In this article
SoftWave vs Focused Shockwave Therapy: What’s the Difference?SoftWave is a brand; “shockwave” describes a broader technology familyHow SoftWave generates acoustic energyHow focused ESWT generates and distributes energyComparison at a glanceClaims the previous article got wrongWhy CityIR favors focused ESWTQuestions to ask any shockwave providerCityIR disclosure
SoftWave vs Focused Shockwave Therapy: What’s the Difference?
SoftWave is a brand; “shockwave” describes a broader technology family
People often search for “SoftWave versus shockwave,” but the wording can be misleading. SoftWave TRT manufactures electrohydraulic pulsed acoustic-wave devices. Focused extracorporeal shockwave therapy can be generated through electrohydraulic, electromagnetic, or piezoelectric systems, depending on the device.
The practical comparison is not “real shockwave versus something else.” It is between specific devices, pressure fields, treatment parameters, regulatory indications, evidence, and the patient’s diagnosis.
Learn about CityIR’s focused and radial shockwave evaluation
How SoftWave generates acoustic energy
FDA documentation for the SoftWave OW100S describes a high-voltage spark generated in water. The resulting acoustic waves propagate through a water-filled applicator and are reflected toward the treatment area through a coupling membrane and gel.
The OW100S has appeared in different FDA regulatory contexts. A clearance as a therapeutic massager does not establish effectiveness for every musculoskeletal diagnosis. Separate device clearances for a specified wound indication also should not be generalized to tendon, joint, pain, or performance claims.
FDA sources: OW100S K213120 therapeutic-massager clearance and 510(k) summary and OW100S K231710 chronic-wound clearance.
How focused ESWT generates and distributes energy
Focused ESWT concentrates mechanical pressure-wave energy at a selected depth. The exact focal size, depth, energy, and waveform depend on the device and applicator. “Focused” does not by itself establish that a treatment is more effective; it describes an energy-distribution characteristic.
FDA approvals and clearances for focused ESWT are device- and indication-specific. A platform’s approval for one condition cannot be applied automatically to unrelated conditions.
Comparison at a glance
| Question | SoftWave OW100S family | Focused ESWT |
|---|---|---|
| What is it? | A branded electrohydraulic pulsed acoustic-wave platform | A category of systems that concentrate pressure-wave energy at a selected depth |
| How is energy generated? | A spark discharge in water, transmitted and reflected through the applicator | Electrohydraulic, electromagnetic, or piezoelectric generation depending on the device |
| Is the field focused? | Characterization must come from the exact device documentation and measured pressure field | Designed to create a defined focal treatment zone |
| Is one universally stronger or better? | No | No |
| Does FDA status apply to every use? | No; status is tied to the device and labeled indication | No; status is tied to the device and labeled indication |
| What should determine use? | Diagnosis, target anatomy, evidence, device labeling, protocol, tolerance, and clinician judgment | Diagnosis, target anatomy, evidence, device labeling, protocol, tolerance, and clinician judgment |
Claims the previous article got wrong
SoftWave should not be described as merely a weak, imprecise, or ineffective version of focused ESWT. It also should not be described as more invasive or as inherently requiring anesthesia or pain medication. Conversely, focused ESWT should not be called categorically faster, safer, more effective, or superior for all chronic-pain conditions.
Those conclusions require diagnosis- and device-specific comparative evidence. The identified FDA documents explain device design and regulatory status; they do not support a universal winner.
Why CityIR favors focused ESWT
CityIR generally favors focused ESWT when the examination identifies a localized tissue target at a clinically meaningful depth. A defined focal treatment zone allows the clinician to direct and adjust energy around the diagnosed anatomy rather than treating a broad area without the same depth-specific intent. CityIR also integrates focused treatment with loading, mobility, strength, and outcome measurement instead of presenting the device as a stand-alone cure.
This is CityIR’s clinical preference—not evidence that focused ESWT is universally superior to every SoftWave device or protocol. Results still depend on the diagnosis, target anatomy, device parameters, clinician technique, rehabilitation plan, and patient response. A broader pressure field may be reasonable for a different tissue area or clinical objective.
Questions to ask any shockwave provider
- What exact device and applicator will be used?
- How does that device generate and distribute acoustic energy?
- What is the proposed diagnosis and treatment target?
- Is the proposed use FDA-approved/cleared or off-label?
- What evidence applies to this device, diagnosis, and protocol?
- What alternatives and rehabilitation plan should be considered?
- How will meaningful improvement be measured, and when will treatment stop?
CityIR disclosure
CityIR provides focused and radial shockwave services and has a financial interest in those treatments. CityIR does not provide SoftWave TRT treatment. CityIR generally prefers focused ESWT for localized, depth-specific targets after a clinical examination. This page explains that clinical preference without claiming that focused ESWT is universally superior for every diagnosis, patient, device, or protocol.
Request a CityIR shockwave evaluation or explore focused and radial ESWT.
Evidence reviewed: August 2026.