Shockwave Definitions: A Complete Glossary of Terms, Abbreviations & Acronyms

Precise terminology is essential in medicine, and nowhere is this truer than in Shockwave medicine. A clear definition of Shockwave is essential for accurate research, safe patient care, and consistent outcomes. Yet, confusion still exists, particularly when Focused Shockwave and Radial Pressure Wave are mistakenly referred to as the same despite being distinct technologies with different mechanisms and clinical uses.

This comprehensive list provides clinicians with a straightforward, evidence-based glossary. Each section answers the question or definition directly, making it easy to revisit as a reference.

What is ESWT (Extracorporeal Shockwave Therapy)?

ESWT refers to Focused Shockwaves which penetrate deep into tissue and deliver targeted biological effects. These waves can reach 40–80 MPa within nanoseconds, traveling faster than sound in tissue. It is supported by robust clinical evidence and is a trusted option for:

• Chronic tendinopathies
• Calcific deposits
• Bone injuries and delayed unions

By aligning with the accepted definition of Shockwave in medicine, ESWT provides reproducible outcomes and is recognized as the gold standard.

What is EPAT^® / Radial Pressure Wave (RPW)?

Extracorporeal Pulse Activation Technology (EPAT^®)  also known as Radial Pressure Wave (RPW), delivers radial pressure waves that rise more slowly (10–15 MPa) and act on superficial structures. Radial Pressure Wave (RPW) plays a vital role in musculoskeletal care.

Clinical uses include:

• Fascia-related pain
• Myofascial trigger points
• Muscle activation and pain modulation

Radial Pressure Wave and Focused Shockwave are unique technologies, each with its own advantages and benefits. Additionally, the two modalities are highly complementary when used in combined treatment protocols.

What is ESWL (Extracorporeal Shockwave Lithotripsy)?

Before Focused Shockwave  and Radial Pressure Wave were applied in orthopedics, Extracorporeal Shockwave Lithotripsy (ESWL) was the first medical use of Shockwaves. In urology, ESWL fragments urinary stones, paving the way for broader use in musculoskeletal medicine.

This historical milestone set the stage for the development of modern Focused Shockwave treatment.

What is TPS (Transcranial Pulse Stimulation)?

A noninvasive Shockwave-based technology used in neurology, primarily for Alzheimer’s dementia. TPS delivers low-intensity acoustic pulses through the skull to targeted brain regions, with studies suggesting benefits in blood flow, neuroplasticity, and cognitive function.

What is CSWT (Cardiac Shockwave Therapy)?

A non-invasive application of Shockwave technology in cardiology, CSWT delivers low-intensity pulses to ischemic heart tissue. Evidence indicates it may stimulate angiogenesis, improve myocardial perfusion, and support patients with coronary artery disease.

What is AWT (Acoustic Wave Therapy)?

A broad term sometimes used interchangeably with EPAT^® or Radial Pressure Wave. However, technically it encompasses any therapeutic use of acoustic (sound) waves. AWT is increasingly used in wellness and aesthetics for cellulite and skin tightening applications, in addition to musculoskeletal care.

What is EMTT^® (Extracorporeal Magnetotransduction Therapy)?

EMTT^® generates high-frequency magnetic fields that penetrate deeply into tissue and ignite a cascade of biological effects, stimulating repair processes. Its clinical effects include:

• Reducing pain and inflammation
• Supporting bone and joint regeneration
• Pairing effectively with both Radial Pressure Wave and Focused Shockwave for synergistic outcomes

It is important to note that EMTT^® is not the same as PEMF. EMTT^® delivers higher intensity, greater biological impact, and documented regenerative potential.

What is PEMF (Pulsed Electromagnetic Field)?

PEMF therapy applies low-frequency electromagnetic fields and has long been used in rehabilitation. However, compared to EMTT^®, it is less intense and produces weaker biological effects.

The distinction between PEMF and EMTT^® is important as it ensures that clinicians' treatment decisions are based on accurate definitions and realistic expectations.

Which Devices Define the Gold Standard?

STORZ Medical devices set the gold standard in Shockwave technology. Specific devices have become synonymous with reliable outcomes in Shockwave and EMTT^®. CuraMedix offers the full STORZ Medical suite, including:

• DUOLITH^® – Focused Shockwave
• MASTERPULS^® / ORTHOPULSE^® – EPAT^® / Radial Pressure Wave
• MAGNETOLITH^® – EMTT^®

Device choice should align with clinical indication and the definition of Shockwave in practice.

What Physics Terms Define Shockwave Reporting?

