Effect of low-intensity laser therapy and deep friction massage on tendon thickness and strength in individuals with lateral elbow pain – an ultrasonographic analysis

Background. Lateral epicondylitis (LE) is one of the most common lesions of the arm. Contradictory outcomes have been shown for treatment with low-intensity laser therapy (LILT). Deep transverse friction massage (DFM) is a soft tissue technique applied for its mechanical effects and its ability to break cross-links. LILT and DFM are both recommended for lateral epicondylitis, but only limited data are available on their combined effect. Hence, this study aims to determine the combined therapeutic effect. Aim of the study. The aim of the study is to compare the combined effects of low-intensity laser therapy and deep friction massage with therapeutic ultrasound and general exercises in individuals with lateral epicondylitis. Materials and methods. A randomized controlled trial was conducted with 44 individuals with unilateral lateral epicondylitis. Both genders, aged 25 to 60 years, were recruited for the study after obtaining written consent. Pain severity, grip strength, tendon thickness, and disability were assessed in both groups using the numeric pain rating scale (NPRS), a handheld grip dynamometer, ultrasonography, and the PRTEE (Pain-Rated Tennis Elbow Evaluation) questionnaire. The experimental group received LILT and DFM, whereas the control group received therapeutic ultrasound and general exercises for one week. Results. All outcomes improved in both groups following treatment (p < 0.0001). In the between-group comparison, pain severity, grip strength, regional function, and common tendon thickness improved significantly in the experimental group with a large effect size (Cohen’s d > 1). Conclusion. Low-intensity laser therapy and deep friction massage improved pain severity, grip strength, and regional function in the short term with a large effect size in individuals with lateral epicondylitis.