Comparison of High Intensity Laser and Epicondylitis Bandage in the Treatment of Lateral Epicondylitis

Abstract

Objectives: This study aims to investigate the effects of high-intensity laser therapy (HILT) and epicondylitis bandage treatment in patients with lateral epicondylitis (LE). Patients and methods: Sixty-five patients with unilateral LE (18 males, 47 females; mean age 46.5±8.1 years; range 30 to 61 years) with unilateral complaints were included. Patients were randomly assigned into two treatment groups. The first group (n=31) was treated with HILT for 10 sessions, while the second group (n=34) used only LE bandage for treatment. The patients were assessed for handgrip strength, pain, disability, and quality of life at baseline and sixth week after treatment by using visual analog scale, the Disabilities of the Arm Shoulder and Hand questionnaire, and Short-Form 36 (SF-36). Results: Both groups showed significant improvement in all evaluated parameters including pain scores, hand grip strength, disability, and SF-36 scores at sixth week after the treatment (all p<0.05). A comparison of percentage changes in parameters between treatment groups did not show a significant difference, except for resting visual analog scale (p=0.036) and SF-36 physical component subscale (p=0.049) scores which indicated better improvement in HILT group. Conclusion: Our findings showed significant improvement in handgrip strength, pain, disability, and quality of life parameters in both groups. However, HILT produced better resting visual analog scale and SF-36 physical component subscale scores compared to LE bandage.

The Beneficial Effects of High-Intensity Laser Therapy and Co-Interventions on Musculoskeletal Pain Management: A Systematic Review

“…25,26 Finally, 19 studies (HILT: 11, +other interventions: 8) were included for qualitative and quantitative assessment. [11][12][13][15][16][17]19,[31][32][33][34][35][36][37][38][39][40][41][42] The characteristics of all studies in two groups are listed in Table 1.…”

“…32 Conversely, the studies which did not supporting a positive effect of HILT (low differences in ES) most commonly did not specify the amount of introduced energy or the simultaneous consumption of non-steroid anti-inflammatory drugs, so it was not possible to make a judgment on whether the energy parameters may have contributed to a suboptimal outcome. 34,36,41 The consumption of non-steroid anti-inflammatory drugs may be a confounding factor in evaluating the effects of laser therapy, as identified in some studies 13,41 Some studies did not mention the effects of disease chronicity, despite the fact that this is a major factor in determining the amount of energy density and power output which is needed in the treatment protocol by laser therapy. 13,18,[32][33][34]36,38,41,42 It seems that adding thermal and non-thermal agents to HILT may enhance the effects of laser therapy.…”

“…34,36,41 The consumption of non-steroid anti-inflammatory drugs may be a confounding factor in evaluating the effects of laser therapy, as identified in some studies 13,41 Some studies did not mention the effects of disease chronicity, despite the fact that this is a major factor in determining the amount of energy density and power output which is needed in the treatment protocol by laser therapy. 13,18,[32][33][34]36,38,41,42 It seems that adding thermal and non-thermal agents to HILT may enhance the effects of laser therapy. 16,[38][39][40]42 The Management of acute and chronic pain is based on different mechanisms and it seems that we should apply more irradiance of laser therapy in chronic pain conditions.…”

“…50,51 The treatment area of the scanner lasers is a major contributor to laser efficacy, indicated by some studies. 13,18,36,39 Others just mentioned the probe size which is not as important as the treatment area. The etiology and diagnosis of the disease are important when using a laser.…”

Short-Term Efficacy Comparison of High-Intensity and Low-Intensity Laser Therapy in the Treatment of Lateral Epicondylitis: A Randomized Double-Blind Clinical Study

“…A number of previous studies have investigated the efficacy of HILT in LE. For example, Salli et al 31 investigated the HILT treatment efficacy with epicondylitis bandages and observed significant improvement in favor of the HILT in all of the hand grip strength, pain, disability, and quality of life parameters. Additionally, Akkurt et al 10 investigated the long-term HILT treatment effects and reported significant improvements in the VAS (in both activity and rest), DASH, hand grip strength, and SF-36 scores starting at the second week after treatment, which continued to increase through the sixth month.…”