Extracorporeal shock wave therapy versus Kinesio taping in treating musculoskeletal disorders: A GRADE-assessed systematic review and meta-analysis

Background 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).