The patient was a female, 80 years old, with bilateral knee pain for six months, unable to walk long distances, waking up with pain at night, and unable to go up and down stairs. The diagnosis of osteoarthritis was confirmed after radiographs and other examinations. The patient was given a multimodal analgesic protocol. At the first visit, medication + ultrasound-guided joint cavity injection was given. At the follow-up visit one week later, the pain was less pronounced at night and significantly reduced, but still unable to go up and down stairs. Second treatment: shock wave therapy + medication + ultrasound-guided joint cavity injection. The third follow-up was shock wave therapy + medication + ultrasound-guided joint cavity injection. The patient felt that walking was the same as before the onset, with no obvious pain and discomfort. 1, medication, the elderly try to reduce the application of drugs such as fotarine, but the application of weak opioids, not only can significantly reduce the pain, and will not have fotarine gastrointestinal side effects. 2, ultrasound-guided joint cavity injection, compared with non-ultrasound guidance, more accurate and more targeted and effective. 3.Shockwave therapy. Generally knee pain peripheral muscles and ligaments, etc. will have inflammation and other lesions. Shock wave treatment is a non-invasive treatment that promotes local vasodilation, accelerates blood circulation, enhances the stimulation of nerve fibers, prevents the increase of pain stimulation and thus enhances the pain relief effect; destroys the cell membrane of pain receptors and inhibits the production and transmission of pain signals. In addition, shock waves can effectively improve the metabolism of the treated area, reduce the inflammatory response of the affected area, eliminate edema, and improve the mechanical load of the tissue. There are no side effects and in vitro loosening of soft tissues can be accomplished directly through the skin.