has demonstrated a previous unwillingness or inability to do so by itself.

In addition to stimulating the healing process, ESWT seems to have a direct effect on nerves,
diminishing pain.

Many traditional therapies--such as anti-inflammatory medications, steroid injections,

physiotherapy, massage, acupuncture, and so forth--can assist the body during the early,
acute phase of an injury. However, they are much less effective in assisting the body to heal
when an injury becomes chronic. As an example, many patients can relate to a history where
a steroid injection (like cortisone) seemed to be effective in resolving pain early in their
healing process, but subsequent injections were much less effective. This isn't really
surprising when you realize that a chronic-state, degenerative injury isn't likely to respond
well to a medication designed to affect an acute-phase, inflammatory condition.

What makes ESWT unique is that it is one of the very few technologies in any field of
medicine that seems to work best when an injury reaches the chronic, non-healing state.
ESWT appears to be able to jump start the healing process in chronic, non-healing injuries
and move them back into the acute phase of healing.

How do the physics of ESWT promote tissue healing?

While investigations are still being conducted to more fully understand the
precise mechanism behind ESWT's effects on injured tissues, the picture is
becoming much clearer.

True ESWT produces a very strong energy

pulse (5-100 MPa) for a very short length of
time, (approximately 10 milliseconds).

The energy pulse quite literally breaks the

sound barrier, and this is what creates the
shockwave.
To the right is a photograph of a plane flying faster
than the speed of sound and creating shockwaves.
Shockwaves produced by an extracorporeal
shockwave machine are identical, only on a
smaller scale.

One difference with the shockwaves our

machine is able to produce is that the
shockwave is generated, controlled, and
focused precisely.

In fact, the machine we use allows us to be

able to control and focus the shockwaves to
such an extent we are able to pass the
shockwaves through the uninjured portions of
the body without any effect, and deliver the
energy to a focus point at the level of the
injured tissue, where it has several known
medicinal effects:

 First, this shockwave exerts a

mechanical pressure and tension
force on the afflicted tissue. This has
been shown to create an increase in
cell membrane permeability,
thereby increasing microscopic
circulation (right) to the tissues and
the metabolism within the treated
tissues, both of which promote
healing and subsequent dissolution of
pathological calcific deposits.
 Second, the ESWT shock waves
pressure front creates behind it what
are known as "cavitation
bubbles". An example of a single
cavitation bubble is pictured to the
right.

Cavitation bubbles are simply small

empty cavities created behind an
energy front. They tend to expand to a
to a maximum size, then collapse,
much like a bubble popping.

As these bubbles burst, a resultant

force is created. In the human body,
this force is strong enough to
help break down pathological deposits
of calcification in soft tissues.
  Third, as
cavitation
bubbles
collapse,
they create
smaller,
secondary
energy
waves
known as
microjets.
You can see
how a
microjet
forms in the
diagram to
the right, and
you can see
it pictured in
the center of
the
cavitation
bubble in the
photograph
immediately
above.

These
microjets
also create a
lot of force
that also
breaks down
pathological
deposits of
calcification
in the soft
tissues
through
direct,
mechanical
means.

In the application of an ESWT treatment in

a medical setting, however, it's not just one
cavitation bubble or just a few cavitation
bubbles being produced, but hundreds
and thousands.

To the right you can see what hundreds of

cavitation bubbles formed from a single
shockwave looks like.

Multiply this by several thousand

shockwaves being administered to an
injured tissue through a course of ESWT
treatment and you can imagine the forces
that can be mustered to break down
deposits of calcification that are found in
joints, soft tissues and spurs.
 Beyond breaking down
pathological calcification deposits,
ESWT has been shown
to stimulate cells in the body
known as osteoblasts. These bone
cells, (pictured to the right), are
responsible for bone healing and
new bone production, so
stimulating them obviously
enhances the healing process of
bone.
 ESWT shockwaves have also been
shown to stimulatefibroblasts, (pictured
to the right). Fibroblasts are the cells
responsible for the healing of
connective tissuessuch as tendon,
ligaments, and fasica.
 ESWT also diminishes pain. It does so
in two ways. First, as mentioned above,
ESWT initially diminishes pain through
what is known as hyperstimulation
anesthesia. This is where the nerves
sending signals of pain to the brain are
stimulated so much that their activity
diminishes, thereby decreasing or
eliminating pain. This effect is usually,
(but not always), short lived.

