Tennis Elbow (Lateral Epicondylitis) Treatment Using LLLT/PBMT

Low Level Laser Therapy (LLLT), also known as Photobiomodulation Therapy (PBMT), uses red and near-infrared light applied over targeted areas. In our clinic it is used as part of a GP-led treatment approach for selected musculoskeletal pain and injury presentations, including tennis elbow.

PBMT/LLLT is non-invasive and generally well tolerated. Suitability and response vary, and treatment recommendations depend on the diagnosis, severity, duration of symptoms and individual clinical factors. PBMT/LLLT has been studied for a range of musculoskeletal pain and injury conditions. See our references page for supporting literature.

Gentle. Drug-Free. Evidence-Informed.

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Key Points

  • Tennis elbow (lateral epicondylitis) is a common overuse injury affecting the tendons on the outside of the elbow, typically due to repetitive gripping or wrist extension.
  • Often triggered by sports such as tennis or manual work such as carpentry or painting, it can also occur from desk work or daily repetitive activities.
  • Symptoms include pain on the outer elbow, weakness when lifting or twisting, and difficulty with common actions such as pouring a kettle or turning a doorknob.
  • The condition involves microtears and tendon degeneration rather than inflammation alone, which is why some conventional anti-inflammatory treatments may fall short.
  • Low Level Laser Therapy (LLLT), or Photobiomodulation Therapy (PBMT), is considered for selected tennis elbow presentations where tendon irritation, pain or local inflammatory processes are contributing to symptoms.
  • LLLT may be particularly relevant where pain limits rehabilitation or exercise, or where other treatments such as cortisone or PRP injections have provided only temporary or partial relief.
  • Some commonly used approaches, such as medication, injections, repeated loading, bracing, stretching or manual pressure, may not be suitable for every stage of recovery. We provide advice based on the diagnosis, symptom severity and clinical assessment.
  • Treatment is provided under the medical supervision of Dr Shikha Parmar as part of a structured six-week program tailored to each patient’s condition.
  • PBMT/LLLT has been studied in a range of musculoskeletal pain and injury conditions and is generally well tolerated. Individual responses vary, and outcomes depend on the condition being treated and the stage of recovery.
  • LLLT can be considered for people with persistent or recurrent tennis elbow who have not improved with usual conservative care, after appropriate medical assessment.
Click here for FAQ/Costs

What is Tennis Elbow?

Tennis elbow is the common name for lateral epicondylitis, a painful condition caused by overuse or strain of the tendons connecting the forearm muscles to the outer elbow.

Despite its name, it affects not just athletes but also people whose jobs or hobbies involve repetitive gripping or twisting. The condition is driven by microtears in the tendon, which lead to degeneration and pain.

Causes of Tennis Elbow

Common causes include:

  • Repetitive wrist extension or gripping (e.g. using tools, lifting, typing)
  • Sports such as tennis, squash, or weightlifting
  • Manual labour, such as carpentry, painting or gardening
  • Poor ergonomics at workstations
  • Underlying age-related tendon changes

Tennis elbow may develop gradually or follow a specific overuse event.

Symptoms 

  • Pain on the outer elbow, especially during gripping or lifting
  • Weak grip strength
  • Tenderness over the lateral epicondyle
  • Pain with resisted wrist or finger extension
  • Discomfort when turning door handles, pouring, or shaking hands

How is Tennis Elbow Diagnosed?

Diagnosis is usually clinical, based on:

  • History of overuse or repetitive strain
  • Localised tenderness at the lateral epicondyle
  • Pain with resistance tests (e.g. Cozen’s test)

Ultrasound can help visualise tendon thickening or tears if needed. MRI is rarely required unless symptoms are persistent or atypical.

Tennis Elbow – Treatment Overview

Low Level Laser Therapy (LLLT), also known as Photobiomodulation Therapy (PBMT), is a non-invasive treatment approach used as part of a structured program for selected tennis elbow presentations. It may help modulate pain and local inflammatory processes and support tendon and soft tissue recovery without adding mechanical stress to already irritated tendon tissue.

Why Consider Low Level Laser Therapy (LLLT)?

Many patients present after limited relief from rest, physiotherapy, bracing, massage, exercises, injections, or anti-inflammatory medication. These approaches may ease symptoms temporarily, but are not suitable or effective for everyone, especially if strengthening is introduced too early or aggravates sensitive tendon tissue.

