Extracorporeal shock wave therapy (ESWT) and Kinesio taping (KT) are used for musculoskeletal disorders (MSKDs). Despite limited supporting evidence and misalignment with contemporary rehabilitation approaches, they endure in practice to relieve pain and enhance function; however, their comparative effectiveness remains uncertain.
Objectives
This systematic review aimed to compare the effects of ESWT versus KT on pain, functionality, strength, and quality of life (Qol) in individuals with MSKDs.
Methods
Systematic searches of randomized clinical trials (RCTs) were performed across six databases from inception to June 2025. Two researchers independently screened titles, abstracts, and full-text articles. Risk of bias was assessed using the revised Cochrane Collaboration tool (RoB 2.0). Meta-analysis was conducted using RevMan 5.4 software, and the certainty of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach.
Results
Fifteen RCTs (n = 907) were included. Comparative analysis revealed no statistically significant difference between ESWT and KT in improving pain 0.12 (95% CI: −0.17, 0. 41, p = 0.41), function 0.04 (95% CI: −0.43, 0.51; P = 0.86), strength 0.68 (95% CI: −7.46, 8.81; P = 0.87), or Qol (P >> 0.05) in the short-term. However, medium-term favored ESWT in pain −1.15 (95% CI: −1.52, −0.78, p < 0.00001) and function −0.89 (95% CI: −1.35, −0.42; P = 0.0002) over KT. The certainty of evidence for all outcomes was very low.
Conclusions
Very low-quality evidence indicates no difference between ESWT and KT in improving pain, function, strength, and Qol in patients with MSKDs in the short-term, with a possible medium-term advantage for ESWT in improving pain and function. Our findings should be placed within the context of limited and geographically narrow evidence. High-quality, long-term RCTs are warranted.
Other: No funding was received for this review. PROSPERO registration number (CRD42024559635).
GillTKMittintyMMMarch LM, et al.Global, regional, and national burden of other musculoskeletal disorders, 1990–2020, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021. Lancet Rheumatol2023; 5: e670–e682.
2.
HumphreysJHVerstappenSM. The burden of musculoskeletal disease. Med (United Kingdom)2022; 50: 82–84.
3.
de Melo Espirito SantoCSantosVSKamperSJ, et al.Overview of the economic burden of musculoskeletal pain in children and adolescents: a systematic review with meta-analysis. Pain2024; 165: 296–323.
4.
DubéMOLangevinPMassé-AlarieH, et al.Do patients’ preferences and expectations match clinical guidelines? A survey of individuals seeking private primary care for a musculoskeletal disorder. Musculoskelet Sci Pract74. Epub ahead of print 2024. DOI: 10.1016/j.msksp.2024.103195
5.
ZadroJO’KeeffeMMaherC. Do physical therapists follow evidence-based guidelines when managing musculoskeletal conditions? Systematic review. BMJ Open9. Epub ahead of print 2019. DOI: 10.1136/bmjopen-2019-032329
6.
AyberkBÖzgülBBuryJ, et al.Rotator Cuff disorders: a survey of current physiotherapy practice in Turkiye. Turkish J Physiother Rehabil2023; 34: 346–356.
7.
BanerjeeGJohnsonM. Should kinesiology taping be used to manage pain in musculoskeletal disorders? An evidence synthesis from systematic reviews. Physiother - J Indian Assoc Physiother2020; 14: 17.
8.
PaperR. Review paper A comprehensive review of extracorporeal shockwave therapy in the management of musculoskeletal disorders : efficacy. Mech Clin Appl2024; 7: 831–838.
9.
KirdarNKanyilmazT. Efficacy of kinesio taping versus extracorporeal shock wave therapy in the short term for the calcaneal spur. J Exp Clin Med2023; 40: 57–61.
10.
ŞahV. Comparative effects of conventional physical therapy, Kinesio taping and extracorporeal shock wave therapy in acute upper trapezius myofascial pain syndrome. East J Med2023; 28: 107–114.
11.
GulerTYildirimP. Comparison of the efficacy of kinesiotaping and extracorporeal shock wave therapy in patients with newly diagnosed lateral epicondylitis: a prospective randomized trial. Niger J Clin Pract2020; 23: 704–710.
12.
GünaydinÖEBayrakci TunayV. Comparison of the added effects of kinesio taping and extracorporeal shockwave therapy to exercise alone in knee osteoarthritis. Physiother Theory Pract2022; 38: 661–669.
13.
TezelNUmayEBulutM, et al.Short-Term efficacy of kinesiotaping versus extracorporeal shockwave therapy for plantar fasciitis: a randomized study. Saudi J Med Med Sci2020; 8: 181–187.
14.
GençbayMBIşıksaçanNKoşerM, et al.The effectiveness of extracorporeal shock wave and kinesio tape treat ments in shoulder impingement syndrome. Nobel Medicus2019; 15: 56–62.
15.
