Journal Article

Effects of photobiomodulation therapy combined with static magnetic field on pain and function in patients with lateral epicondylitis: a multicentre, randomised, placebo-controlled trial

Tomazoni, Shaiane Silva, Casalechi, Heliodora Leão, Leal-Junior, Ernesto Cesar Pinto, Lino, Matheus Marinho Aguiar, Ribeiro, Neide Firmo, Machado, Caroline dos Santos Monteiro, de Oliveira, Marcelo Ferreira Duarte, Araújo-Silva, Older Manoel, Johnson, Douglas Scott, Dias, Luana Barbosa

2025

Overview

IntroductionPhotobiomodulation therapy (PBMT), particularly when combined with a static magnetic field (PBMT-sMF), is a promising non-pharmacological approach for managing musculoskeletal disorders. However, high-quality evidence for its efficacy in lateral epicondylitis remains limited.ObjectivesThe study aims to investigate the effectiveness of PBMT-sMF vs placebo in reducing pain, improving function and modulating inflammatory markers in individuals with lateral epicondylitis.DesignMulticentre, randomised, triple-blinded, placebo-controlled trial.SettingThree outpatient physiotherapy clinics in Brazil.Participants50 adults (18–50 years) with unilateral lateral epicondylitis and baseline pain ≥50 on the visual analogue scale (VAS).InterventionsParticipants received either active PBMT-sMF (n=25) or placebo (n=25), 2 times per week for 3 weeks. PBMT-sMF involved multi-wavelength irradiation at 4 epicondyle sites (60 s; 27.1 J/site). The placebo group underwent the same procedure without active irradiation.Primary and secondary outcome measuresThe primary outcome was degree of pain rating (VAS). Secondary outcomes included forearm disability (Patient-Rated Tennis Elbow Evaluation, PRTEE), grip strength, serum tumour necrosis factor-alpha (TNF-α) levels and treatment satisfaction. Assessments were conducted at baseline, post-treatment (3 weeks) and at 4-week follow-up.ResultsPBMT-sMF yielded a higher responder rate (defined as the proportion of participants achieving at least a 30% reduction in pain intensity relative to baseline) than placebo (72% vs 40%, p=0.045), with a clinically and statistically significant between-group difference. Compared with placebo, the PBMT-sMF group showed significantly greater reductions in pain intensity both at the end of treatment (51.4±19.8 vs 36.9±22.6; p=0.0223) and at follow-up (37.4±24.1 vs 20.3±21.2; p=0.0049). TNF-α levels also decreased significantly in the PBMT-sMF group compared with placebo at both time points (p<0.0001 and p=0.0019, respectively). No significant between-group differences were observed for PRTEE scores, grip strength or treatment satisfaction. No major adverse events were reported.ConclusionsPBMT-sMF significantly reduced pain intensity and TNF-α levels, suggesting an anti-inflammatory mechanism. Although functional outcomes were not improved, PBMT-sMF may be a valuable short-term, non-invasive option for lateral epicondylitis pain management.Trial registration numberNCT04829734 on ClinicalTrials.gov

• Publisher: British Medical Journal Publishing Group,BMJ Publishing Group LTD,BMJ Publishing Group
• Subject: Adolescent / Adult / Brazil / Chronic fatigue syndrome / Clinical Trial / Clinical trials / Combined Modality Therapy / Double-Blind Method / Elbow Tendinopathy / Female / Humans / Inflammatory diseases / Light emitting diodes / Light therapy / Low-Level Light Therapy - methods / Magnetic Field Therapy - methods / Magnetic fields / Male / Middle Aged / Musculoskeletal diseases / Musculoskeletal disorders / Non-pharmacological intervention / Pain / Pain management / Pain Management - methods / Pain Measurement / Physical therapy / Physical Therapy Modalities / Rehabilitation medicine / Steroids / Tennis Elbow - physiopathology / Tennis Elbow - therapy / Therapists / Treatment Outcome / Tumor Necrosis Factor-alpha - blood / Young Adult