Physics drives outcomes, and reporting aligned with the definition of Shockwave parameters ensures reproducibility and comparability across studies. Key terms every provider should know include:

• Energy Flux Density (EFD): Considered the gold standard for intensity, expressed in mJ/mm². Not interchangeable with pressure.
• Peak Positive / Negative Pressures (p⁺ / p⁻): Define compressional and tensile forces that drive tissue effects.
• Cavitation: The formation and collapse of bubbles play a role in mechanotransduction.
• Coupling: Proper gel use and applicator contact are essential; poor coupling reduces energy delivery.
• IEC Standards: Require full reporting of EFD, pressures, rise time, and pulse duration, not just device level and frequency.
• Penetration Depth: Refers to how deep Shockwaves can reach within the body. Focused Shockwaves can penetrate deeper tissues such as bones or tendons, while Radial Pressure Waves are limited to more superficial areas. Clinicians use depth to match treatment modality with condition.
• Frequency: The number of shockwaves delivered per second, measured in Hertz (Hz). Adjusting frequency can affect treatment comfort and efficiency.
• Total Pulses: The total number of Shockwaves delivered in a treatment session. Typical ranges vary from 2,000 to 5,000 pulses depending on the indication being treated.

What are Shockwave Generation Technologies?

There are three primary methods of generating Shockwaves, each shaping the definition of Shockwave energy in clinical practice:

• Electromagnetic Source: Shockwaves are generated through a magnetic coil and membrane. The most widely used today, precise, consistent, and durable.
• Electrohydraulic Source: Shockwaves are created through underwater sparks between electrodes. These powerful waves can penetrate deeply, making this one of the earliest and most robust methods of Shockwave generation.
• Piezoelectric Source: Shockwaves are produced by piezoelectric crystals under electrical current. Extremely focal with lower penetration depth; used mainly in research or niche applications.

Understanding the definition of Shockwave and the technologies behind it ensures accurate communication, strengthens clinical decision-making, and aligns practice with evidence-based standards.

What are Mechanisms of Action?

• Neovascularization:  The process of forming new blood vessels. Shockwave therapy promotes neovascularization, enhancing blood flow and oxygen delivery to injured tissues, which accelerates healing.
• Mechanotransduction:  The cellular process where mechanical energy (Shockwaves) is converted into biochemical signals. This triggers a cascade of regenerative effects, from stem cell activation to growth factor release.
• Analgesic Effect:  Shockwave therapy modulates pain by desensitizing nerve endings, altering neurochemical signaling, and stimulating pain-inhibitory pathways. Many patients experience immediate relief even before long-term healing occurs.
• Cellular Regeneration:  Shockwaves stimulate fibroblast activity, collagen production, and tissue remodeling—crucial for repairing chronic tendon injuries and musculoskeletal disorders.

How Do These Definitions Apply in Clinical Practice?

It's critical that medical providers match the right technology to the anatomy and pathology being treated:

• ESWT (Focused Shockwave/FSW): Deep targets—tendons, calcific deposits, bone injuries.
• Extracorporeal Pulse Activation Technology (EPAT^®):RPW (Radial / EPAT^®): Superficial fascia, muscle, and pain modulation.
• EMTT^®: Extends regenerative capacity, especially in bone marrow lesions, spine disorders, and osteoarthritis.

Accurate reporting and documentation aligned with IEC standards ensure consistent results and comparability across practices.

For additional information, watch the Institute Webinar: Demystifying Shockwave – The Technologies. The Evidence. The Truth. This informative webinar features Prof. Dr. Karsten Knobloch who cuts through common misconceptions and highlights what truly defines Shockwave medicine.

“My medical practice deals mainly with soft-tissue repetitive strain/overuse injuries. ESWT and EMTT^® are an essential part of the multi-disciplinary approach I use to successfully treat these problems.”
— Dr. Anthony DuBose, MD, Stanford University Occupational Health Center, DuBose Medical Group

CuraMedix + STORZ Medical

CuraMedix is proud to represent STORZ Medical as the leading full-service U.S. distribution partner supporting the complete suite of Radial Pressure Wave, Focused Shockwave, and “High Energy” Magnetotransduction (EMTT^®) devices.

👉 Check out the complete suite of CuraMedix devices, powered by STORZ Medical

Shockwave Glossary

Precise terminology is critical in Shockwave medicine. To help reduce confusion and support evidence-based practice, this glossary summarizes key terms, devices, and generator types at a glance.

Conclusion

By aligning with the international consensus on the definition of Shockwave and other related terms, providers ensure safer, evidence-based protocols and consistent outcomes.

Clear language matters. It’s more than semantics, as it is essential to ensure safe, effective, and evidence-based use of Shockwave technologies. By distinguishing between ESWT, EPAT^®/RPW, EMTT^®, PEMF, and ESWL, medical professionals can avoid missteps, improve patient outcomes, and align their documentation and protocols with international standards.

Ready to learn how Shockwave and EMTT^® can strengthen your practice? Connect with one of the experts on the CuraMedix team today to explore the best options for your patients and your practice.