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.

Abstract

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