Abstract: A handheld focused extracorporeal shock wave therapy (f-ESWT) device includes a plurality of piezoelectric elements, a power supply circuit, and a plurality of driver circuits. The piezoelectric elements are each configured to generate an individual shock wave. The power supply circuit is configured to output a first DC voltage and a second DC voltage. The first DC voltage greater than the second DC voltage. The driver circuits are each operably connected to the first DC voltage, the second DC voltage, and to a corresponding piezoelectric element of the plurality of piezoelectric elements. Each driver circuit includes a switching element electronically configurable in an open state and in a closed state. When the switching element is in the open state, the first DC voltage and the second DC voltage are applied to the corresponding piezoelectric element to pre-charge the corresponding piezoelectric element with a DC pre-charge voltage having a first polarity.