 ESWT is also believed to diminish pain

over longer periods of time through the
stimulation of what is known as the
"gate-control" mechanism, where
nerves can be stimulated to "close the
gate" to pain impulses sent to the
brain. It is sometimes thought of as
activating a sort of "reset" button that
recalibrates pain perception.

Interestingly, and in apparent support of

this theory, it was demonstrated by
research presented at the 2005
conference in Vienna that using
anesthesia with ESWT alters the sensor
input - motor output balance of nerve
fibres, inhibiting the pain-killing effect
of ESWT.

In other words, ESWT appears to be

most helpful for patients who are not
anesthetized. (This explains why some
some early studies where anesthesia
was used before the administration of
extracorporeal shockwave therapy did
not get results as good as what is
found in patients where no anesthesia
is used.)
 As the piezoelectric version of shockwave we use does not require a
serves as one explanation as to why piezoelectric shockwave works

While ESWT is used on a wide variety of body tissues and medical condition
conditions can you treat with ESWT? section above), the effects of shockwa
documented in areas of changes in tissue density, such as where tendon att
(enthesiopathies) and where bone attaches to ligaments (desmopathies).
is very effective for painful connective tissue pain in such locations as the fo
elbow, and shoulder.

Are there different forms of shockwave therapy?

While there are numerous shockwave machines on the market today, they ar
one of four basic shockwave (or shockwave-like) technologies.
they were introduced in Canada, they are:

 Electrohydraulic shockwave (such as the HMT OssaTron machine)

 Electromagnetic shockwave (such as the Sonocur and Dornier Epos

 Radial pressure wave (such as the Dolorclast system)

 Piezoelectric shockwave (such as the machine we use, the Piezoson

What's the difference between these forms of shockwave therap

Electrohydraulic, electromagnetic, and piezoelectric technologies are all true

corporeal shockwave therapy. Each technology produces a pulse that litera
speed of sound, thereby creating a shockwave.

These technologies differ in the manner in which the shockwaves are produ
the shockwave to be controlled and focused, the depth to which the shockw
penetrate, the intensity of the shockwave being produced, the sorts of condi
able to treat, and whether they require anesthesia.

The third technology on the list above, radial therapy, is actually quite differe
other three technologies in several regards and is usually not considered tru
shockwave therapy--but more of a pressure wave therapy.

We'll try to differentiate all this for you. First let's go through the three true f
electrohydraulic, electromagnetic, and piezoelectric.

Manner of Generation and Delivery of Shockwaves

 Electrohydraulic shockwave therapy uses a type of spark plug to gen
shockwave, with the shockwaves focused by an ellipsoid reflector.
 Electromagnetic shockwave therapy machines typically use a cylind
arrangement of an electromagnetic generator and a parabolic reflect
shockwaves.

 The piezoelectric shockwave is generated by an electric pulse, and th

focused by thousands of small crystals in the applicator head.

Each of these three technologies is similar in that the shockwaves and force
machines is translated past the skin and superficial tissues without effect, a
focused at the desired tissue depth.

The fourth technology, Radial shockwave (RSWT) or more accurately, pressu

differs from the other forms of shockwave technology in a couple major regards. First, in
order for a shockwave to truly be defined as a shockwave, the energy wave must literally be
faster than the speed of sound, or 1500 meters per second. This is the speed at which the
"shock" of the shockwave is generated, from breaking the sound barrier.

In comparison, RSWT waves travel at speeds of approximately 10 meters per second, a small
fraction of true shockwave. This speed does not break the sound barrier, and hence, no
actual shockwave is produced.

Indeed, the very wave form produced by radial technology differs from true shockwave
rather noticeably. True focused shockwaves are very short and very intense; radial pressure
waves are slower, less intense, elongated, and more sinusoidal in appearance.

Because no actual shockwave is produced with RSWT, and because the waveform is so
different, you can better see why RSWT is not considered a shockwave technology. It is
more accurately described as a pressure wave technology, and most researchers now use
this term to describe this technology. However, some facilities with these machines
continue to inaccurately label their technology as shockwave therapy.