EraslanLYuceDErbiliciA, et al.Does kinesiotaping improve pain and functionality in patients with newly diagnosed lateral epicondylitis?Knee Surgery, Sport Traumatol Arthrosc2018; 26: 938–945.
16.
OrdahanBTürkoğluGKarahanAY, et al.Extracorporeal shockwave therapy versus kinesiology taping in the management of plantar fasciitis: a randomized clinical trial. Arch Rheumatol2017; 32: 227–233.
17.
ElsabryMYMahmoudSAIbrahimAS. Shockwave therapy versus therapeutic ultrasound and kinesio tape in lateral epicondylitis. Al-Azhar Int Med J2024; 5: 21.
18.
SultanogluTESultanogluH. Comparison and short term effect of extracorporeal shock wave therapy and kinesiotaping in treatment of lateral epicondylitis. J Basic Clin Heal Sci2020; 4: 218–223.
19.
ZhaoJJiangY. The therapeutic effect of extracorporeal shock wave therapy combined with kinesio tape on plantar fasciitis. J Back Musculoskelet Rehabil2023; 36: 1203–1211.
20.
AhmedAMEl KoseirySMAbou El EneinMF, et al.Extra Corporeal Shock Wave Versus Kinesio Tape in the Treatment of Carpal Tunnel Syndrome in Post- Menopausal Women. NeuroQuantology20.Epub ahead of print 2022. DOI: 10.14704/nq.2022.20.7.NQ33142
21.
OrhanÖAğırHSarıkayaB, et al.Pain relief and functional improvement provided by extracorporeal shock wave therapy in plantar fasciitis is better than corticosteroid injection and kinesio taping: a randomized trial. Turkish J Phys Med Rehabil2023; 69: 469.
22.
ÖzmenTKoparalSSKarataşÖ, et al.Comparison of the clinical and sonographic effects of ultrasound therapy, extracorporeal shock wave therapy, and Kinesio taping in lateral epicondylitis. Turkish J Med Sci2021; 51: 76–83.
23.
YalçınÜ. Comparison of the effects of extracorporeal shockwave treatment with kinesiological taping treatments added to exercise treatment in myofascial pain syndrome. J Back Musculoskelet Rehabil2021; 34: 623–630.
24.
SchmitzCCsászárNBMMilzS, et al.Efficacy and safety of extracorporeal shock wave therapy for orthopedic conditions: a systematic review on studies listed in the PEDro database. Br Med Bull2015; 116: 115–138.
25.
MaffulliNMaffulliG. The assessment of the effectiveness of extracorporeal shock wave therapy (ESWT) for soft tissue injuries (ASSERT): the future. Muscles Ligaments Tendons J2018; 8: 457–458.
26.
YaoGChenJDuanY, et al.Efficacy of extracorporeal shock wave therapy for lateral epicondylitis: A systematic review and meta-analysis. Biomed Res Int2020. Epub ahead of print 2020. DOI: 10.1155/2020/2064781
27.
WuerfelTSchmitzCJokinenLLJ. The effects of the exposure of musculoskeletal tissue to extracorporeal shock waves. Biomedicines10. Epub ahead of print 2022. DOI: 10.3390/biomedicines10051084
28.
TenfordeASBorgstromHEDeLucaS, et al.Best practices for extracorporeal shockwave therapy in musculoskeletal medicine: clinical application and training consideration. PM R2022; 14: 611–619.
29.
MontalvoAMCaraELMyerGD. Effect of kinesiology taping on pain in individuals with musculoskeletal injuries: systematic review and meta-analysis. Phys Sportsmed2014; 42: 48–57.
30.
MostafavifarMWertzJBorchersJ. A systematic review of the effectiveness of kinesio taping for musculoskeletal injury. Phys Sportsmed2012; 40: 33–40.
31.
TranLMakramAMMakramOM, et al.Efficacy of kinesio taping compared to other treatment modalities in musculoskeletal disorders: a systematic review and meta-analysis. Res Sport Med2023; 31: 416–439.
32.
AgerALde OliveiraFCLRoyJS, et al.Effects of elastic kinesiology taping on shoulder proprioception: a systematic review. Brazilian J Phys Ther27. Epub ahead of print May 2023. DOI: 10.1016/j.bjpt.2023.100514
33.
BrophyRHFillinghamYA. AAOS Clinical practice guideline summary: management of osteoarthritis of the knee (nonarthroplasty), third edition. J Am Acad Orthop Surg2022; 30: E721–E729.
34.
DesmeulesFRoyJSLafranceS, et al.Rotator Cuff Tendinopathy Diagnosis, Nonsurgical Medical Care, and Rehabilitation: A Clinical Practice Guideline. 2025. Epub ahead of print 2025. DOI: 10.2519/jospt.2025.13182
35.
LucadoAMDayJMVincentJI, et al.Lateral elbow pain and muscle function impairments. J Orthop Sports Phys Ther2022; 52: CPG1–CPG111.
