Radial pulse wave (RPW) is a new innovative technique that uses sound waves to help reduce pain in chronic conditions. It goes by many different names, Extracorporeal Shockwave (ECSW) or just Shockwave therapy. This modality uses high air pressure to move a piston in the tool which collides with a transmitter thus making a sound wave. This sound wave can be used to target different tissues throughout the body. A special feature of this wave is how it moves through the body in a latitude and longitudinal pulsing motion and not in a heat building motion as ultrasound does.

When looking at sound waves and how they move in space, the RPW or sometimes referred to as “Shock Wave” uses radial pressure waves to help break up adhesions in the tissue. How this works is the tissue is targeted by sound waves and the cells in the tissue convert this energy to a biochemical process thus activating the connective tissue. This process helps reduce pain and bring blood flow to the area. The types of tissue that can be targeted to help ailments are trigger points (bundles of tight muscles), tendons and muscle bellies of hypertonic or under-activating muscles, as well as facia.

Research has shown that when activating muscles that have become inactive as well as breaking up the adhesions in the surrounding tissue, chronic conditions can see positive results. Just some examples of this in low back pain, plantar fasciitis, tendinopathies, carpal tunnel syndrome, shin splints, and more.

Radial pulse wave is not a comfortable therapy, it is meant to produce some discomfort while having the modality performed. This pain should be from a 5-7 on a 1-10 pain scale, but the technique only takes a few minutes. We instruct our patients that the treatment should be intense enough for us to be unable to hold a casual conversation but not too painful to allow a full treatment time. The benefits of immediate pain reduction after the therapy as well as the long term benefit of restoring proper motion and joint mechanics mean that a lot of our patients love the “shock wave” and how it has helped their life. Walesizc’s research has also shown that individuals who have gone through a RPW care plan are less likely to rebound with more pain at a later date than individuals who did not receive this modality.

Our chiropractors here at Back on Track Chiropractic and Acupuncture have received extra training in the use of Radial Pulse Wave by Chattanooga. If you would like to call and consult with Dr. Crow or Dr. Martin, they can help determine if this therapy would be beneficial for your care. Shock Wave is for most chronic conditions but there are some that it is not appropriate for. If you have a malignancy, a blood clotting disorder, are currently pregnant, have polyneuralgia or have had a recent corticosteroid injection let your practitioner know before starting this therapy.

Updated 06/21/2022


Chattanooga Radial Wave Therapy Course

Bihter Akinoğlu, PhD, Nezire Köse, PhD, Nuray Kirdi, PhD, Yavuz Yakut, PhD, Comparison of the Acute Effect of Radial Shock Wave Therapy and Ultrasound Therapy in the Treatment of Plantar Fasciitis: A Randomized Controlled Study, Pain Medicine, Volume 18, Issue 12, December 2017, Pages 2443–2452, https://doi.org/10.1093/pm/pnx113

Walewicz, Karolina et al. “The Effectiveness Of Radial Extracorporeal Shock Wave Therapy In Patients With Chronic Low Back Pain: A Prospective, Randomized, Single-Blinded Pilot Study.” Clinical interventions in aging vol. 14 1859-1869. 30 Oct. 2019, doi:10.2147/CIA.S224001 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6857735/