Efficacy of high intensity laser versus ultrasound therapy in the management of patients with lateral epicondylitis

Abstract

Lateral epicondylitis, 'tennis elbow', is a common condition seen in general practice. Patients present with lateral elbow pain radiating distally and exacerbated by wrist and finger extension against resistance. Pain is also accompanied with functional impairment of the upper limb and hand. High intensity laser therapy (HILT) is a relativelynewpain managementmodality used for treating musculoskeletal disorder. Aim of the work: To compare the efficacy of therapeutic HILT and ultrasound (US) in pain reduction and functional improvement in patients with chronic lateral epicondylitis. Patients and methods: 45 patients were randomly distributed into three equal groups: Group I treated by HILT and US; Group II treated by HILT only and Group III by US only. Patients were treated day after day for 12 sessions. The hand grip-strength was assessed by the dynamometry, pain measured by visual analogue scale (VAS) and the disorder of arm, shoulder and hand (DASH) scored. The HILT emitted a double wave length (915 nm and 808 nm) at a power of 3.2 Watt (W) and energy density of 5 Joule/cm2 while the US was used at an intensity of 1.5 W/cm2. Results: Patients were 24 females and 21 males with mean age of 44.9 ± 7.3 years. There was a significant improvement in the VAS, DASH and grip-strength for the three groups after sessions (p < 0.0001). Results were superior in the combined HILT and US group than each alone for VAS (p < 0.0001) and DASH (p < 0.001). Conclusion: Combined HILT and US is potentially more effective in treating lateral epicondylitis.