The Efficacy of Class IV Laser Treatment for Epicondylitis; A Randomised Controlled Trial

Abstract

References Introduction When administered correctly the cellular and clinical evidence for the effectiveness of LLLT in the promotion of tissue healing is strong (Pires et al 2011, Tumilty et al 2010). However, until recently these treatments were limited by the low power of the class IIIb lasers (0.5 W) and the long exposure required to achieve an effective dose (45 min). Here we report on the effects of a dose of 10 J/cm2 administered directly to the extensor carpi radialis brevis tendon and surrounding area in only minutes, using a powerful new class IV Laser (10W), on chronic lateral epicondylitis one year following treatment. Low level lasers (LLLT) have been shown to decrease PGE2 levels (Bjordal et al, 2006), increase nitric oxide synthase activity (Samoilova et al 2008) and collagen turnover (Lopes-Martins et al, 2007). Previous studies have used class IIIb lasers with power outputs of less than 0.5W; here we evaluate a dual wavelength (980/810 nm) class IV laser with a power output of 10W. PURPOSE: To determine the efficacy of class IV laser therapy to alleviate the pain and dysfunction associated with chronic epicondylitis. METHODS: Fifteen subjects volunteered for a double blind randomized study using laser therapy (LT) (LiteCure LCT 1000), or an identical sham. Subjects underwent clinical examination (pain, range of motion, strength and ultrasonic imaging) to confirm chronic tendinosis of the extensor carpi radialis brevis tendon followed by eight treatments of 10 J/cm2 over 18 days. The exam was repeated at 0, 3, 6 and 12 months post-treatment. RESULTS: No differences were seen between the two groups prior to treatment. In the year following treatment pain and strength measures consistently improved significantly in the LT group but not in the Sham group. Table 1. Post-LT pain and strength scores. Mean SD CONCLUSION: These findings suggest that LT is efficacious for the long term relief of the symptoms associated with chronic epicondylitis. The potential for a fast, safe and effective treatment warrants further investigation. Supported by a grant from LiteCure LLTTM •• Figure 1. Handgrip strength