Why ice, anti-inflammatories, cortisone, and PRP may not support long-term recovery. Read more here.

How LLLT Supports Healing

LLLT uses red and near-infrared light and may support:

  • Helping modulate inflammation and oxidative stress
  • Local circulation and oxygenation
  • Lymphatic drainage
  • Cellular energy production (ATP)
  • Tendon and soft tissue recovery processes where irritation is present
  • Assisting pain reduction without mechanical loading or stressing the elbow
tennis elbow
golfers

Non-Invasive and Supported by Research

PBMT/LLLT is non-invasive and generally well tolerated. It has been studied in a range of musculoskeletal pain and injury conditions. Individual responses vary, and outcomes depend on the condition being treated and the stage of recovery. Read more here.

See how LLLT may support the cellular environment involved in tissue recovery here.

Our Treatment Program

All patients are assessed by Dr Shikha Parmar (GP). Treatment is delivered within a structured six-week program, including:

  • Up to 12 LLLT sessions
  • Early progress review after the first 6 treatments
  • Individualised advice and activity modification
  • Guided rehabilitation to support longer-term function

Progress is reviewed during the program. Many patients notice appreciable improvement after the first 6 treatments. If there has not been sufficient improvement by this review point, further treatment may not be recommended.

View the full treatment protocol and expected outcomes here.

Ready to Discuss Your Tennis Elbow Treatment Options?

If you are struggling with persistent pain from tennis elbow, we invite you to contact our team at Laser Pain Therapy to discuss the suitability of LLLT for your presentation. Treatment suitability and outcomes vary, and assessment is required before recommendations can be made.

Contact us to arrange your consultation.
📍 Located in Melbourne
📞 (03) 8529 2225 Contact Us

View treatment cost here

Cost / FAQ

At Laser Pain Therapy, we use the terms Low-Level Laser Therapy (LLLT) and Photobiomodulation Therapy (PBMT) interchangeably, as they both refer to the same therapeutic approach. “LLLT” specifically focuses on the use of laser light, while “PBMT” is the broader scientific term describing how light interacts with the body to promote healing.

Both therapies stimulate cellular activity, reduce inflammation, repair tissue, and accelerate the healing process.

The initial consultation with Dr Shikha Parmar requires up to 60 minutes where your condition is fully assessed along with your medical history. Dr Parmar will take a thorough history of your problem from its onset, through its progression to now. She will review any imaging reports pertaining to your problem, and may recommend further investigations. Dr Parmar will give you a detailed explanation of your problem, and will discuss our holistic approach and management plan including the utilisation of Low Level Laser Therapy (LLLT). If your condition is amenable to LLLT the treatment is commenced at the initial consultation. A medical consultation with Dr Shikha Parmar, GP, is billed and is rebatable through Medicare for patients who hold a Medicare card.

The fee for an initial consultation including Low Level Laser Therapy treatment is $257.00. This includes a Medicare rebate for the GP consultation of $84.90, the out of pocket cost being $172.10.

Pension and Health Care Card holders receive a further reduced fee for the initial consultation of $207.00 only with the out of pocket fee (gap fee) being $122.10.

For each subsequent follow-up consultation  involving review of progress, tailored advice and management etc, and Low Level Laser Therapy treatment, a fee of $129.25 applies. This includes a Medicare rebate for the GP consultation of $43.90, the out of pocket cost (gap fee) being $85.35.

Longer review visits are charged at $210.20 which includes a Medicare rebate $84.90, the out-of-pocket cost being $125.30.
An $8.00 surcharge applies to appointments after 6pm.

Fees may be subject to change and will be confirmed with you at the time of booking. We utilise state of the art equipment from Europe and the USA operated with the assistance of highly trained clinic assistants.  No further rebate can be claimed from private health insurance. We are unable to offer bulk billing.

Yes.  LLLT has been in active and beneficial use in Europe for nearly 30 years. There are more than 200 double blind positive studies confirming the clinical effect of LLLT.
Published in the world’s top scientific journals:

  • Nature, Pain, PNS, Blood, BMJ, Spine, Muscle and Nerve, The Lancet, Circulation, BJSM
  • 30 LLLT papers published a month
  • Over 4000 laboratory studies and over 400 randomised controlled trials

Over 2,500 clinical studies and published research reports have shown the effectiveness of LLLT for a variety of health issues. Looking at the limited LLLT dental literature alone (370 studies), more than 90% of these studies do verify the clinical value of laser therapy.
LLLT has been a staple in veterinary practices for decades.
In the past 6 years, professional sports teams have begun utilising LLLT.

