The benefits of intermittent vibration

By adopting intermittent vibration, you can support patients dealing with chronic knee pain and lead the way in conservative, science-backed musculoskeletal care.

Knee pain is one of the most common musculoskeletal complaints and continues to rise in prevalence with an aging population. It ranks among the top 10 reasons patients seek chiropractic care,¹ with osteoarthritis being the sixth most common reason adults aged 65 or older visit a DC.² For these patients, this knee pain can significantly limit mobility and impact proprioception, making routine everyday tasks such as walking or stair navigation challenging.

For a DC, this patient population represents a significant opportunity for conservative care interventions with few or no risks. While traditional knee pain treatment often relies on a combination of pharmaceuticals, bracing, manual therapies or invasive procedures, a novel approach providing cutaneous intermittent vibration at the knee activated by movement can be a powerful adjunct therapy, helping patients reduce pain, enhance proprioception and restore impaired quadriceps muscle function.

The science behind intermittent vibration activated by movement for pain relief

While vibration therapy has long been in use in clinical settings, the application of motion-activated intermittent cutaneous vibration, precisely synchronized with specific phases of a patient’s movement cycle, represents a novel advancement. This approach holds significant potential for enhancing patient care between in-person clinical visits, stimulating the somatosensory system to both interrupt pain perception and enhance muscle function.

By using principles of Gate Control Theory,³ this technique works by activating large-diameter nerve fibers through non-painful cutaneous vibration stimulation applied to the knee during movement (Figure 1). These signals travel to the brain faster than pain signals carried by small-diameter nerve fibers, effectively modulating transmission of pain and reducing the perception of discomfort to enable patients to move with less pain and better mobility.

Critically, because the intermittent vibration is triggered by the user’s own movement, this therapy provides an added benefit of encouraging your patients to be active, which is essential for both joint health⁴ and overall well-being.⁵ From aiding weight management to supporting mental health and reducing the risk of chronic disease and all-cause mortality, the benefits of staying active are extensive. Though some patients may fear movement will worsen pain, evidence⁶ shows regular exercise can reduce discomfort and improve function and quality of life. Providing effective tools to support activity between chiropractic visits can empower your patients to take an active role in their knee health and overall wellness.

Clinical evidence supports enhancing proprioception and muscle function

Patients with knee pain often experience limited mobility due to a combination of pain, proprioceptive deficits and quadriceps muscle inhibition. Among the earliest reported functional limitations is stair navigation.⁷ Impaired quadriceps function, essential for supporting and stabilizing the knee joint, is well-documented in this population.⁸ Proprioceptive deficits may result from muscle weakness, impaired mechanoreceptor signaling or inflammation with proprioception believed to play an important role in joint stabilization and protection against progressive functional decline.⁹ These findings support the clinical value of interventions that enhance both muscle function and proprioception in managing chronic knee pain.

A study conducted at Stanford University¹⁰ investigated the effects of cutaneous intermittent vibration activated by movement on stair navigation in adults with chronic knee pain from osteoarthritis, meniscal tears or anterior cruciate ligament (ACL) injuries. In this single-blind, randomized, longitudinal crossover study, participants were assigned to wear two treatments over separate four-week periods in random order. The active treatment delivered cutaneous motion-activated intermittent vibration via two bands placed above and below the knee. The intermittent vibration activated just prior to heel strike and deactivated at mid-stance of level and stair walking. The control treatment was a commercially available passive dual knee band that provided only compression.

After four weeks of using the intermittent cutaneous vibration device, participants reported significant pain relief with an average reduction in pain of 33% during stair navigation, a benefit not observed after wearing the passive control treatment. Participants also demonstrated significant increases in quadriceps muscle activation during stair ascent and enhanced proprioception and movement control during stair descent after using the intermittent cutaneous vibration treatment. These results expanded upon previous research¹¹ showing significant pain relief and quadriceps muscle function during level walking with the same device.

Collectively, the findings support the use of motion-activated cutaneous intermittent vibration as a promising adjunct in chiropractic care, particularly for improving mobility, proprioception and muscle function in knee pain patients.

Clinical benefits for treating knee pain

An innovative approach to pain relief

For your patients seeking an effective alternative to traditional pain relief methods, cutaneous intermittent vibration activated by movement provides an effective and easy-to-use treatment that allows patients to move with less discomfort while avoiding reliance on medications.

Improved mobility and function

By reducing pain and enhancing muscle function and proprioception, cutaneous intermittent vibration applied at the knee helps patients restore natural movement patterns. This can be particularly beneficial for older adults, athletes and post-surgical patients who struggle with knee mobility.

Complementary to chiropractic therapy

Cutaneous intermittent vibration stimulation can be integrated seamlessly into chiropractic treatment plans. It complements manual adjustments, soft tissue therapy and rehabilitative exercises, providing a multi-faceted approach to knee pain relief.

