A new milestone in non-invasive pain management has been confirmed by a 2025 randomized, controlled study published in Lasers in Medical Science. Led by Dr. Nedelka and colleagues, the research demonstrates that high-energy focused extracorporeal shockwave therapy (fESWT) provides significant and lasting relief for patients suffering from chronic lumbar facet joint (FJ) pain.

Key Findings

Patients treated with fESWT experienced:

  • 64% reduction in pain after 12 months
  • 42% improvement in function based on Oswestry Disability Index (ODI) scores
  • Resolution of bone marrow edema on MRI in nearly 60% of cases
  • Reduction of neuropathic pain symptoms, an often-overlooked factor in traditional care

In comparison, patients in the placebo (sham) group saw only short-term improvements, with pain returning to near-baseline within months.

Why This Matters

Facet joint pain is one of the most common causes of chronic low back pain. Conventional treatment options such as steroid injections, opioids, or nerve ablations often provide only temporary relief and carry risks of side effects.

This study highlights that focused shockwave therapy is:

  • Non-invasive
  • Drug-free
  • Safe
  • Supported by long-term clinical evidence

Clinical Implications for Providers

Healthcare professionals treating patients with any of the following should take note:

  • Chronic low back pain
  • Facet joint syndrome
  • MRI evidence of Modic changes or bone marrow edema
  • Neuropathic pain features (e.g., burning, shooting pain)

Adding a focused shockwave therapy system—such as the STORZ DUOLITH SD1 Ultra—can significantly expand treatment capabilities and improve patient outcomes.

It is important to note that focused ESWT is not the same as radial or vibration-based therapy. Focused technology penetrates deeper into tissue, stimulates biological healing, reduces inflammation, and restores function at the source of pain.

Why Providers Should Consider Focused Shockwave Therapy

  • Backed by high-quality, peer-reviewed clinical research
  • Requires no downtime for patients
  • Seamlessly integrates into orthopedic, spine, chiropractic, and sports medicine practices

To learn more about focused shockwave or to develop a plan for approaching low back pain patients with shockwave, reach out to Kinas Medical’s 25-year shockwave experts at info@kinasmedical.com or call us at 770.612.8245.