Focused vs Radial Shockwave Therapy: Erectile Dysfunction Treatment

Written by: Shibin Vinod BPT MSc, HCPC PH124277, CSP 111177. Sport and Exercise Medicine, Senior MSK Physiotherapist & Shockwave Therapy Specialist

Medically Reviewed by: Mr Andrew O’Neill M.Ost GOsC 11018. Registered Osteopath & Shockwave Therapy Specialist

Erectile dysfunction (ED) is something many men experience at different stages of life, and while tablets are often the first option, some prefer to explore alternatives that don’t rely on medication. One treatment that has gained attention over the past few years is extracorporeal shockwave therapy (ESWT). This is a non-invasive technique that uses gentle acoustic waves to encourage healthier blood flow and tissue repair across our flagship clinics in Canada Water SE16 and Stratford E15.

There are two main types of shockwave therapy sometimes discussed in connection with ED: focused shockwave therapy (fSWT) and radial shockwave therapy (rSWT). Both use energy waves, but the way they act in the body is very different.

This article explains how the two approaches compare, what the evidence says, what treatment involves, and what patients can expect in terms of comfort, cost, and longer-term outcomes. The aim is to provide clear, balanced information to help you feel informed before exploring treatment options.

Mechanism of Action

Shockwave therapy works by sending low-intensity sound waves into tissue. These waves gently disturb the cells, which in turn encourages the body’s natural repair processes. In the context of erectile dysfunction (ED) , the aim is to stimulate new blood vessel growth (neovascularization) and improve circulation in the penile tissue. Better blood flow often supports stronger and more reliable erections.

With focused shockwave therapy (fSWT), the energy is directed at a precise point beneath the surface. This concentrated delivery means the waves can reach deeper layers of erectile tissue (up to 12cm depth within the corpus cavernosum), where they may trigger small-scale regeneration, support nerve repair, and release growth factors linked with healing without causing epidermal surface trauma.

By comparison, radial shockwave therapy (rSWT) spreads the energy in a more general way. Instead of travelling deep into the erectile tissue, the energy disperses across the surface layers (losing velocity within 3-4cm of the skin). This type of radial device is widely used for treating muscle or tendon pain, but its ability to affect the tissue linked with erections appears limited.

In short, the main distinction is depth: focused waves reach the areas most involved in erections, while radial waves remain at the surface. Focused waves reach the deep layers essential for function, while radial waves remain at the surface. You can learn more about these internal structures in our MSK ED Glossary.

Our Clinical Perspective at Bodytonic Clinic “While clinical studies provide the framework, our practitioners at our Canada Water and Stratford clinics see the real-world impact of focused shockwave therapy every week. In our experience, the precision of focused waves is essential for ED, as it allows us to target the specific depth of the penile tissue that radial devices simply cannot reach. By using medical-grade focused technology, we ensure that the energy is delivered exactly where it’s needed to support tissue repair and vascular health.”

Effectiveness for Erectile Dysfunction (ED)

Research into shockwave therapy for erectile dysfunction has focused mainly on the focused method (fSWT). A number of clinical trials and reviews suggest that men receiving focused treatment often report measurable improvements on scoring systems such as the International Index of Erectile Function (IIEF-5) and the Sexual Health Inventory for Men (SHIM). For example, a 2025 meta-analysis of 15 studies found that focused therapy produced significantly stronger outcomes than radial therapy across several measures of erectile function. Men receiving focused treatment often report measurable improvements on clinical scoring systems. Definitions for these assessments and other health terms are available in our full Men’s Health & ED Glossary.

Earlier work supports this, too. A controlled pilot study published in European Urology followed patients for six months after focused therapy and showed that improvements were sustained throughout follow-up. More recent randomised, sham-controlled trials have reinforced these findings, with men treated by fSWT reporting significant improvements compared with placebo groups.

When it comes to radial shockwave therapy (rSWT), the picture is less convincing. Some retrospective studies have noted moderate improvement, but when radial therapy has been tested in controlled trials against sham procedures, the results often showed little or no meaningful difference.

To summarise the evidence base:

Focused shockwave therapy (fSWT): supported by several clinical studies and meta-analyses, with improvements that may last for months.
Radial shockwave therapy (rSWT): weaker support, with some trials suggesting its effects are no stronger than placebo.

While further research is ongoing, current data tends to support focused therapy as the more promising non-invasive option for erectile dysfunction.

Number and Duration of Treatment Sessions

Most treatment plans for focused shockwave therapy (fSWT) follow a fairly standard approach. A common protocol involves one session per week for around six weeks. Each appointment usually lasts 10-15 minutes and doesn’t require anaesthesia. The procedure itself is simple, and most men can return to their usual routine straight afterwards without any downtime.

Because radial shockwave therapy (rSWT) isn’t widely supported as an erectile dysfunction treatment, there isn’t a recognised or evidence-backed schedule in place. Many clinics that do offer radial treatment borrow protocols from musculoskeletal therapy, but these are designed for tendon or muscle pain, not erectile function. This lack of an established plan reflects the limited and inconsistent results that radial therapy has shown in clinical trials.

