Is There Any Difference Between High-Intensity Laser and Low-Level Laser in the Treatment of Tennis Elbow? A Meta-analysis of Randomized Controlled Trials.

OBJECTIVE

The aim of the study was to evaluate the efficacy of laser therapy (high-intensity vs. low-level) in treating tennis elbow.

DESIGN

PubMed, Scopus, Embase, and Web of Science were systematically searched for randomized controlled trials up to February 2025. Cochrane risk-of-bias tool was used for quality assessment. Data were analyzed via RevMan 5.4.

RESULT: Twelve randomized controlled trials were included. Laser therapy demonstrates significant improvements in pain, grip strength, and functional outcomes for tennis elbow patients. Subgroup analysis reveals that both high-intensity laser therapy ( P = 0.01) and low-level laser therapy ( P < 0.00001) effectively reduce pain versus baseline with comparable efficacy, although high-intensity laser therapy shows nonsignificant improvement versus placebo ( P = 0.07). Regarding functional improvement, high-intensity laser therapy is similar to low-level laser therapy (both significant, P < 0.05). For grip strength, both modalities show significant improvement ( P < 0.05), with high-intensity laser therapy exhibiting superior effects. Further analysis of combination therapies showed that laser combined with bandage demonstrates more significant pain relief and functional improvement.

CONCLUSIONS

High-intensity laser therapy and low-level laser therapy are both effective modalities for improving symptoms of tennis elbow (pain, function, and grip strength). Low-level laser therapy demonstrates more consistent significance in pain relief, while high-intensity laser therapy shows greater advantages in enhancing grip strength. More importantly, laser therapy combined with bandage produces synergistic effects, highlighting its value as a key complementary component within multimodal rehabilitation programs.