Comparison of the effectiveness of extracorporeal shock wave therapy and high-intensity laser therapy in patients with knee osteoarthritis: a single-blind randomized clinical trial

Abstract Objective The aim of this single-blind randomized clinical trial was to compare the effectiveness of extracorporeal shock wave therapy (ESWT) and high-intensity laser therapy (HILT) on clinical parameters in knee osteoarthritis. Patients and methods A total of 60 patients aged between 40 and 75 years, diagnosed with primary knee osteoarthritis and admitted to the Department of Physical Medicine and Rehabilitation, Gaziantep University, were included in the study. Sixty patients were randomized into two groups using the envelope method. Group 1 received ESWT (3 sessions/week, total of 6 sessions), and Group 2 received HILT (5 sessions/week, total of 10 sessions) for a duration of 2 weeks. A standardized home exercise program was applied to all patients. Patients were evaluated before treatment, after treatment, and at the 6th week post-treatment using the Visual Analog Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Lequesne algofunctional knee index. Statistical analyses were performed using SPSS 22.0 (IBM Corp., Armonk, NY, USA), including t -test, chi-square, ANOVA, and Pearson correlation; significance was set at p < 0.05. Results In both groups, compared to pre-treatment values, significant improvements were observed in VAS ( p < 0.001), WOMAC pain, stiffness, and physical function ( p < 0.001), as well as Lequesne index scores ( p < 0.001) after treatment and at the 6th week post-treatment. No significant differences were found between the groups in intergroup comparisons. Conclusion Both ESWT and HILT are effective and safe treatment methods for reducing pain, disease severity, and improving physical function in knee osteoarthritis. Our findings support broader clinical use of both treatments, though further comprehensive studies are required. Key Points • In both the ESWT and laser groups, significant improvements were observed in VAS, WOMAC pain, stiffness, and physical function and Lequesne index scores at 6 weeks post-treatment compared to pre-treatment values. • In patients with knee osteoarthritis receiving ESWT and HILT treatment, improvement was achieved in terms of pain and functionality, but our study showed that neither agent was superior to the other.