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Can LLLT Benefit Tennis Elbow?

 Tennis elbow, or lateral epicondylitis (“LET”), is a painful condition of the elbow caused by overuse. True to its name, playing tennis or other racquet sports can cause this condition. However, several other sports and activities can also cause it. Tennis elbow is characterized by inflammation of the tendons that join the forearm muscles on the outside of the elbow. The forearm muscles and tendons become damaged from overuse — repeating the same motions again and again. This leads to pain and tenderness on the outside of the elbow.

Stasinopoulos et al. (2009) investigated the effect of LLLT on pain and function in 50 subjects with unilateral (on one side of the body). LET In the controlled trial, subjects were assigned to receive either an exercise program with LLLT or an exercise program with polarized polychromatic non-coherent light. The exercise program consisted of eccentric and static stretching exercises of wrist extensors. Endpoints were evaluated at baseline, at the end of the treatment (week 4), and 3 months after the end of treatment (week 16). At both weeks 4 and 16 (the end of treatment), subjects treated with LLLT and exercise experienced a significant decrease in pain and a rise in function compared to baseline (p < 0.0005). Accordingly, this study demonstrates the effectiveness of LLLT in reducing pain and increasing function in individuals with tennis elbow.

Emanet et al. (2009) examined the effectiveness of LLLT in relieving pain and improving functional activity in 49 subjects with tennis elbow. In the placebo-controlled clinical trial, elbows were randomized into two groups: laser (LLLT) at 905 nm or sham/placebo laser. Either treatment or placebo was applied to subjects for 15 sessions (5 days per week for 3 weeks). Main outcome measures were VAS for pain, tenderness, Disability of the Arm Shoulder and Hand (“DASH”) questionnaire, the Patient-Related Lateral Epicondylitis Evaluation (“PRTEE”) test, pain-free grip strength, and the Nottingham Health Profile (“NHP”) questionnaire. Evaluations were performed before treatment, at the end of 3 weeks of treatment, and 12 weeks after treatment ended. After three weeks, subjects experienced significant improvement over the placebo in pain (p < 0.01), DASH scores (p < 0.01), and the PRTEE test (p < 0.01). At the 12-week evaluation, a significant improvement was observed in favor of the active treatment group for pain with resisted extension of the wrist, tenderness with pressure, and for both the total and subgroup scores of the DASH questionnaire and PRTEE test, as well as for the pain subgroup of the NHP questionnaire (p < 0.05). Thus, the study demonstrates that LLLT helps reduce pain and improves daily function in those with tennis elbow.

Bjordal et al. (2006b) conducted a review of animal and in vitro studies and found strong evidence that LLLT modulates biochemical inflammatory markers and produces local anti-inflammatory effects in cells and soft tissue.41 Specifically, the review found strong evidence from 18 out of 19 studies that red and infrared wavelengths of LLLT can act locally and rapidly to modulate the inflammatory processes in injured tissue. These anti-inflammatory effects include changes in biochemical markers, altered distribution of inflammatory cells, and reduced formation of edema, hemorrhage, and necrosis. The reduced formation of edema, defined as “swelling caused by fluid” in the body’s tissues.

Morimoto et. al. administered LLLT on both tender points and acupuncture points. The rate of effectiveness in cases of irradiation by a physician was 100%.  Jumper’s knee, lateral epicondylitis of humerus and Achilles tendinitis are injuries commonly treated for long periods of time. It is difficult to manage these disorders. The rate of effectiveness in cases of jumper’s knee, tennis elbow and Achilles tendinitis was high. LLLT is an effective treatment for sports injuries, particularly jumper’s knee, tennis elbow and Achilles  tendinitis. The results of our study show a higher rate of effectiveness in patients with these disorders, and we believe that LLLT can be a useful treatment.        

Inflammation is a significant component in Tennis Elbow. Biorda et. al.  as well as many other authors provided clear evidence that LLLT produces significant anti-inflammatory effects. The studies and reports by Stasinopoulos et. al., Emanet et al, and Morimoto et. al, as well as numerous other authors provide competent and reliable scientific evidence that LLLT has a beneficial effect on tennis elbow.

 References

Stasinopoulos D, et al. (2009), Comparing the effects of exercise program and low-level laser therapy with exercise program and polarized polychromatic non-coherent light on the treatment of lateral elbow tendinopathy, Photomed. Laser Surg. 27(3):513-520 

Morimoto Y, Saito A, TokuhashI Y, Low level laser therapy for sports injuries. Laser Therapy 2013, 22.1: 17-20.

Emanet SK, et al. (2010), Investigation of the effect of GaAs laser therapy on lateral epicondylitis, Photomed. Laser Surg. 28(3):397-403. 

Bjordal JM, Lopes-Martins RAB, & Iversen VV (2006a), A randomized, placebo controlled trial of low level laser therapy for activated Achilles tendinitis with microdialysis measurement of peritendinous prostaglandin E2 concentrations, Br. J. Sports Med. 40:76­­-80.