Combined Efficacy of Instrument-Assisted Soft Tissue Mobilization and Extracorporeal Shockwave Therapy in Myofascial Pain Syndrome Associated with Knee Osteoarthritis: A Case Report

Abstract

Knee osteoarthritis (KOA) is a progressive degenerative condition associated with pain, stiffness, and
functional limitations, particularly in older individuals. Myofascial pain syndrome (MPS), characterized by
the presence of trigger points (TrPs), significantly contribute to pain and disability in KOA. This case report
is the first to report the combined effect of Instrument-Assisted Soft Tissue Mobilization (IASTM) and
Extracorporeal Shock Wave Therapy (ESWT) in the treatment of myofascial pain syndrome associated with
KOA. The patient was a 52-year old female with knee pain and TrPs around affected hamstrings and
quadriceps muscle, reduced muscle strength, and difficulty in performing daily functional activities. The
intervention consisted of IASTM and ESWT, administered three times per week for a duration of four weeks.
Baseline assessment was taken for pain intensity, muscle strength, high-sensitivity C-reactive protein (hs-
CRP), and functional activity. Following the treatment period, the patient showed considerable
improvements in pain intensity, muscle strength, and functional performance. These findings suggest that,
integration of IASTM and ESWT may be an effective treatment approach for managing myofascial pain
syndrome associated with KOA.