Inclusion Criteria:  Patients will have grade II of primary knee osteoarthritis. Patients with bilateral primary knee osteoarthritis, the more painful knee will be selected as the affected knee in this study. Age of patients will range from 45 years to 65 years old. Duration of illness will range from 3- 12 months.  Exclusion Criteria:  Malignancy presence of skin lesions or infections at the treatment sites