In the last 10 years 8 systematic reviews have found in favour of LLLT

  • American College of Physicians Guidelines include a “strong recommendation” for Low-Level Laser Therapy as a non-invasive Treatments for Acute, Subacute & Chronic Low Back Pain. (2017) Click here
  • BMJ LLLT for chronic non-specific low back pain: a systematic review and meta-analysis of randomised controlled trials found “moderate quality of evidence” and “clinically important benefits” in the short term. (2016) Click here
  • BMJ sports medicine journal, systematic review of surgical and conservative interventions for frozen shoulder found “strong evidence” for LLLT. (2010) Click here
  • The BMJ clinical evidence recommendations for tennis elbow 2011 now include LLLT Click here
  • American Physical Therapy Association guidelines recommend LLLT for Achilles tendonitis. (2010) Click here
  • Lancet systematic review: “LLLT reduces pain immediately after treatment in acute neck pain and up to 22 weeks after completion of treatment in patients with chronic neck pain”. (2009) Click here
  • World Health Organisation (Bone and Joint Task Force) for neck pain Low Level Laser Therapy “more effective than no treatment, sham, or alternative interventions” (2008) Click here

Laser Therapy does not heat or cut tissue, unlike high intensity lasers. The question is often asked “If it’s a laser aren’t they used in surgical operations, to cauterise tissue?” The answer is “Yes” – hot lasers are able to cauterise (cut) tissue. However, the ones we use are “Low Level Lasers” of class 3B, the most researched and proven class in LLLT, and with designed parameters that make it impossible to damage even one cell in the body. Our lasers stimulate and energise the cells.

In the past 4 years, the FDA has ruled that LLLT (Low Level Laser Therapy) is safe and the only contraindication (warning) is not to use it directly in the eyes.

For the past 30 years the technology of Low Level Laser Therapy (LLLT) has been formally accepted in many parts of the world such as Canada, USA, Brazil, Europe, Scandinavia, Russia and Japan. In all this time there have been no recorded long-term adverse effects from its use. It is considered to be non-invasive, painless and safe.

Industry has been using laser diodes for years in such applications as barcode readers, CD players, DVD players, laser printers and pointers. The FDA has listed bio-stimulation lasers as non-significant risk (NSR) devices.

Hundreds of research studies have shown Laser Therapy to be safe and effective. Laser Therapy is non-invasive, non-toxic and non-thermal. Unlike other forms of radiation, Laser Therapy is beneficial rather than harmful to tissue. Over 400 LLLT clinical trials (RCTs) and over 2500 laboratory studies have been published. It has proven more effective and safer than pharmaceutical anti-inflammatories across a range of musculoskeletal conditions.

LLLT also improves healing and reduces muscle fatigue, muscle damage and delayed onset muscle soreness or DOMS.

There are normally no adverse effects from LLLT, however, patients occasionally experience mild discomfort/ache after treatment. This is due to a restimulation of the inflammatory phase and should settle down after 24 – 48 hours.

The answer is no. No mutational effects have been observed resulting from light with wavelengths in the red or infrared range and of doses used within LLLT. But what happens if I treat someone who has cancer and is unaware of it? Can the cancer’s growth be stimulated? The effects of LLLT on cancer cells in vitro have been studied, and it was observed that they could be stimulated by laser light. However, with respect to a cancer in vivo, the situation is rather different. Experiments on rats have shown that small tumours treated with LLLT can recede and completely disappear, although laser treatment had no effect on tumours over a certain size. It is probably the local immune system, which is stimulated more than the tumour.

The situation is the same for bacteria and virus in culture. These are stimulated by laser light in certain doses, while a bacterial or viral infection is eradicated more quickly after treatment with LLLT.

Laser Therapy should be avoided in the following instances:

  • Over the womb for women in pregnancy
  • Over cancerous tumour, primary or secondary (LLLT is not a treatment for these conditions)
  • Direct irradiation of the eyes

At Laser Pain Therapy, we use state-of-the-art, TGA-approved laser devices, applied by highly trained assistants. Our laser devices deliver the appropriate red and infrared laser energy to trigger the desired tissue response. With the application of up to 37 diodes (laser lights) across multiple devices, we ensure time-efficient treatment without compromising dosage or energy delivery. Unlike LED devices, our laser technology provides deeper penetration and more effective tissue healing.