Side Effects and Safety Profile

Both focused and radial forms of shockwave therapy are non-surgical and considered safe when carried out by trained professionals registered with professional governing bodies such as the HCPC, GCC or GOsC. Side effects, when they do occur, are usually mild and short-lived.

With focused shockwave therapy (fSWT), most men describe the procedure as painless. Occasionally, some may notice slight bruising, tingling, or mild discomfort in the treated area. These effects typically pass within a day or two and don’t interfere with normal activities.

Radial shockwave therapy (rSWT) can feel quite different. Because the energy spreads more widely across the skin, treatment may be uncomfortable and sometimes requires a numbing cream beforehand. Short-term side effects such as redness, swelling, or skin irritation are more likely with radial therapy, although they are still temporary.

Overall, focused therapy tends to be better tolerated and requires little to no aftercare, while radial therapy has a higher chance of surface-level discomfort. Both approaches, however, are low-risk compared with invasive treatments.

Cost Considerations

The cost of treatment is an important factor for many men when weighing up their options. In the UK, focused shockwave therapy (fSWT) typically costs around £300-400 per session. With a usual course involving six weekly appointments, the total can add up to several thousand pounds. These prices reflect the use of medical-grade devices designed specifically for erectile tissue and supported by published clinical research.

By contrast, radial shockwave therapy (rSWT) is often advertised at a lower rate. The equipment is less costly for clinics to run, which explains the reduced price point. However, because the evidence for radial therapy in treating erectile dysfunction is weak, some men may find that it offers poor value despite being cheaper upfront.

In practical terms, focused therapy is the more expensive option, but it is also the one with stronger research support. Radial therapy may appear more affordable, yet its effectiveness for erectile function remains uncertain. For a full breakdown of 2026 fees, visit our ED Therapy Cost Guide 2026.

Patient Experience and Comfort

For many men, the treatment experience itself is just as important as the results.

With focused shockwave therapy (fSWT), sessions are usually described as comfortable and straightforward. The device makes a quiet clicking sound, often compared to the spark of a gas lighter, and the sensation is typically mild. Most men don’t need any numbing gel or anaesthetic, and because the procedure is short, they can walk out of the clinic and carry on with their day as normal.

Radial shockwave therapy (rSWT) tends to feel very different. The machine produces a louder, mechanical thumping noise, and the sensation on the skin can be uncomfortable. Many clinics apply a numbing cream before treatment to make it more tolerable. Even with this, men often report that radial therapy feels harsher, with some short-term irritation on the surface of the skin.

The contrast in comfort levels is often striking, and for some patients, this difference alone can influence which treatment they feel more willing to consider.

Long-Term Results and Follow-Up

The long-term impact of shockwave therapy for erectile dysfunction is still being studied, but the results so far are encouraging for focused therapy (fSWT). A controlled study in European Urology reported that improvements in erectile function were sustained for at least six months. More recent meta-analyses and randomised trials have suggested that some men continue to experience benefits beyond this timeframe, although outcomes can vary, and more long-term data is still needed.

For radial shockwave therapy (rSWT), the picture is less clear. Few trials have followed patients over time, and those that have generally failed to demonstrate lasting improvement. Without high-quality evidence on durability, it’s difficult to know whether radial therapy provides any meaningful benefit in the longer term.

At present, the best available research suggests that focused therapy may offer sustained improvements for several months, while radial therapy remains unproven for lasting results. As studies continue, clearer guidance on how long benefits can be expected, and for which patients, will hopefully emerge.

What to Expect During Your Visit

We understand that seeking treatment for ED requires discretion and sensitivity. Your journey at Bodytonic Clinic includes:

Private Consultation: A confidential discussion in one of our private treatment rooms (Canada Water, Stratford) to review your medical history.
Comfort-First Approach: Unlike radial therapy, which can be noisy and uncomfortable, our focused shockwave sessions are quiet and generally painless.
No Downtime: Sessions last 15-30 minutes, allowing you to return to your day immediately.
Professional Environment: All treatments are carried out by practitioners who specialise in shockwave technology.

Ready to Restore Your Confidence?

Don’t settle for surface-level treatments. Experience the precision of Focused Shockwave Therapy at one of our London locations. We offer flexible appointments from Monday to Saturday.

If you’d like to take that step, get in touch with us today to arrange a private appointment.

Our Catchment Areas & Nearby Practice Locations

Bodytonic Clinic delivers expert men’s health care, focused shockwave therapy (FSWT), and erectile dysfunction treatments across London from our flagship practices in Canada Water SE16 and Stratford E15 (near East Village E20). Our accredited clinical team regularly treats commuters, office workers, and patients traveling from nearby Bermondsey SE16, London Bridge SE1, Canary Wharf E14, and The City of London E1. We also welcome patients from across East and South East London, including Wapping E1W, Bow E3, Leyton E10, Leytonstone E10, Deptford SE8, and New Cross SE14.