As manual therapy professionals, we consistently seek effective interventions to reduce pain, improve range of motion (ROM), and restore function in our patients. Instrument-Assisted Soft Tissue Mobilization (IASTM) has gained widespread popularity as a myofascial intervention, but in 2025 how strong is the evidence supporting its use?
The Evolving Evidence for IASTM
Historically, systematic reviews on IASTM presented conflicting or inconclusive results regarding its effectiveness for pain, ROM, and function. However, a recent systematic review and meta-analysis offers a fresh perspective, updating the evidence and using different inclusion criteria compared to previous studies. This new research aimed to reassess the impact of IASTM on pain and function in patients with musculoskeletal disorders.
Key Findings from the Latest Research:
This systematic review and meta-analysis, incorporating data from 11 randomized controlled trials (RCTs) involving a total of 427 participants, provided some encouraging insights:
- Pain Reduction: IASTM was found to significantly reduce patient-reported pain. This finding is supported by moderate-certainty evidence.
- Clinical Tip: This suggests that IASTM can be a valuable adjunct in your pain management strategies for musculoskeletal conditions.
- Improved Function: The study also indicated that IASTM can significantly improve patient-reported function, although this evidence is of low certainty.
- Clinical Tip: While promising, consider IASTM as one component of a comprehensive functional rehabilitation program, and continue to prioritize other evidence-based interventions for functional gains.
- Pressure Pain Threshold (PPT) and Balance: The research also noted that IASTM significantly improved PPT (in one trial with 28 participants) and balance (in one trial with 24 participants). However, the certainty of this evidence is low to very low due to the limited number of studies.
- Clinical Tip: If you are looking to address local pain sensitivity or balance deficits, IASTM may be a consideration, but more research is needed to solidify its role in these areas.
What Makes These Findings Different?
The current study's positive findings for pain and function contrast with some earlier reviews. The authors attribute this difference to two main factors:
- Updated Data: This latest review included more recent studies (searched up to February 2025), with many of these newer trials showing positive results.
- Specific Inclusion Criteria: Unlike previous studies that compared IASTM to other treatments or placebo, this review specifically focused on RCTs that compared IASTM combined with other treatments versus other treatments alone. This approach aims to avoid underestimating IASTM's effectiveness when used as an additive therapy.
Clinical Takeaways and Future Directions
The results of this study offer further support for incorporating IASTM into your clinical practice for musculoskeletal disorders. The conditions examined in the included studies covered a range of common issues, including:
- Cervicogenic headache
- Shoulder adhesive capsulitis
- Chronic neck pain
- Neck myofascial pain
- Plantar heel pain/plantar fasciitis
- Insertional Achilles tendinopathy
- Chronic ankle instability
- Chronic lateral elbow pain
- Chronic migraine
The study also highlighted a significant finding regarding short-term pain relief for nonspecific chronic neck pain and cervicogenic headache.
Helpful Clinical Tips:
- Consider IASTM for Pain Relief: The moderate-certainty evidence for pain reduction makes IASTM a valuable tool in your pain management toolkit for various musculoskeletal conditions.
- Integrate, Don't Isolate: Remember, IASTM is often most effective when combined with other rehabilitation therapies, such as exercise and stretching, as reflected in the study's inclusion criteria.
- Individualized Treatment: While the study provides general insights, always tailor your IASTM application (tools, duration, frequency) to the individual patient's needs and response. The most common single treatment duration in the reviewed studies was less than or equal to 10 minutes, with 2-3 treatments per week for 4 weeks.
- Ongoing Assessment: Continuously assess your patient's pain and functional progress to determine the efficacy of your treatment plan, including IASTM.
- Stay Informed: While this study offers positive news, the authors emphasize the need for future high-quality RCTs with low risk of bias, particularly for objective outcomes like PPT and functional measures, to further strengthen the evidence base.
In conclusion, this updated research suggests that IASTM can indeed be a beneficial addition to your practice for reducing pain and improving function in patients with musculoskeletal disorders.
Its also good for your own musculoskeletal health too, as discussed in our previous Blog
Tang, S., Sheng, L., Wei, X., Liang, M., Xia, J. and Chen, J., 2025. The effectiveness of instrument-assisted soft tissue mobilization on pain and function in patients with musculoskeletal disorders: a systematic review and meta-analysis. BMC Musculoskeletal Disorders, 26(1), p.257.
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