COMPARING LOW-LEVEL LASER THERAPY AND ULTRASOUND THERAPY FOR CHRONIC NECK PAIN MANAGEMENT: A RANDOMIZED CONTROLLED TRIAL
Keywords:
Chronic neck pain, Low-level laser therapy, Muscle relaxation, Pain management, Physiotherapy, Randomized controlled trial, Range of motion, Therapeutic ultrasoundAbstract
Background: Chronic neck pain is a common musculoskeletal disorder that significantly impacts daily functioning and quality of life. Non-pharmacological approaches in physiotherapy, including low-level laser therapy (LLLT) and therapeutic ultrasound (US), are often employed to alleviate symptoms and enhance functional recovery. Nevertheless, comparative data on their effectiveness are scarce and inconclusive.
Objective: This study aimed to evaluate and contrast the influence of low-level laser therapy versus therapeutic ultrasound on pain levels, cervical mobility, and muscle relaxation in patients with chronic neck pain.
Methods: A six-month randomized controlled trial was carried out in tertiary physiotherapy facilities located in South Punjab. Sixty individuals between 25 and 55 years of age, diagnosed with nonspecific chronic neck pain, were randomly divided into two groups of equal size: Group A underwent low-level laser therapy, while Group B received therapeutic ultrasound. Both groups completed 12 treatment sessions across four weeks, supplemented by a consistent regimen of stretching and postural correction exercises. Pain was quantified with the Visual Analogue Scale (VAS), cervical range of motion was measured using a goniometer, and functional limitation was assessed via the Neck Disability Index (NDI). Data were analyzed with paired and independent t-tests, adopting a significance threshold of .
Results: Both treatments led to significant decreases in pain and improvements in mobility and function. However, the LLLT group exhibited a more pronounced reduction in pain (VAS: to ) relative to the ultrasound group (VAS: to ). Superior improvements were also recorded across all directions of cervical movement and in NDI scores for the LLLT group ().
Conclusion: In conclusion, low-level laser therapy yielded better clinical results than therapeutic ultrasound, indicating its potential as a more effective physiotherapy treatment for chronic neck pain.
References
1. de la Barra Ortiz HA, Arias M, Liebano REJLiMS. A systematic review and meta-analysis of randomized controlled trials on the effectiveness of high-intensity laser therapy in the management of neck pain. 2024;39(1):124.
2. Shrestha D, Sharma SJRPeF. Comparison of the clinical effectiveness of Class IV Laser therapy and therapeutic ultrasound in patients with chronic neck pain: a randomized controlled trial. 2024;14:e5538-e.
3. de la Barra Ortiz HA, Avila MA, Miranda LG, Liebano REJT. Effect of high-intensity laser therapy in patients with non-specific chronic neck pain: study protocol for a randomized controlled trial. 2023;24(1):563.
4. Ali AAZ, ElBasiouny MS, Morsy MI, Abouamra HS, Elshennawy SJBJoMS. Immediate effects of 850 nm Diode Laser on patients with Cervical Myofascial Pain Syndrome: a Randomized-controlled trial. 2024;23(2):337-44.
5. Foypikul S, Eungpinichpong W. Effects of a combined low-level laser therapy and strengthening exercise program on pain perception and quality of life in office workers with chronic non-specific neck pain.
6. Xie Y, Diao Y, Wu D, Liao M, Liao LJFiM. Immediate effects of high-intensity laser therapy for nonspecific neck pain: a double-blind randomized controlled trial. 2025;12:1550047.
7. Ali AAZ, El Basiouny MS, Morsy MI, Abouamra HS, Elshennawy S. Effect Low Level Laser Therapy versus Extracorporeal Shockwave Therapy in the management of pain and function of Cervical Myofascial Pain Syndrome patients: a Randomized-Comparative Study.
8. He P, Fu W, Shao H, Zhang M, Xie Z, Xiao J, et al. The effect of therapeutic physical modalities on pain, function, and quality of life in patients with myofascial pain syndrome: a systematic review. 2023;24(1):376.
9. Hao J, He Z, Huang B, Li Y, Remis A, Yao Z, et al. Comparative effectiveness of six biophysical agents on neck pain rehabilitation: a systematic review and network meta-analysis. 2025:1-18.
10. de la Barra Ortiz HA, Parizotto NA, Liebano REJLiMS. Effectiveness of high-intensity laser therapy in patients with spinal radiculopathy: a systematic review with meta-analysis. 2025;40(1):328.
11. SHRESTHA D, HUSSAIN MA, BEGUM BARBHUIYA NN, RAHMAN Y, KALITA M, SHARMA SJJoC, et al. An Overview and Implication of High Intensity Laser Therapy in Neck Pain: A Narrative Review. 2023;17(9).
12. Alowaimer HA, Al Shutwi SS, Alsaegh MK, Alruwaili OM, Alrashed AR, AlQahtani SH, et al. Comparative efficacy of non-invasive therapies in Temporomandibular Joint Dysfunction: a systematic review. 2024;16(3).
13. de la Barra Ortiz HA, Arias M, Meyer von Schauensee M, Liebano REJLiMS. Efficacy of High-intensity laser therapy in patients with temporomandibular joint disorders: A systematic review and meta-analysis. 2024;39(1):210.
14. Bhoi S, Koushal D, Manas A, Sidhu R, Shergill NK, Kakkad A, et al. Efficacy of TENS, ultrasound and low level laser in the management of TMJ disorder. 2025;21(5):969.
15. Ranjithkumar N, Paul J, Alagesan J, Viswanathan RJB, Journal P. Comparative Effectiveness of Extracorporeal Shock Wave Therapy, Low-level Laser Therapy, and Ultrasound in the Treatment of Rotator Cuff Tendinopathy. 2025;18(1):849-66.
16. El-Sadany SM, Sayed AA-A, Kamel KM, El-ghitany SIJAiR. High intensity laser therapy versus scapular stabilization exercises on ventilatory function in forward head posture. 2024;38(1).
17. Liu J, Zhang F, Cai Y, Liu YJAMR. Physical therapy in patients with temporomandibular joint disorders. 2025;4(1):1-12.
18. Polonsky MJLiDS. Evaluation of patient-related outcomes following treatment of temporomandibular disorders with a 940-nm diode laser: a retrospective clinical pilot study. 2023;7(2):53-9.
19. Alshammari SS, Amin S, Siddiqui AA, Malik YR, Alshammari AF, Amin J, et al. An evidence-based treatment of myofascial pain and myofascial trigger points in the maxillofacial area: a narrative review. 2023;15(12).
20. Arribas-Pascual M, Hernández-Hernández S, Jiménez-Arranz C, Grande-Alonso M, Angulo-Díaz-Parreño S, La Touche R, et al. Effects of physiotherapy on pain and mouth opening in temporomandibular disorders: an umbrella and mapping systematic review with meta-meta-analysis. 2023;12(3):788.
21. Miller LA, Alves JCJLTiVMP. Musculoskeletal disorders and osteoarthritis. 2025:129-50.
22. Burris BJ, Bavarian R, Shaefer JRJDC. Nonsurgical management of temporomandibular joint arthropathy. 2023;67(1):27-47.
23. Hyppolito JP, Hesham A, Sunavala‐Dossabhoy G, Kim DDJOD. Fibrosis, Contractures, and Trismus: Delayed Complications of Treatment of Head and Neck Cancer. 2025.
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Copyright (c) 2025 Muhammad Dawood, Kashaf Royyan, Muhammad Wasim Salim (Author)
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