36.
ChimentiRLNevilleCHouckJ, et al.Achilles pain, stiffness, and muscle power deficits: midportion achilles tendinopathy revision - 2024. J Orthop Sports Phys Ther2024; 54: 1–32.
37.
MajidiLKhateriSNikbakhtN, et al.The effect of extracorporeal shock-wave therapy on pain in patients with various tendinopathies: a systematic review and meta-analysis of randomized control trials. BMC Sport Sci Med Rehabil2024; 16: 93.
38.
ZisslerAStoiberWPittnerS, et al.Extracorporeal shock wave therapy in acute injury care: a systematic review. Rehabil Process Outcome2018; 7: 117957271876513.
39.
PaantjensMAHelmhoutPHBackxFJG, et al.Extracorporeal shockwave therapy for mid-portion and insertional achilles tendinopathy: a systematic review of randomized controlled trials. Sports Med Open2022; 8: 68.
40.
BoschJEBrownMRieckE, et al.The effects of rigid and elastic adhesive tape on pain in musculoskeletal and sports conditions: a systematic review with meta-analysis of randomized controlled trials. JOSPT Open2025; 3: 1–14.
41.
PageMJMoherDBossuytPM, et al.PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. Br Med J372. Epub ahead of print March 2021. DOI: 10.1136/BMJ.N160
42.
SchardtCAdamsMBOwensT, et al.Utilization of the PICO framework to improve searching PubMed for clinical questions. BMC Med Inform Decis Mak2007; 7: 1–6.
43.
OuzzaniMHammadyHFedorowiczZ, et al.Rayyan-a web and mobile app for systematic reviews. Syst Rev2016; 5: 1–10.
44.
SterneJACSavovićJPageMJ, et al.Rob 2: a revised tool for assessing risk of bias in randomised trials. Br Med J2019; 366: 1–8.
45.
WanXWangWLiuJ, et al.Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. BMC Med Res Methodol2014; 14: 1–13.
46.
HigginsJPTThomasJChandlerJ, et al.Cochrane handbook for systematic reviews of interventions. 2nd ed. Chichester, UK: John Wiley & Sons, 2019, pp. 1–694. DOI: 10.1002/9781119536604
47.
BalshemHHelfandMSchünemannHJ, et al.GRADE Guidelines: 3. Rating the quality of evidence. J Clin Epidemiol2011; 64: 401–406.
48.
KafaNCitakerSOmerogluS, et al.Effects of kinesiologic taping on epidermal–dermal distance, pain, edema and inflammation after experimentally induced soft tissue trauma. Physiother Theory Pract2015; 31: 556–561.
49.
Yeung-JenCWangCJYangKD, et al.Extracorporeal shock waves promote healing of collagenase-induced Achilles tendinitis and increase TGF-β1 and IGF-I expression. J Orthop Res2004; 22: 854–861.
50.
MittermayrRHartingerJAntonicV, et al.Extracorporeal shock wave therapy (ESWT) minimizes ischemic tissue necrosis irrespective of application time and promotes tissue revascularization by stimulating angiogenesis.Ann Surg2011; 253: 1024–1032.
51.
MalliaropoulosNThompsonDMekeM, et al.Individualised radial extracorporeal shock wave therapy (rESWT) for symptomatic calcific shoulder tendinopathy: a retrospective clinical study. BMC Musculoskelet Disord2017; 18: 513.
52.
SongHJSeoHJLeeY, et al.Effectiveness of high-intensity laser therapy in the treatment of musculoskeletal disorders: a systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore)2018; 97: e13126.
53.
ChanuKPBimolNSinghYN, et al.Effectiveness of extracorporeal shock wave therapy in the management of plantar fasciitis: a randomized controlled trial. IOSR J Dent Med Sci2019; 18: 16–19.
54.
HawkerGAStewartLFrenchMR, et al.Understanding the pain experience in hip and knee osteoarthritis - an OARSI/OMERACT initiative. Osteoarthr Cartil2008; 16: 415–422.
55.
BindawasSMVennuVAlfhadelS, et al.Knee pain and health-related quality of life among older patients with different knee osteoarthritis severity in Saudi Arabia. PLoS One13. Epub ahead of print May 2018. DOI: 10.1371/JOURNAL.PONE.0196150
56.
PalCPSinghPChaturvediS, et al.Epidemiology of knee osteoarthritis in India and related factors. Indian J Orthop2016; 50: 518–522.
57.
DedeoǧluMGafuroǧluÜYilmazÖ, et al.The relationship between hand grip and pinch strengths and disease activity, articular damage, pain, and disability in patients with rheumatoid arthritis. Arch Rheumatol2013; 28: 069–077.
58.
AlizadehkhaiyatOFisherACKempGJ, et al.Pain, functional disability, and psychologic status in tennis elbow. Clin J Pain2007; 23: 482–489.
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