The Swiss DolorClast method is suitable for the following indications: tendinopathies, muscle pain, ostheoartritis, non-union fractures, spasticity, cellulitis, acute and chronic soft tissue wounds and lymphedema.

The overall warranty of the products is 2 years. Only the maintenance kits in the handpiece have a lifetime limitation: 1 million impulses for the Evo Blue handpiece and 600’000 for the Power+ handpiece.

Compressor: the level of liquid in the bottle needs to be checked every month by the user. The filters of the compressor need to be checked every year by the user.
Device: the device needs to be cleaned regularly.
Handpiece: O’rings should be replaced every 200,000 impulses, for the maintenance kit, see the question above.

The Swiss DolorClast Method is the most clinically proven shock wave technology, combined with training to provide end-users with the best treatment outcomes.

The Swiss DolorClast Classic is FDA approved as a “Generator, Shock Wave, For Pain Relief” device, Class III. It is the only FDA approved shock wave radial device.
All our competitors have registered their radial devices with the FDA as Electric Therapeutic Massagers (Class I). They are not allowed to use the terminology shock wave device. Furthermore, doctors in the USA must not bill treatment performed with these devices according to any Current Procedural Terminology (CPT) code. Electric Therapeutic Massagers are intended for minor muscle aches and pain.

These terms are used by certain companies without providing technical and/or scientific details. It is reasonable to hypothesize that the term “defocused” should imply that there is no second focus point or no focus point at all, irrespective of whether the waves are convergent/concentrated, planar or radial. Furthermore, the term “planar” most probably means that the waves are linear and thus, neither convergent/focused nor divergent/radial.

Whether defocused and planar shock waves show any scientific/medical advantage over radial waves has not been demonstrated in the literature.

Most of the clinical studies proved the efficacy of the Swiss DolorClast Method with 3 sessions. Nevertheless, there is no contraindication to add more sessions as long as the patient’s condition improves. In most cases you should not go over 8 to 10 sessions.

We recommend keeping a one-week interval between two sessions to let the inflammation caused by shock wave treatment decrease. Nevertheless, if a patient is feeling well after 3-4 days without inflammatory signs such as redness or swelling, the next treatment can be given.

The higher the air pressure, the higher the energy density and cavitation level delivered to the patient (shown in Chitnis and Cleveland, 20061). Shock wave treatment is dose dependent. The air pressure should be set to the pain threshold of the patient.

References:
1) Chitnis PV, Cleveland RO. Acoustic and cavitation fields of shock wave therapy devices. In: Therapeutic Ultrasound. 5th International Symposium on Therapeutic Ultrasound (AIP Conference Proceedings Vol. 829). 1st edition. Edited by Clement GT, McDannold NJ, Hynynen K. College Park: American Institute of Physics; 2006:440-444.

Most of the clinical studies were designed using fixed pressure (often above 3 bar) to be reproducible. But they do not take into account the patient feedback. According to a systematic analysis of more than 100 published randomized controlled trials on ESWT by Schmitz et al. (2015)1 shock wave treatment is dose dependent: the higher the pressure, the better. A good practice during treatment is to ask for the patient’s biofeedback (pain level) and increase the pressure until you reach the patient’s pain threshold. You can do this at the beginning of treatment, after 500 impulses and after around 1200 impulses.