Tissue Depth Penetration:

As you might imagine intuitively, being able to aim shockwaves directly on the desired
tissues and only the desired tissues is generally considered to be superior to not being able
to direct the shockwaves to the specific injured tissues.

Electrohydraulic, electromagnetic, and piezoelectric shockwave can all be aimed and

delivered past the skin and down to different tissue depths, allowing for delivery of the
therapeutic waves to the injured tissue.

Radial pressure waves are applied to the skin only, and must dissipate to the tissues from
there. They are therefore not able to be aimed to different tissue depths. Deeper tissue
injuries are therefore more difficult to treat with radial shockwave.

Focus Area:

A third characteristic to consider is how

precisely the energy waves are able to be
focused onto the injured tissue and away
from uninjured tissues.

The tighter the focus area, the more

precisely the shockwaves can be delivered
to specific tissues, and the less energy is
wasted in areas not requiring treatment.

Not only does this mean a greater concentration of therapeutic energy on the specific injured
tissues, it also means less trauma to the surrounding uninjured tissues.

As alluded to above, the piezoelectric technology we use has, by far, the tightest focus area
of any competing technology in the world.

For instance, even at maximum energy level, the focus area for the Piezoson 100, (the
machine we use), is 1.3mm x 1.3mm x 4.2mm. (This equates roughly to 1/20th of an inch x
1/20th of an inch x 1/6th of an inch.)

In comparison with other machines in North America, the focus area for the Ossatron is
8.7mm x 8.7mm x 67.6mm; the focus area for the Sonocur is 4.8mm 4.8mm x 48.3mm and for
the Epos it's 2.9mm x 2.9mm x 22.0mm. (Radial pressure waves cannot be focused at all.)

(Source for these statistics, the German site on physical parameters of extracorporeal shock wave therapy
technologies: http://stosswellentherapie.org/fach/vergl.html)

As these statistics make clear, the piezoelectric technology is the most accurate ESWT
technology on the market. Treatment is more precisely directed at injured tissues and the
least traumatic to uninjured tissues surrounding the site being treated.

However, because piezoelectric technology is so precise, it needs to be applied carefully and

precisely to the correct tissues. This is why we don't hire ESWT technicians to perform the
therapy. We only have doctors applying the treatment. This is actually the law in many
jurisdictions in Europe, but the exception in North America, where technicians perform most
ESWT treatments in the vast majority of facilities.

Energy Level:

Another important differentiating characteristic is how high an energy output the machine
produces. In fact, this characteristic is commonly used in marketing various machines.

For instance, you'll see many websites touting the benefits of their machine being either
"high energy" or "low energy". Facilities with "high energy" machines claim, for example,
that their technology is superior because only one treatment is typically required and the
technology has been around longer. Facilities with "low energy" machines advertise that it
doesn't require anesthesia and it's cheaper.

While there is some truth to each of these claims, the larger question is frequently not
mentioned. That is to say, the question that should be asked is what is better at actually
treating a particular condition? High energy or low energy?

Before we can answer this question, you should know that the energy level of a machine is
actually a fairly complicated subject and it deserves some discussion.

For instance, you'd think that the energy produced by a machine would be a pretty clear-cut
characteristic. But there are several different--and confusing--ways to measure energy. For
example, you could consider the amount or type of energy produced by the machine, the
amount or type of energy delivered into the body, the amount or type of energy delivered into
the focus area, the amount or type of energy delivered to a central point inside the focus
area, or the amount or type of energy present at a certain radius from that central focus
point.

Each of these characteristics is important to the scientists studying various characteristics

of ESWT machines, and different manufacturers and scientists use different definitions of
"energy".

As you might expect, so many variables make it rather confusing to both patients and
physicians. After all, even doctors aren't sure what type of energy is most important when
judging which technology is a better in which to invest.

For the purposes of this discussion, we'll concentrate on the most common standardized
measurement of energy in the field, something called the "energy flux density", expressed in
millijo
ules
per
millime
ter
(mJ/m
m2)..

Energy
flux
densit
y can
be
define
d as
the
amoun
t or
conce
ntratio
n of
energy
in the
focus
area.
In
other
words,
this is
the
amoun
t of
therap
eutic
energy
being
deliver
ed to
the
injured
tissue.
The
physic
s of
the
other
measu
res of
energy
are
interes
ting,
but we
feel
this is
the
charac
teristic
in which most patients and physicians are interested.

