Focal Extracorporeal Shock Wave Therapy With Two Different Dosing Regimens for Chronic Low Back Pain (ESWT-LBP)

June 9, 2026 updated by: Armando Tonatiuh Avila Garcia

Effects of Two Dosing Regimens of Focal Extracorporeal Shock Wave Therapy in Patients With Chronic Low Back Pain: A Randomized Clinical Trial

The purpose of this clinical trial is to evaluate and compare the efficacy of two different dosing regimens of focal extracorporeal shock wave therapy (F-ESWT) in patients diagnosed with chronic mechanical low back pain. Participants will be randomly assigned to one of two experimental groups to receive different parameters of shock wave intervention. The main objective is to determine which dosing scheme provides a more significant reduction in pain intensity and a better recovery of lumbar function.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Chronic mechanical low back pain is a common musculoskeletal condition that leads to functional disability and diminished quality of life. While focal extracorporeal shock wave therapy (F-ESWT) has emerged as a non-invasive treatment option to promote tissue regeneration and modulate inflammation, clinical protocols lack precise standardization regarding energy density and session distribution.

This randomized, double-blind clinical trial aims to analyze the clinical effects of two specific dosing regimens of F-ESWT. Eligible participants from the Physical Medicine and Rehabilitation Service will be randomly allocated to either Group A or Group B. Both groups will undergo targeted applications to the lumbar region using predefined therapeutic parameters detailed in the protocol.

Clinical evaluations will be performed at baseline and during post-treatment follow-up periods. Pain intensity, functional disability, and localized mobility will be measured using validated clinical tools to define which dosing scheme optimizes short-term and mid-term patient recovery.

Study Type

Interventional

Enrollment (Estimated)

60

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

  • Name: Armando Tonatiuh Ávila García, MD
  • Phone Number: 43021 523339424400
  • Email: atavila@hcg.gob.mx

Study Contact Backup

Study Locations

  • Mexico
    • Jalisco
      • Guadalajara, Jalisco, Mexico, 44280
        • Antiguo Hospital Civil de Guadalajara "Fray Antonio Alcalde", Servicio de Medicina Física y Rehabilitación
        • Contact:
          • Armando Tonatiuh Ávila García, MD
          • Phone Number: 71234 523339424400
          • Email: atavila@hcg.gob.mx
        • Contact:
        • Principal Investigator:
          • Armando Tonatiuh Ávila García, MD
        • Sub-Investigator:
          • Ana Lilia Villagrana Rodríguez, MD
        • Sub-Investigator:
          • Carlos Fernando Godínez González, MD
        • Sub-Investigator:
          • Ismael Caballero Quirarte, MD
        • Sub-Investigator:
          • Daniel Miller Serrano, MD
        • Sub-Investigator:
          • Aram Jesús Gómez Nájera, MD
        • Sub-Investigator:
          • José de Jesús Sandoval Zuno, MD

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Individuals of both sexes.
  • Age between 18 and 65 years.
  • Clinical diagnosis of mechanical chronic low back pain (cLBP), defined as pain localized between the lower costal margin and the gluteal fold, with at least 12 weeks of evolution.
  • Lumbar pain intensity of at least 5/10 on the Numeric Pain Rating Scale (NPRS).
  • Predominantly mechanical pain, exacerbated by activities such as prolonged standing, trunk movements, extension, or lumbar rotation, and without clinical data of predominant radicular pain.
  • Plain radiograph of the lumbar spine available as part of the baseline evaluation.
  • Ability to attend all 4 treatment sessions and subsequent follow-up evaluations.
  • Signed informed consent form previously approved by the Institutional Review Board / Research Ethics Committee.

Exclusion Criteria:

