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Evidence summaries

Laser Therapy in Lateral Epicondylitis

Low intensity laser therapy is probably not effective in lateral epicondylitis. Level of evidence: "C"

The effectiveness of low intensity laser therapy in the treatment of lateral epicondylitis was assessed in a randomized clinical trial 1. Fifty-two ambulatory men and women (age range, 18-70 yr) with symptomatic lateral epicondylitis of more than 30 days in duration and a normal neurologic examination were randomized into 2 groups. All underwent irradiation for 60 seconds at 7 points along the symptomatic forearm 3 times weekly for 4 weeks by a masked therapist. The sole difference between the groups was that the probe of a 1.06-microm continuous wave laser emitted 204 mW/cm2 (12.24 J/cm2) for the treated subjects and was inactive for the control subjects. Subjects were assessed at the beginning, midpoint (session 6), and end (session 12) of treatment, as well as at follow-up 28 to 35 days after their last treatment.

The treated and untreated groups were well matched demographically. Masking was maintained for subjects and therapists; however, the groups did not vary to a statistically significant extent in terms of the main outcome measures either during treatment or at follow-up. Secondary outcome variables, such as grasp and pinch strength, medication use, and pain with grasp and pinch, also failed to statistically differ significantly between the groups. No significant treatment side effects were noted.

Comment: The quality of evidence is downgraded by imprecise results (few patients and wide confidence intervals) and potential reporting bias (no thorough literature search was performed).

    References

    • Basford JR, Sheffield CG, Cieslak KR. Laser therapy: a randomized, controlled trial of the effects of low intensity Nd:YAG laser irradiation on lateral epicondylitis. Arch Phys Med Rehabil 2000 Nov;81(11):1504-10. [PubMed]

Primary/Secondary Keywords