Now even when we've defined what we mean by an energy level and defined the unit of
measurement, you should know that different authors use different cut-off measurements to
define "high energy" and "low energy". One author's "high energy" setting may only qualify
as a "low energy" setting in another author's opinion. So the terms "high energy" and "low
energy" are rather imprecise and arbitrary. (This demonstrates why the marketing of "high
energy" and "low energy" machines is somewhat dubious.)

For the purposes of this discussion, we'll define low energy here as less than 0.27 mJ/mm 2 ,
medium energy as 0.27 mJ/mm2 to 0.59 mJ/mm2 , and high energy as anything over
0.60 mJ/mm2. These are frequently-used cut-off points, but do keep in mind that other
practitioners, researchers, manufacturers, and websites may use different values.

So now that we've defined what energy is, what's considered high, medium, or low energy,
let's get back to the question of what energy settings are better to treat a specific injury.

The answer that seems to becoming more clear in research is that both high energy settings
and low energy settings have their indications.

For instance, certain tissues (like bone) appear to respond better to higher energy settings.
Conditions like avascular necrosis and delayed unions and pathological calcifications are
examples of conditions that are typically thought of as being more responsive to higher
intensity settings. In addition, the original medical application for shockwaves, the treatment
of kidney stones, too, seem to be most effective with higher energy settings.

However, other tissues (like tendons and other more sensitive structures) typically require
lower energy settings, as research indicates that these they may be damaged by higher-
intensity settings.

Complicating matters further, what does a patient do when both hard and soft tissues need
to be treated for a single injury, as is often the case? For example, what if a patient has both
a bone spur and a soft tissue injury like fasciitis or tendonitis? Is it better to go with a so-
called "high energy" machine or a "low energy" machine?

The good news is that it doesn't have to be an either-or proposition. The beauty of the
piezoelectric ESWT technology we use is that it covers the energy spectra employed by the
other technologies.

For instance, piezoelectric ESWT can be applied in energy levels as low as .05 mJ/mm 2--
obviously well into the lowest levels of energy--and it can be raised as high as 1.48 mJ/mm2--
an energy level well above even the classic "high energy" machines.

In other words, in terms of the amount of energy applied in the focus area, (the so-called
"energy flux density"), piezoelectric technology can be delivered in energy doses as low as
virtually any other competing technology and as high or higher than virtually any other
technology.

Further, piezoelectric technology can be readily adjusted to any energy level, depending
upon the specific condition and indication of each individual case. And as mentioned above,
the energy can be precisely focused to the specific depth required.

Our patients don't have to compromise for a single energy range or a specific tissue type.

And because the machine we use is so precise, we can use high energy settings in areas
very close to the most sensitive tissue
structures. This allows the piezoelectric
technology noticeable advantages to
machines with much less precise focus
areas.

Anesthesia Requirements:

The energy the machine produces also

affects the need for anesthesia (whether
local, general, or spinal) or IV sedation. All
things being equal, it's obviously preferable
for the patient not to have to go through
anesthesia or sedation. It's not only safer, it's
also less expensive.

Beyond the issues of safety and expense,

though, there is mounting evidence that the
use of anesthesia diminishes the
effectiveness of ESWT. Specifically, the use
of anesthesia with ESWT alters the sensory
input - motor output balance of nerve fibres,
which seems to be why anesthesia
diminishes the pain killing effect of ESWT.

So unlike other so-called "high-energy"

machines, the piezoelectric technology does
not typically require anesthesia--even at high
energy settings. And further, this means it's
more likely to work than versions requiring
anesthesia.

Which is the best version of

shockwave therapy?

There is a natural tendency for practitioners

to feel some bias towards the form of
technology which they use personally.

However, we can tell you that

when Shockwave Therapy - BC was formed,
all these different technologies were
available to us, and we had the opportunity to
examine each of them. We've even examined
and investigated many machines not
available in North America.

After all our investigations into each form

of shockwave technology and each
generation of machine, it became
apparent to us that the piezoelectric form
of ESWT technology in the form of the
Piezoson 100 offers distinct advantages in
comparison with any other ESWT
technology. So we believe that this form
of shockwave therapy is the best version
available anywhere.

