The short-term effectiveness of low-level laser, phonophoresis, and iontophoresis in patients with lateral epicondylosis

J Hand Ther. 2019 Oct-Dec;32(4):417-425. doi: 10.1016/j.jht.2018.01.002. Epub 2018 Feb 13.


Study design: Randomized parallel group trial.

Introduction: Various treatment options for lateral epicondylosis have been reported in the literature.

Purpose of study: We aimed to compare the effectiveness of low-level laser therapy (LLLT), phonophoresis, and iontophoresis in terms of pain, function, and grip strength.

Methods: This study that comprised 37 patients with lateral epicondylosis was planned as a prospective randomized parallel group trial. Twelve participants were randomized to the LLLT group, 12 to the phonophoresis group, and 13 to the iontophoresis group. The Visual Analog Scale (VAS), pressure algometer, the Patient-Rated Tennis Elbow Evaluation, and grip strength dynamometer were used to measure outcomes. The measurements were performed at baseline and at the end of 15 sessions.

Results: Investigation of the pain scores revealed that all VAS scores were improved in both the laser and iontophoresis groups (VAS at rest: P = .015, effect size (ES) = 1.49 and P = .016, ES = 0.58, respectively; VAS during activity: P = .008, ES = 1.05 and P = .008, ES = 1.16, respectively; VAS at night: P = .013, ES = 1.01 and P = .016, ES = 0.72, respectively). Only advance in function and grip strength was associated with the iontophoresis group (Patient-Rated Tennis Elbow Evaluation P = .006, ES = 0.78; grip strength with elbow extension P = .011, ES = 1.03; with elbow flexion P = .003, ES = 0.52).

Discussion: The most effective approach could not be highlighted among the existing studies in the literature as they were applied in combination with other therapies.

Conclusion: In our study, we observed that LLLT provides a benefit only for pain, whereas iontophoresis is beneficial for both pain and function. If the effect size is evaluated, LLLT is more influential than iontophoresis for decreasing pain. However, when we compared phonophoresis and iontophoresis in terms of effectiveness, we found that iontophoresis has better effects for pain, function, and grip strength.

Keywords: Iontophoresis; Laser; Lateral epicondylosis; Phonophoresis; Tennis elbow; Ultrasound.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Female
  • Hand Strength
  • Humans
  • Iontophoresis*
  • Low-Level Light Therapy*
  • Male
  • Middle Aged
  • Phonophoresis*
  • Prospective Studies
  • Tennis Elbow / therapy*
  • Visual Analog Scale