Radial Pressure Wave Therapy 

What Is It?

EPAT (Extracorporeal Pulse Activation Technology) is RPW (Radial Pressure Wave).

They are not true shockwave therapy but often will be marketed to patients as shockwave. It can be beneficial in the treatment of superficial soft tissue issues, but is not true shockwave therapy and has better results when used in conjunction with true Focused Shockwave Therapy and EMTT.

non-invasive treatment that uses compressed air to generate acoustic pressure waves that radiate outward from the skin surface into the surrounding soft tissue

highly effective for treating muscles, tendons, and connective tissue close to the surface of the body.

​

RPW vs SWT?

Radial pressure waves spread outward from the applicator tip, covering a broader, more superficial area making it ideal for large muscle groups, trigger points, and surface-level tendon issues while Focused shockwave, by contrast, pinpoints energy at a precise depth for deeper structures.

 

 

What Can It Treat?

What conditions does radial pressure wave therapy treat?

• Plantar fasciitis & heel pain

• Achilles tendinopathy

• Shin splints (medial tibial stress syndrome)

• IT band syndrome

• Tennis & golfer's elbow

• Shoulder impingement & rotator cuff tendinopathy

• Patellar tendinopathy (jumper's knee)

• Chronic muscle tension & trigger points

• Myofascial pain syndrome

• Hip flexor & gluteal tendinopathy

• Upper & lower back muscle tightness

one of the most effective treatments available for chronic muscle trigger points and myofascial pain. The broad, dispersing energy breaks up tight bands of muscle tissue and improves blood flow to stubborn, painful areas.

 

Research findings:

Radial pressure wave therapy has a strong body of clinical evidence supporting its use for musculoskeletal conditions. It is widely used in sports medicine, orthopedics, and physical therapy settings around the world, with studies showing significant pain reduction and functional improvement particularly for chronic tendinopathies and myofascial conditions.

​

How does it promote healing? 

Radial pressure waves work by stimulating circulation, breaking down scar tissue and calcifications, releasing trigger points, and activating the body's natural tissue repair processes. It also reduces pain by decreasing the concentration of substance P, a chemical involved in pain signaling.

​

 

What Should I Expect?

Does radial pressure wave therapy hurt? Most patients describe the sensation as a rapid tapping or pulsing feeling — similar to a deep tissue massage. Tender or inflamed areas may feel more sensitive during treatment, but intensity is always adjusted to your comfort level. Any discomfort typically subsides quickly after the session ends.

How long does a session take? Treatment sessions typically last 10–15 minutes

How many treatments will I need? Most patients see significant improvement in 3–6 sessions, scheduled approximately one week apart. Your physical therapist will monitor your progress and adjust your plan accordingly.

What can I expect after treatment? Mild soreness, warmth, or redness in the treated area is normal and typically resolves within 24–48 hours. This is a sign that your body's healing response has been activated. Most patients can resume normal daily activities right away.

When will I start to feel results?

Some patients notice improvement after just 1–2 sessions. For chronic conditions, meaningful relief often builds progressively over the course of treatment. Your therapist will track your progress at each visit.

​

 

Is It Right for Me?

Who is a good candidate for radial pressure wave therapy? RPWT is an excellent option for people experiencing chronic soft tissue pain, muscle tension, or tendon problems — especially those who have not found lasting relief through rest, stretching, or traditional physical therapy alone. It is also popular with athletes looking for faster recovery.

Are there any contraindications? Radial pressure wave therapy is not recommended for patients who are pregnant, have a pacemaker or implanted electronic device, have active infections, open wounds, or tumors in the treatment area, are on anticoagulant medications, or have had a cortisone injection within the past 6 weeks at the target site.

Can radial pressure wave therapy be used alongside other treatments? Yes, and it often works best as part of a comprehensive plan. It pairs well with therapeutic exercise, manual therapy, dry needling, and other physical therapy modalities for faster, longer-lasting results.

​

What is focused shockwave?

Focused shockwave is a non-invasive treatment that delivers high-energy acoustic sound waves to a precise, targeted area deep within tissue. Focused shockwave can penetrate deeper structures, making it ideal for tendons, bones, and joints.

​

How is focused shockwave different from radial pressure wave (EPAT)?

Radial pressure wave (EPAT) disperses energy outward from the skin surface, treating more superficial areas. Focused shockwave concentrates energy at a specific depth inside the body, allowing for more precise treatment of deep tissue injuries.

​

Is focused shockwave good for chronic pain?

Yes. It is especially effective for chronic tendon and soft tissue conditions that have not responded to other treatments like rest, physical therapy, or cortisone injections.

has strong clinical evidence behind it. Studies show success rates of 70–90% for conditions like plantar fasciitis, calcific rotator cuff tendinitis, and chronic tendinopathies. It is FDA-cleared and widely used in orthopedic and sports medicine settings worldwide.

Shockwaves stimulate your body's natural healing response by increasing blood flow, stimulating collagen production, breaking down calcifications, and reducing substance P (a pain-signaling chemical) in the treated area.

​

What Should I Expect?

Does focused shockwave therapy hurt? Most patients feel a deep pressure or aching sensation during treatment. Because focused shockwave is very precise, the intensity can be adjusted to your comfort level but should be a 5 out of 10 sensation to let your brain know healing needs to take place. 

​

How long does a treatment session take?

A typical session lasts 10-12 minutes.

​

How many treatments will I need?

Most patients require 4-6 sessions, spaced 5-10 days apart. Chronic conditions may require more.

​

What happens after a session?

You may experience mild soreness or redness in the treated area for 24 to 48 hours, bruising is rare. This is a normal healing response. Most patients can return to daily activities immediately. High-impact activity and use of NSAIDs (Advil, Aleve) are avoided for 48 hours.

​

 

Is It Right for Me?

Who is a good candidate for focused shockwave therapy? People who have had chronic tendon, joint, or soft tissue pain for more than 3 months and have not found relief through traditional treatments are often excellent candidates. Along with more acute tendonitis and inflammatory injury conditions.

Are there any contraindications?

Focused shockwave is not recommended for patients who are pregnant, have a pacemaker, have active infections or tumors in the treatment area, or have had a cortisone injection within the past 4 to 6 weeks at the treatment site. Blood thinners can be a precaution and more likely to have bruising.

​

Can focused shockwave be combined with other physical therapy treatments? Absolutely. It is often most effective when combined with targeted exercise, manual therapy, and a structured rehabilitation program.