Comparing Extracorporeal and Intracorporeal Shockwave Therapy

Shockwave therapy has revolutionized the treatment of various musculoskeletal and urological conditions, offering a non-invasive and effective alternative to surgery or pharmaceutical interventions. Two primary modalities of shockwave therapy exist: extracorporeal shockwave therapy (ESWT) and intracorporeal shockwave therapy (ISWT). While both approaches harness the power of acoustic waves to stimulate tissue repair and alleviate symptoms, they differ in their delivery methods, indications, and efficacy. In this blog post, we’ll compare extracorporeal and intracorporeal shockwave therapy, helping you understand their differences and choose the right approach for your needs.

Extracorporeal Shockwave Therapy (ESWT):

Extracorporeal shockwave therapy involves delivering acoustic waves from outside the body to the targeted area of treatment. This non-invasive approach is commonly used to address various musculoskeletal conditions such as tendinopathies, plantar fasciitis, and calcific shoulder tendinitis. During treatment, a handheld device applies high-energy acoustic waves to the skin surface above the affected area, allowing the waves to penetrate deep into the tissues.

Advantages of ESWT:

  1. Non-invasive: ESWT does not require incisions or anesthesia, making it a preferred option for patients seeking conservative treatment.
  2. Wide applicability: ESWT is suitable for a broad range of musculoskeletal conditions, offering versatility in clinical practice.
  3. Minimal downtime: Patients can typically resume their daily activities immediately after ESWT sessions, with minimal to no post-procedural discomfort.

Intracorporeal Shockwave Therapy (ISWT):

Intracorporeal shockwave therapy, also known as focused shockwave therapy, involves delivering acoustic waves directly to the targeted tissues through a probe inserted into the body. This approach is commonly used in the treatment of erectile dysfunction (ED), Peyronie’s disease (PD), and other urological conditions. The probe delivers focused shockwaves to specific areas of the penis or pelvic floor, stimulating tissue regeneration and improving blood flow.

Advantages of ISWT:

  1. Targeted delivery: ISWT allows for precise targeting of affected tissues, maximizing the therapeutic effects while minimizing damage to surrounding structures.
  2. High efficacy: ISWT has shown promising results in improving erectile function and penile curvature in patients with ED and PD, offering a non-invasive alternative to surgery.
  3. Customizable treatment: ISWT protocols can be tailored to individual patient needs, optimizing treatment outcomes and patient satisfaction.

Choosing the Right Approach:

When considering extracorporeal versus intracorporeal shockwave therapy, several factors should be taken into account, including the specific condition being treated, treatment goals, patient preferences, and clinical expertise. While ESWT is suitable for a wide range of musculoskeletal conditions and offers a non-invasive treatment option, ISWT may be preferred for urological conditions requiring targeted delivery of shockwaves to internal tissues.


Wang, C. J. (2012). Extracorporeal Shockwave Therapy in Musculoskeletal Disorders. Journal of Orthopedic Surgery and Research. doi: 10.1186/1799X-7-11


Kalyvainakis, D., Memmos, E., Mykoniatis, I., Kapoteli, P., Memmos, D. & Hatzichristou, D. (2018). Low-Intensity Shockwave Therapy for Erectile Dysfunction: A Randomized Clinical Trial Comparing 2 Treatment Protocols and the Impact of Repeating Treatment. Journal of Sexual Medicine. doi: 10.1016/j.sxm.2018.01.003


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