Piezo-ceramic elements are geometrically arranged on a concave surface so that when they are excited simultaneously by a brief, high-voltage pulse, they expand by a few micrometers to generate a pressure pulse. The piezo elements are precisely aligned so that each pressure pulse generated focuses in a specific area. This precise focusing of the pulse creates a shockwave at the point of focus. The piezo shockwaveˇ¦s "direct focusing" technology eliminates the need for additional reflectors resulting in a compact therapy source design and a precise and well defined focal zone. The virtually painless therapy is applied quietly and energy levels can be freely adjusted with almost no adverse effect on the size of the focal zone. The piezo shockwave technology is extremely durable. Piezo shockwave therapy sources are available with single-layer or double-layer technology, depending on the required energy levels, with peak pressures of up to 82 MPa.

Extracorporeal shockwaves are mechanical stressors capable of inducing biochemical changes in living tissue; at a molecular level these changes can influence gene expression in cells and, if used selectively, can produce specific reactions in tissue. This process is referred to as mechanotransduction. Mechanical stimuli can affect almost all cellular functions in living tissue, including growth, cell differentiation, cell migration, protein synthesis, physiological apoptosis and tissue necrosis. New studies have shown that ESWT is able to stimulate the endogenous production of lubricin in tendons and septa. Scientific studies and publications, using the highly accurate piezo-shockwave technology, have confirmed the effectiveness of focused shockwaves for various common musculoskeletal conditions as well as trigger point diagnosis and treatment. ESWT is one of the few medical technologies which can treat chronic pain syndromes of the musculoskeletal system effectively by jump-starting self-healing processes.

Chronic pain of the musculoskeletal system is one of the most common debilitating conditions affecting people at epidemic proportions. The majority of these painful conditions are the result of enthesiopathies such as tennis elbow, calcaneal heel spurs, or calcifications of the shoulder joint. Myofascial trigger points have also increasingly been diagnosed as major causes of chronic pain. Focused ESWT has now become established as a useful method for the diagnosis and treatment of many acute and chronic pain syndromes of the musculoskeletal system.

Tennis elbow, Calcific tendonitis of the shoulder, Golferˇ¦s elbow, Trigger point treatment, Pseud-Arthrosis, Greater trochanteric pain syndrome, Patellar tip syndrome, Medial tibial stress syndrome, Plantar talalgia and Achilles tendinopathy can be treated by Piezo-ceramic elements.