  • Low back pain of probable non-mechanical origin or secondary to a specific cause that substantially modifies clinical management.
  • Clinical data of predominant lumbar radiculopathy, including pain radiating below the knee with a dermatomal distribution, focal motor deficit, objective sensory alterations, or compatible reflex changes.
  • Diagnosis or suspicion of cauda equina syndrome.
  • History of previous lumbar spine surgery.
  • Current vertebral fracture or recent history of lumbar fracture.
  • Spondylolisthesis grade II or higher.
  • Significant structural scoliosis or severe lumbar deformity that prevents treatment standardization.
  • Suspicion or evidence of a tumor, infection, spondylodiscitis, or axial inflammatory disease.
  • Severe clinically documented osteoporosis or history of vertebral fragility fracture.
  • Pregnancy or lactation.
  • Coagulation disorder, use of anticoagulants at therapeutic doses, or a hemorrhagic condition that increases procedure risk.
  • Previous epidural infiltration, facet block, radiofrequency, or other lumbar interventional procedure within a recent period defined by the protocol.
  • Current treatment with another physical rehabilitation modality or instrumental therapy directed at low back pain, if it cannot be suspended during the intervention period.
  • Current use of nonsteroidal anti-inflammatory drugs (NSAIDs) that the patient cannot suspend according to the study indications.
  • Concomitant neurological, rheumatological, oncological, or musculoskeletal disease that significantly interferes with pain or disability evaluation.
  • Cognitive impairment, decompensated psychiatric disorder, or any condition that prevents understanding instructions, answering questionnaires, or completing follow-up.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Group A: Regimen 1
Participants in this group will receive focal extracorporeal shock wave therapy (F-ESWT) administered to the lumbar region using the first specific dosing scheme, characterized by designated energy flux density and session frequency parameters as outlined in the protocol.
Device: Focal Extracorporeal Shock Wave Therapy (F-ESWT)
Non-invasive shock wave therapy applied to specific painful lumbar points using the BTL-6000 FSWT focused shockwave device. The equipment delivers focused acoustic energy to modulate localized pain and stimulate tissue response, according to the designated dosing regimens established in the study protocol.
Experimental: Group B: Regimen 2
Participants in this group will receive focal extracorporeal shock wave therapy (F-ESWT) administered to the lumbar region using the second specific dosing scheme, characterized by alternative energy flux density and session frequency parameters as outlined in the protocol.
Device: Focal Extracorporeal Shock Wave Therapy (F-ESWT)
Non-invasive shock wave therapy applied to specific painful lumbar points using the BTL-6000 FSWT focused shockwave device. The equipment delivers focused acoustic energy to modulate localized pain and stimulate tissue response, according to the designated dosing regimens established in the study protocol.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change from Baseline in Pain Intensity on the Visual Analog Scale (VAS)
Time Frame: Baseline, 2 months, 4 months, 6 months, and 12 months post-treatment
Pain intensity will be evaluated using a 100-mm Visual Analog Scale (VAS), where 0 mm represents "no pain" and 100 mm represents "the worst possible pain". Higher scores indicate greater pain severity. The outcome is measured as the change in millimeter scores from baseline to each subsequent post-treatment follow-up assessment.
Baseline, 2 months, 4 months, 6 months, and 12 months post-treatment

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change from Baseline in Lumbar Functional Disability Using the Oswestry Disability Index (ODI)
Time Frame: Baseline, 2 months, 4 months, 6 months, and 12 months post-treatment
Functional disability associated with mechanical low back pain will be measured using the Oswestry Disability Index (ODI). The questionnaire consists of 10 items assessing limitations in daily activities. Total scores range from 0% (no disability) to 100% (maximum disability). Higher percentages reflect greater functional impairment.
Baseline, 2 months, 4 months, 6 months, and 12 months post-treatment
Incidence of Treatment-Related Adverse Events
Time Frame: From the first treatment session up to 12 months post-treatment
Safety and tolerability will be evaluated by monitoring and recording the frequency, severity, and type of any localized adverse events associated with focal extracorporeal shock wave therapy (F-ESWT), such as transient erythema, mild bruising, or temporary pain increase.
From the first treatment session up to 12 months post-treatment

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Armando Tonatiuh Avila Garcia

Investigators

  • Principal Investigator: Tonatiuh Avila Ávila García, MD, Hospital Civil de Guadalajara

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

June 15, 2026

Primary Completion (Estimated)

December 30, 2027

Study Completion (Estimated)

January 30, 2028

Study Registration Dates

First Submitted

June 9, 2026

First Submitted That Met QC Criteria

June 9, 2026

First Posted (Actual)

June 12, 2026

Study Record Updates

Last Update Posted (Actual)

June 12, 2026

Last Update Submitted That Met QC Criteria

June 9, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • CEI 121/26

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

De-identified individual participant data underlying the results reported in future publications (including text, tables, and figures) will be made available to researchers for secondary academic and clinical analyses.

IPD Sharing Time Frame

Data will become available beginning 6 months after main publication and will remain accessible for up to 3 years.

IPD Sharing Access Criteria

Data will be shared with qualified researchers who provide a methodologically sound proposal. Requests should be directed to the corresponding investigator.

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • ICF

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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