Chronic low back pain (LBP) is more than just a nuisance—it’s a leading cause of disability worldwide. While many patients are told their only options are “managing” the pain with pills or undergoing invasive surgery, a breakthrough in regenerative medicine is changing the narrative.
Specifically, Focused Extracorporeal Shockwave Therapy (fESWT) is emerging as a premier treatment for one of the most common, yet overlooked, culprits of back pain: the facet joints.
Understanding the Culprit: Facet Joint Syndrome
Your spine is held together by small, hinge-like joints located between each vertebra called facet joints. These joints allow you to twist and bend. Over time, due to aging, poor posture, or repetitive stress, these joints can become inflamed, leading to a condition known as Facet Joint Syndrome.
Symptoms often include:
- Deep, aching pain in the lower back that may radiate into the buttocks or thighs.
- Increased pain when leaning backward or twisting.
- Stiffness that is often worse in the morning.
The Science: 2025 Research Validates Focused Shockwave
While shockwave therapy has been used for years in sports medicine, a landmark 2025 randomized controlled trial (Nedelka et al.) has provided the “smoking gun” for its efficacy in treating the spine. The study focused specifically on patients with chronic lumbar facet joint pain, and the results were nothing short of transformative:
- 64% Pain Reduction: Patients reported a significant drop in pain intensity that lasted at least 12 months.
- 42% Improved Function: Significant increases in mobility and the ability to perform daily tasks (measured by the Oswestry Disability Index).
- Healing the Bone: For the first time, MRI scans showed a resolution of bone marrow edema (swelling inside the bone) in nearly 60% of treated patients—proving that shockwave doesn’t just “mask” pain; it heals the structure.
- Neuropathic Relief: The therapy also successfully reduced shooting and burning sensations often associated with nerve irritation.
Why “Focused” Matters: Depth vs. Surface
It is vital to distinguish between Radial and Focused shockwave therapy.
- Radial Shockwave: Spreads energy superficially and is excellent for surface-level muscle tension.
- Focused Shockwave: Uses high-energy acoustic waves that converge at a specific, adjustable depth.
Because facet joints are located deep within the spinal architecture (often 4–6 cm beneath the skin), focused technology is essential. It allows a practitioner to “aim” the healing energy directly at the joint without losing power at the surface.
Clinical Success in Tampa: The Dr. Hanson Advantage
In Tampa, Florida, Dr. Josh Hanson has become a leading figure in applying these advanced regenerative protocols. At his clinic, Hanson Complete Wellness, he has seen remarkable success treating complex low back cases that failed to respond to traditional physical therapy or injections.
“Many patients come to us after being told they have ‘bone-on-bone’ issues or need a fusion,” says Dr. Hanson. “By using focused shockwave, we can often trigger the body’s own healing response, reducing inflammation and restoring joint glide without a single incision.”
Dr. Hanson’s approach combines a “lost art”—the comprehensive physical exam—with gold-standard technology. His success with focused shockwave is built on the understanding that back pain is often a combination of joint dysfunction and myofascial trigger points, both of which fESWT is uniquely equipped to treat.
How It Works: The Biological “Reset”
Focused shockwave therapy works through a process called mechanotransduction. The acoustic waves create micro-pressure on the cells, which triggers:
- Neovascularization: The growth of new blood vessels to nourish damaged joints.
- Nitric Oxide Release: A natural vasodilator that flushes out inflammatory “trash.”
- Substance P Modulation: Reducing the chemical responsible for transmitting pain signals.
- Stem Cell Activation: Recruiting the body’s natural repair cells to the site of the injury.
Is Focused Shockwave Right for You?
If you have been struggling with chronic low back pain, particularly if it feels “stiff” or gets worse with standing, your facet joints may be the cause. Focused shockwave therapy offers a non-invasive, drug-free path back to an active life.
We offer an initial “Pain Mapping” consultation & Treatment where we discover the true cause of your back pain by using the focused shockwave machine and seeing which tissues “react”. It let’s us both know – 1. That you are a candidate for full treatment & recover and 2. That you ARE a responder to focused shockwave there.