If you’re a chiropractor evaluating shockwave therapy devices, the StemWave vs. SoftWave comparison comes up often. Both are electrohydraulic systems, both are actively marketed to clinical practices, and both treat overlapping musculoskeletal presentations. They differ significantly, though, in wave delivery architecture, FDA regulatory standing, device-specific evidence depth, and day-to-day operational design.
For most chiropractic practices, SoftWave TRT is the stronger clinical choice. SoftWave (Gold Series) holds four FDA Class II 510(k) clearances for musculoskeletal and soft tissue indications, uses broad-focused electrohydraulic technology with a patented parabolic reflector, has been in clinical use for over two decades, and is supported by 240+ peer-reviewed publications. StemWave (Modus-F) is FDA-registered as a Class I device for minor aches and pains only, uses focused electrohydraulic delivery that converges at a narrow point, entered the U.S. market in 2022, and has no peer-reviewed studies on the device itself. The sections below break down each of those differences in clinical and operational terms.
StemWave vs. SoftWave: Side-by-Side Comparison
| Factor | StemWave (Modus-F) | SoftWave TRT (Gold Series) |
|---|---|---|
| Wave delivery | Focused electrohydraulic acoustic wave | Broad-focused electrohydraulic true shockwave |
| Treatment field | Converges at a narrow focal point | Wide and deep field via patented parabolic reflector |
| FDA status | Class I registered for minor aches and pains | Four FDA Class II 510(k) clearances |
| Device-specific evidence | No peer-reviewed studies on Modus-F | 240+ peer-reviewed publications |
| Country of origin | Manufactured in Turkey | Manufactured in Germany |
| U.S. market entry | 2022 | Over two decades of clinical use |
| Water system | Daily manual water replacement, mid-treatment bubble clearing | Closed-loop, auto-filtration |
| Unit weight | 110 lbs, over three feet tall | 36.5 lbs, tabletop footprint |
| Electrode lifespan | Up to 50,000 pulses | 100,000 to 500,000 pulses |
| Provider network | 500+ U.S. clinics | 1,400+ clinics across North America |
Technology and Delivery: What Each Device Actually Does
Shockwave is a category, not a single technology. The differences in delivery type between these two devices have direct clinical implications for chiropractic use.
StemWave (Modus-F) is a focused electrohydraulic acoustic wave device. Its energy converges at a narrow, localized point. It entered the U.S. market in 2022 and is manufactured in Turkey. Focused delivery can suit highly discrete pathology, but for the diffuse soft tissue presentations common in chiropractic practice, it requires more repositioning per session to cover the same treatment area.
SoftWave TRT (Gold Series) is a broad-focused true shockwave therapy device using electrohydraulic technology. Its patented parabolic reflector generates a wave field that is simultaneously wide and deep, treating larger tissue zones in fewer passes. It is manufactured in Germany and has been in clinical use for over two decades.
That distinction matters in a typical chiro treatment room. Conditions like lumbar paraspinal hypertonicity, posterior tibial tendinopathy, or iliopsoas tightness involve diffuse soft tissue zones, not discrete focal points. A broad-focused field covers those areas efficiently in fewer passes. A focused device converging at a single point requires more repositioning and may produce less consistent coverage across the same treatment zone.
The two devices also differ significantly in operational footprint:
- StemWave requires daily manual water replacement and mid-treatment bubble clearing. Electrode changes involve water and electrical components, introducing a sterility and safety consideration in clinical environments. At 110 lbs and over three feet tall, the unit and its applicator add physical demand on providers and staff across a full patient day.
- SoftWave’s closed-loop water system handles filtration automatically with no daily refilling or treatment interruptions. Its 36.5 lb tabletop footprint and lightweight ergonomic applicator reduce staff fatigue during high-volume clinical operations.
FDA Status: What It Means for Documentation, Marketing, and Compliance
The regulatory gap between these two devices is the most clinically consequential difference for a chiropractic practice.
StemWave (Modus-F): FDA Class I registered. Per StemWave’s own labeling, the Modus-F’s intended use is “addressing minor aches and pains in accordance with the User Manual.” StemWave states directly on its website that use of the product for any other purpose “has not been reviewed by the U.S. Food and Drug Administration and is considered off-label use.”
SoftWave TRT: Four FDA Class II 510(k) clearances, which require demonstrated safety and effectiveness for specific intended uses:
- Temporary relief of minor or chronic musculoskeletal or myofascial pain
- Temporary improvement of local blood circulation
- Activation of connective tissue
- Temporary relief of minor pain associated with burns
A 510(k)-cleared device has undergone a more rigorous FDA review process tied to specific clinical indications. A Class I registration confirms basic safety and manufacturing standards but does not carry the same clinical claim authority.
For a chiropractic practice treating tendinopathies, plantar fasciitis, Achilles injuries, lateral epicondylitis, sacroiliac joint dysfunction, and lumbar or cervical soft tissue conditions, that distinction is not abstract. A chiropractor using StemWave for chronic Achilles tendinopathy or calcific rotator cuff disease is working outside the device’s formal regulatory indication. That affects how you document patient treatments, how you describe the service in practice marketing, and how the device holds up under any audit or credentialing review.
Clinical Evidence: Category Literature vs. Device-Specific Data
No peer-reviewed clinical studies have evaluated the Modus-F or any other StemWave-branded device specifically. What exists is category-level evidence on focused electrohydraulic shockwave therapy as a class of technology, which can inform expectations but does not transfer device-to-device. Outcomes depend on energy delivery parameters, depth of penetration, and device architecture, and those vary meaningfully across focused systems.
What the focused ESWT literature shows:
- Calcific rotator cuff tendinopathy. A 2024 systematic review and meta-analysis of 21 RCTs found focused ESWT produced clinically significant improvements in pain and function compared to control interventions (Brindisino et al., 2024).