Encouragement of physical activity

Pain often discourages movement, but intermittent motion-activated vibration can reduce discomfort and increase patient confidence. This modality specifically encourages patients to stay active between clinic visits as the intermittent vibration is activated by motion; movement is a key factor in maintaining joint health, managing weight and improving overall well-being.

Important features to consider when incorporating into treatment

Vibration should be intermittent and motion-synced, not continuous. Intermittent vibration helps to prevent adaptation of cutaneous receptors to a continuous stimulus.

The device should be easy to use for both practitioners and patients and should integrate seamlessly into patients’ daily activities.

Patient education is key. Explaining the mechanism of action and how a tool supports broader goals of treatment encourages patient adoption.

Devices’ efficacy should be clinically validated through peer-reviewed research.

Final thoughts

As the chiropractic field continues to embrace evidence-based interventions, motion-activated cutaneous intermittent vibration offers a compelling new tool for knee pain management. The technology aligns with chiropractic principles: Activating the body’s own healing mechanisms, improving function through neuromuscular engagement and minimizing reliance on invasive or pharmacologic care.

Jenny Hledik, PhD, is the chief operating officer at SomaTX Design Inc. and co-inventor of KneeMo^®, a smart wearable device delivering intermittent motion-activated vibration for knee pain. Hledik earned her doctorate in biomechanical engineering from Stanford University and has held positions as a researcher at several institutions and medical device companies. She can be reached at jhledik@somatxdesign.com or via thekneemo.com. 

Thomas Andriacchi, PhD, is an emeritus professor at Stanford University, president at SomaTX Design Inc. and co-inventor of KneeMo^®. Andriacchi has more than 50 years of research experience on the biomechanics of the knee focused on solving clinical problems ranging from sports injury to osteoarthritis. His research has been recognized by international awards from both engineering and medical societies. He can be reached at tandriac@somatxdesign.com.

References

1. Beliveau PJH, et al. The chiropractic profession: A scoping review of utilization rates, reasons for seeking care, patient profiles and care provided. ChiroprMan Therap. 2017;25:35. https://pubmed.ncbi.nlm.nih.gov/29201346/. Accessed November 12, 2025.
2. de Luca K, et al. The profile of older adults seeking chiropractic care: A secondary analysis. BMC Geriatr. 2021;21(1):271. https://pubmed.ncbi.nlm.nih.gov/33892643/. Accessed November 12, 2025.
3. Melzack R, Wall PD. Pain mechanisms: A new theory. Science 1965;150:971-979. https://pubmed.ncbi.nlm.nih.gov/5320816/. Accessed November 12, 2025.
4. Fransen M, et al. Exercise for osteoarthritis of the knee: A Cochrane systematic review. Br J Sports Med. 2015;49(24):1554-1557. https://pubmed.ncbi.nlm.nih.gov/26405113/. Accessed November 12, 2025.
5. Bull FC, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med. 2020;54(24):1451-1462. https://pubmed.ncbi.nlm.nih.gov/33239350/. Accessed November 12, 2025.
6. Mo L, et al. Exercise therapy for knee osteoarthritis: A systematic review and network meta-analysis. Orthop J Sports Med. 2023;11(5):23259671231172773. https://pubmed.ncbi.nlm.nih.gov/37346776/. Accessed November 12, 2025.
7. Hensor EMA, et al. Toward a clinical definition of early osteoarthritis: Onset of patient-reported knee pain begins on stairs. Data From the Osteoarthritis Initiative. ArthCare Res 2015;67:40-47. https://pubmed.ncbi.nlm.nih.gov/25074673/. Accessed November 12, 2025
8. Messier SP, et al. Declines in strength and balance in older adults with chronic knee pain: A 30-month longitudinal, observational study. Arthritis Rheum. 2002;47:141–148. https://pubmed.ncbi.nlm.nih.gov/11954007/. Accessed November 12, 2025.
9. Knoop J, et al. Proprioception in knee osteoarthritis: A narrative review. Osteoarthritis Cartilage. 2011;19(4):381-388. https://pubmed.ncbi.nlm.nih.gov/21251988/. Accessed November 12, 2025.
10. Fischer AG, et al. Intermittent vibrational stimulation enhances mobility during stair navigation in patients with knee pain. Gait Posture. 2021;86:125-131. https://pubmed.ncbi.nlm.nih.gov/33721689/. Accessed November 12, 2025.
11. Fischer AG, et al. Utilizing the somatosensory system via vibratory stimulation to mitigate knee pain during walking: Randomized clinical trial. Gait Posture. 2020;80:37-43. https://www.sciencedirect.com/science/article/abs/pii/S0966636220301806. Accessed November 12, 2025.