Dr Shikha Parmar, an experienced GP with over 30 years in General Practice and 14 years of expertise in photobiomodulation therapy, leads our clinic, making her one of the most experienced doctors in this field. Treatment at Laser Pain Therapy is medically supervised, ensuring each patient receives a thorough assessment that takes into account not only their presenting condition but also relevant health factors, such as co-morbidities, medications, lifestyle, work, personal activity demands, and nutritional deficiencies. This holistic approach allows us to tailor care with LLLT at the core, supported by personalised advice.

Additionally, our treatment plans are finite, with clear goal-setting and regular progress reviews, ensuring that each patient is on track towards long-term recovery and optimal outcomes.

At Laser Pain Therapy, we use advanced equipment with laser diodes, not LED lights. Unlike LEDs, laser diodes provide more focused light with deeper penetration, making them significantly more effective for treating musculoskeletal conditions.

Our state-of-the-art equipment features 37 laser diodes, allowing us to efficiently cover a larger surface area. This optimises treatment time, ensuring deeper penetration for superior results. Unlike devices that use just 2-4 diodes, our technology delivers more effective treatment in less time, promoting faster healing, reduced inflammation, and long-lasting pain relief.

The effects of LLLT are accumulative. The good news is that for most patients undergoing a treatment program, the results from the treatments are sustained. While some patients get immediate results, improvements are often not noticed until after 3 to 5 treatments. Most patients usually require 6-12 treatments to achieve resolution of the problem or a lasting effect.

More severe conditions will require more treatments than less severe injuries. Since each person’s condition varies in severity the doctor will determine after reviewing your condition how laser treatments may benefit you and how many you might require

Your situation will be assessed after 6 treatments and if there is no improvement after 6 to 8 treatments (very uncommon), LLLT will not be continued and alternatives will be looked at for your future management.

You will need to follow precautions in order to avoid re-injury or the pain may return. Low Level Laser Therapy not only helps injured tissues heal faster, it also makes them stronger and less vulnerable to re-injury.

Contact us to book a consultation at our clinic or to learn more about how this form of therapy could help you.

No. Low level lasers do not generate perceivable heat. Therefore, when the laser contacts the skin the patient experiences no burning as a result of the laser. Most people feel nothing at all while a few may feel a slight tingling or warmth during the treatment.

No. As Dr Shikha Parmar is a General Practitioner a doctor’s referral is not required.

With our dedicated clinic in Melbourne, contact us at Laser Pain Therapy to discuss how we can assist you

Images and Illustrations Disclaimer
Please note that the images, diagrams, and illustrations used on this website are for demonstration and illustrative purposes only. They are intended to provide a general overview of Photobiomodulation Therapy (PBMT) and Low-Level Laser Therapy (LLLT). The specific methods and equipment we use at Laser Pain Therapy may differ from those depicted. For instance, while some images may show a small laser being applied to the skin, we utilise advanced cluster lasers equipped with multiple diodes, offering superior coverage and effectiveness for treating musculoskeletal conditions. Our treatment protocols are tailored to each patient’s unique needs, using the latest technology for optimal results.

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Laser Pain Therapy

South Yarra, Victoria
Suite 8, 200 Toorak Road
(Ground floor from William St)
South Yarra, Vic 3141
Ph: 03 8529 2225
Email us:
info@laserpaintherapy.com.au

 

Location

TRANSPORT ACCESS:
Train: South Yarra Station, 100m, 1 minute walk
Tram: Route 58, stop no. 127

Easy free street parking:
If driving you will find many free 1P and 2P spots on and around Toorak Rd and William St near the clinic.

 
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Our Mission

We are dedicated to helping our patients with the most technically advanced, proven and affordable medical therapies. Our treatment modalities offer evidence-based, safe, non-invasive and painless solutions to improve health, well-being and quality of life.

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The contents of this website have not been evaluated by the Australian Government Department of Health. The information of this site is not intended to diagnose, treat, cure or prevent any disease. Individual articles are based upon the opinions of the author, who retains copyright as listed…..Continue Reading

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