The purpose of this study was to compare the effect of extracorporeal shock wave therapy and pulsed electromagnetic field in reducing pain, improving function, and increasing ROM in knee osteoarthritis patients.

Knee osteoarthritis is a prevalent and debilitating condition that affects millions of people worldwide. It is particularly common in older adults and is a major cause of disability and reduced quality of life. The disease is characterized by the progressive degradation of articular cartilage, leading to pain, stiffness, and impaired function. The prevalence of knee osteoarthritis has been reported to range between 22% to 39% globally, and in specific regions like India, it is approximately 28.7%.

Extracorporeal shock wave therapy has emerged as a promising non-invasive treatment for knee osteoarthritis. The advantages of extracorporeal shock wave therapy include its ability to alleviate pain and improve joint function. Studies have demonstrated that extracorporeal shock wave therapy can significantly reduce pain scores and enhance physical function in patients with knee osteoarthritis, making it a viable treatment option. Additionally, extracorporeal shock wave therapy has been shown to positively affect cartilage regeneration and reduce inflammation markers like matrix metalloproteinase-3, which is involved in cartilage degradation.

However, the disadvantages of extracorporeal shock wave therapy include the potential for adverse effects on articular cartilage, particularly at higher intensities, which may result in the worsening of cartilage conditions in some cases. Furthermore, while extracorporeal shock wave therapy is generally well-tolerated, its efficacy may vary depending on the energy levels used, with moderate intensity showing the best outcomes.

Inclusion Criteria:

1. Sixty patients must have a confirmed diagnosis of knee osteoarthritis, specifically those with mild to moderate osteoarthritis.
2. Participants must have experienced knee pain lasting more than 3 months.
3. Their ages will be ranged from 40 to 60 years.
4. Their body mass index within the range of 22.7 to 28.5 kg/m² kg/m².
5. Both male and female patients are eligible for the study.
6. At least two positive provocative tests, such as joint line tenderness and crepitus, which are commonly associated with knee osteoarthritis.

Exclusion Criteria:

1. Inflammatory arthritis (e.g., rheumatoid arthritis) or other forms of arthritis that are not osteoarthritis.
2. Undergone knee replacement surgery or any significant knee surgery within the past year.
3. Severe cardiovascular, respiratory, renal, or hepatic diseases that could interfere with study participation or outcomes.
4. Received intra-articular corticosteroid injections in the affected knee within the last 3 months.
5. Pregnant or breastfeeding due to the unknown effects of study treatments on fetal and infant development.
6. Neurological conditions affecting the lower limbs (e.g., stroke, neuropathy). body mass index greater than 30 kg/m², as severe obesity may influence treatment outcomes and complicate assessment.
7. Cognitive impairments or psychiatric conditions that may affect their ability to participate.

The patients will be blinded regarding which treatment group they were allocated into.