Direct answer: Focused and radial shockwave are two different physical mechanisms, not two versions of the same tool. Focused ESWT concentrates peak pressure at a chosen depth; radial ESWT generates pressure at the applicator and loses intensity as it spreads across a broader, more superficial area. Which one fits depends on how deep the target tissue sits, not on which device is generally “stronger.”
Focused ESWT (FESWT). Concentrates peak pressure at a chosen depth. Typically used for a discrete tendon insertion, a calcific deposit, or a deep fibrotic band.
Radial ESWT (RESWT). Pressure wave generated at the applicator, decaying as it travels. Typically used for a broader, more superficial field — fascia envelopes, muscle bellies, and the surface of a tendon.
Focused is typically used when the exam finds a specific, deeper target — a tendon insertion or a fibrotic band that sits below more superficial tissue. Radial is typically used for broader or more superficial targets, such as fascia or muscle bellies, where the treatment area is larger than one focal point. The two are also combined in the same course of care when a condition has both a surface and a depth component; a typical plan uses the exam first, then the device that matches depth, then manual work on the layer that is still stuck.
Neither modality is simply the upgraded version of the other, and which one performs better varies by condition — in some conditions focused has the edge, in others radial does, and in several well-designed head-to-head trials neither outperforms the other at all. For the full, condition-by-condition breakdown of the current research — tendinopathy, tennis elbow, plantar fasciitis, and combined-modality trials — see Radial vs. Focused Shockwave: What Recent Research Actually Shows.
Read more about shockwave therapy in Denver, the full four treatment tools we use, or request an appointment to find out which fits your case.
Last reviewed: September 2026