- Chronic plantar fasciitis. A 2026 systematic review and meta-analysis concluded ESWT, including focused modalities, is effective for pain reduction in chronic plantar fasciitis (Wu et al., 2026).
These findings establish a baseline for the focused electrohydraulic category, but the evidence is not device-specific to the Modus-F.
Device-specific evidence for SoftWave is substantially deeper. The current SoftWave Gold Li Series builds on the OrthoGold 100 and Urogold 100 platforms, both of which have been used in peer-reviewed clinical research. Two studies most relevant to chiropractic practice:
- Chronic plantar fasciitis (OrthoGold 100). A retrospective chart review of 108 patients (119 heels) treated with the OrthoGold 100 reported a mean VAS pain score reduction from 6.7 to 2.6, with significant improvements across Foot and Ankle Outcome Score subscales for pain, daily living, sports activity, and quality of life. 81.5% of patients were satisfied with the procedure at final follow-up (Fansa et al., 2021).
- Chronic low back pain (OrthoGold 100). A 2022 study comparing ultrasound-guided versus blind ESWT across focused, defocused, and radial modes in 26 patients with chronic low back pain used the OrthoGold 100 alongside the Storz Duolith SD1 Ultra. Defocused (broad-focused) delivery was noted as effective for back muscle pathology, with VAS pain reductions across treatment arms (Kalika & Bubnov, 2022).
Beyond those, broader category evidence supports ESWT for the indications that fill most chiropractic schedules. A 2021 systematic review and meta-analysis of RCTs found ESWT significantly reduced pain intensity and disability in chronic low back pain at short-term follow-up (Yue et al., 2021), and a foundational review documented ESWT effectiveness across Achilles tendinopathy, plantar fasciitis, lateral epicondylitis, and rotator cuff pathology (Maffulli et al., 2014).
SoftWave TRT is backed by over 240 peer-reviewed publications, more than $25 million in research and development investment, and more than 30 active clinical trials, with adoption at Mayo Clinic, Cleveland Clinic, Hospital for Special Surgery, UCLA, and Harvard. That volume of device-specific evidence shapes both clinical confidence and the patient conversations providers have when explaining why they chose this technology for their practice.
Practice Integration, ROI, and Operational Fit
Per-session patient pricing. Both devices carry similar per-session patient pricing, typically $150 to $250, with treatments not covered by most insurance plans. HSA and FSA funds are often applicable.
Consumables and per-treatment labor. SoftWave electrodes support 100,000 to 500,000 pulses; StemWave electrodes are rated at up to 50,000 pulses per electrode. At clinical volume, that gap has a direct and ongoing impact on consumable costs. SoftWave’s broader coverage zone also means fewer repositioning passes per session, higher patient throughput per day, and lower per-treatment labor time.
Training, service, and provider network. SoftWave TRT provides certified on-site training conducted alongside real patient sessions, generating revenue for the practice during onboarding rather than requiring off-site travel and downtime. A dedicated service department with nationally certified technicians provides ongoing technical support. SoftWave holds 47 patents with additional patents pending, and operates a provider network of over 1,400 clinics across North America. StemWave reports a network of over 500 U.S. clinics and offers training support, though structure varies by region and sales partner.
Selecting the Right Shockwave Platform for Your Practice
The right platform depends on the clinical presentations driving your patient volume and the operational realities of your practice. Energy delivery architecture, FDA clearance scope, treatment field, and the strength of device-specific evidence shape both clinical outcomes and how the platform integrates into a regenerative service line. Capital cost matters, but it rarely matters more than fit.
SoftWave TRT meets those priorities through clinical adoption few competitors match. The platform is in active use at Mayo Clinic, Cleveland Clinic, HSS, and team medical staffs across the NFL, NBA, MLB, and PGA, with more than two decades of clinical use and over 240 peer-reviewed studies supporting the underlying technology. The operational case is equally direct: broader treatment protocols, fewer repositioning passes per patient, and lower per-treatment labor cost than focused alternatives, supported by structured on-site onboarding and ongoing clinical education. Become a SoftWave Provider or schedule a demo to evaluate fit for your patient mix and practice goals.
Frequently Asked Questions
Is StemWave FDA-cleared for chiropractic use?
StemWave’s Modus-F is FDA Class I registered for “addressing minor aches and pains.” Use for any other purpose, including specific musculoskeletal indications chiropractors typically treat, is considered off-label per StemWave’s own labeling.
What FDA clearances does SoftWave hold?
SoftWave TRT holds four FDA Class II 510(k) clearances: temporary relief of minor or chronic musculoskeletal or myofascial pain, temporary improvement of local blood circulation, activation of connective tissue, and temporary relief of minor pain associated with burns.
Which shockwave machine is best for a chiropractic practice?
For most chiropractic practices, SoftWave TRT is the stronger clinical choice. Its broad-focused delivery covers the diffuse soft tissue zones common in chiropractic case mix in fewer passes, its four FDA Class II clearances cover the indications chiropractors most often treat, and its operational design (closed-loop water system, tabletop footprint, longer electrode lifespan) is built for high-volume clinical days.
How much does shockwave therapy cost per session?
Both StemWave and SoftWave treatments typically cost $150 to $250 per session in outpatient settings, paid out of pocket. Most insurance plans do not cover shockwave therapy, but HSA and FSA funds are often applicable.
Can chiropractors legally use shockwave therapy?
Shockwave therapy falls within scope of practice for chiropractors in most U.S. states, though specific scope language and indication coverage vary by state board. Verify with your state board of chiropractic examiners and your malpractice carrier before adding shockwave to your practice.