For example, the technology we use is the

only form of ESWT that combines each of
these important features:

Below: Applicator pads for ESWT

handpieces 1. Piezoelectric shockwave therapy is the newest, most up-to-
date form of ESWT available anywhere. Simply put, piezoelectric
technology is state-of-the-art.

2. Piezoelectric shockwave therapy employs multiple applicator

heads (left), which enable the therapeutic shockwaves to
be directed to the desired tissue depth. The energy from this
machine is able to literally passes through the body's
undamaged tissues (like, say, skin and muscle) without effect,
then the energy wave is precisely focused and concentrated on
the desired tissue depth.

3. Of all ESWT technologies that can focus their energy waves,

piezoelectric shockwave therapy has, by far, the smallest focus
area, meaning it is able to be focused the most
precisely compared with competing technologies. This allows
for greater precision in delivering the therapeutic energy to the
desired tissues, as well as less trauma to the surrounding
tissues, than any other technology on the market anywhere in the
world.
 4. Piezoelectric shockwaves are adjustable in strength. We can
adjust the strength of the energy wave in the focus area, the so-
called "energy flux density", very precisely to any desired
therapeutic level, whether in the "low energy" region or "high
energy" region.

5. Unlike other high-energy machines, the Piezoson 100

technology does not require hospitalization, anesthesia or IV
sedation. This is means added safety and less cost for the
patient, and better results, as using anesthesia with ESWT
appears to diminish the pain-killing effects of ESWT.

6. The Piezoelectric version of ESWT technology is an extremely

cost effective technology for the patient compared with other
technologies. In fact, patients have found the price difference so
profound that we've had patients from over 1/2 of the Canadian
provinces and U.S. states--not to mention countries as far away
as Asia, Africa, and South America.

Piezoelectric technology offers the best features available in extra-corporeal shockwave

therapy. For these reasons, we believe that the piezoelectric form of ESWT is the best
technology available anywhere.

Until recently, this piezoelectric shockwave technology had been only available in Europe.
So when it recently became approved for use in Canada, we were quick to choose this
technology. We are pleased to say that our facility was the first facility using this newest
form of ESWT technology in Canada. And to the best of our knowledge, we are still the
only facility using this technology in all of western Canada.

This newest form of ESWT technology is still unavailable in the United States--though the
other, older forms of ESWT do exist in the United States.

Below: Various handpieces for different ESWT applications

What form of shockwave therapy do you

use?

We use the newest-generation, and we believe the

best standard of shockwave technology available
anywhere, the piezoelectric standard.

Specifically, we use the Piezoson 100 machine by the

Richard Wolf Company in Germany, which covers
both the high-energy and low-energy spectrum.
How do I know which version of shockwave therapy is being offered at a
facility?

Many facilities don't go into much detail about the different versions of ESWT technology.
Perhaps they may feel it doesn't matter to the patient or that the information is too technical
for most patients. But if you're having significant pain and are searching for answers, if
you're curious which machine may be most applicable to your condition, we feel this is the
sort of information that we find a lot of patients seek. If the facility you're considering isn't
clear about what version of ESWT technology they're using and you wish to know, you
should ask.

Where can I get the best, most up-to-date form of focused ESWT?

At present, the only site we know of in British Columbia or in Western Canada offering
Piezoson 100 ESWT is at our facility in Surrey, British Columbia near Vancouver. While this
technology has been around for many years in Europe and in Canada for nearly two years,
it is not yet available in the United States or in many other countries around the world.

For this reason, we welcome patients from any area who are seeking this newest of ESWT
technology. Overnight or longer stays can be arranged at some of the
recommended hotels near our facility.

We can be contacted at:

Shockwave Therapy - BC
Suite 102
10190 - 152A Street
Surrey, British Columbia
V3R 1J7 Canada

T: 604-589-5234

For more maps and directions to our location, please follow the following link.

___________________

Website Directory
What We Offer
General Information About ESWT
How We're Different
Information About Your Visit
About Us
About Dr. Schumacher
Answers To Financial Questions
Location, Directions and Maps
Hotels Near Our Facility
Traveler's Information
Links
Contact Us
Return Home

___________________