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Class IV laser vs shockwave therapy: how the two technologies differ
Class IV laser therapy and extracorporeal shockwave therapy (ESWT) use different kinds of energy and are specified in different ways. This guide explains the difference and the figures to compare when you assess equipment for a clinic.
The short answer
A Class IV therapy laser delivers light. A shockwave device delivers short acoustic pressure pulses. They are different physical agents, so they are not interchangeable items on a specification sheet. Many clinics own both. Which one suits a given patient is a clinical decision for the treating clinician, based on the condition, the evidence for it and the manufacturer's instructions for use.
Side by side
| Feature | Class IV laser therapy | Shockwave therapy (ESWT) |
|---|---|---|
| Energy type | Light (photons), in the red and near-infrared range | Acoustic pressure pulses |
| How it reaches the patient | A fibre carries light to a handpiece with a lens, held on or near the skin | A handpiece projectile strikes a transmitter placed on the skin with gel |
| Main parameters on a spec sheet | Wavelengths (nm); continuous and peak power (W); pulse frequency (Hz); lens options | Pressure (bar); energy flux density, EFD (mJ/mm²); frequency (Hz); pulses per treatment; transmitter sizes |
| Safety equipment | Protective eyewear for everyone in the room, controlled access, trained operators | Operator training; correct transmitter and settings per the instructions for use |
| Example in the TRIMAX range | Summus Horizon, P4 and H1 (650 to 980 nm; Horizon has independent control of each wavelength) | LiKAWAVE VARIO 3i (up to 6.5 bar; up to 0.88 mJ/mm²; 1 to 25 Hz; transmitters S to XXL) |
Figures are the manufacturers' published specifications as listed on the TRIMAX product pages.
How a Class IV laser is specified
Laser class describes hazard, not performance. Wavelength decides how light interacts with tissue, and power and time decide the energy delivered. For pulsed output, average power matters more than the peak. See Wavelength, power and dose: reading a Class IV laser specification for the full checklist.
How a shockwave device is specified
ESWT devices generate pressure pulses in the handpiece; on the LiKAWAVE VARIO the shockwave is generated pneumatically. Specifications usually list the pressure range, the energy flux density (EFD), the pulse frequency, the maximum pulses per treatment and the available transmitters, which set the treatment depth and area. LiKAMED describes its wide-focus technology as spreading the wave over an area instead of a single focal point. Check how a system displays and records the settings and number of pulses delivered.
The Medical Device Authority register entry for the LiKAWAVE VARIO i-Family states that shockwave treatment must be performed only by persons with medical training, that improper use may cause serious injury to patients, and that the unit is intended for use indoors.
Uses as listed by the manufacturers
These are the manufacturers' own listed applications, not a comparison of effectiveness:
- Summus Medical Laser lists topical heating, temporary relief of minor muscle and joint pain and stiffness, minor arthritis pain and muscle spasms, and a temporary increase in local blood circulation.
- LiKAMED lists plantar fasciitis and heel spur, calcific shoulder, tennis elbow, chronic tendinopathies and muscle pain among the uses of the VARIO 3i.
Evidence differs by condition and by device. A qualified clinician should decide the choice of therapy.
Questions to ask a supplier
- Is the device registered with the Medical Device Authority (MDA), and what is the registration number?
- Which parameters can the operator change, and which are fixed by protocol?
- Which accessories are consumables, and what do they cost to replace (lenses, transmitters, projectiles)?
- What warranty applies, who installs and trains your staff, and who services the unit in Malaysia?
- Can you see a demonstration with your own typical patients' set-up?
Next step
TRIMAX supplies Summus Medical Laser Class IV systems and LiKAWAVE shockwave devices in Malaysia, with installation, training and service from Kuala Lumpur. Talk to a product specialist to arrange a demonstration.
This article is general technical information. A qualified clinician should decide whether a therapy is suitable for each patient and follow the manufacturer's instructions for use.
Common questions
Is a Class IV laser the same as a shockwave device?
No. A Class IV therapy laser delivers light in the red and near-infrared range. A shockwave device delivers acoustic pressure pulses. They are specified with different parameters.
Which parameters should I compare on a shockwave machine?
Pressure, energy flux density (EFD), pulse frequency, the maximum pulses per treatment, the available transmitters, and how the device displays and records the settings.
Which parameters should I compare on a Class IV laser?
Wavelengths first, and whether each can be controlled independently. Then continuous, average and peak power, pulse modes and frequency range, lens options and dose display.
Does TRIMAX supply both in Malaysia?
Yes. TRIMAX supplies Summus Medical Laser and LiKAWAVE shockwave systems, with installation, staff training, preventive maintenance and repair.
Are the LiKAWAVE and Summus devices registered with the Medical Device Authority (MDA)?
Yes. TRIMAX Healthcare Sdn. Bhd. is the authorised representative on the MDA register for the LiKAWAVE VARIO i-Family (registration GB5904624-180955) and the Summus Medical Laser Platinum Series (registration GC3899624-175786). Registration numbers are listed on each product page.