Use of Class IV, High Intensity Laser Therapy as an Adjunct in Treating a Patient with an Acute Shoulder injury: A Case Report

Background: The use of high intensity laser therapy (HILT) in treating musculoskeletal conditions is used in some physical therapy clinics but is not widespread. The purpose of this case report is to present a case in which class IV, high intensity laser therapy was used successfully to treat a patient with acute shoulder pain. Furthermore, the author aims to present evidence supporting the use of high intensity laser therapy as a supplement to conservative interventions in patients with musculoskeletal injuries. Case Description: A 25-year-old female presented to physical therapy by referral from a work compensation physician with shoulder pain after a fall approximately 2 weeks prior to the initial visit. Intervention: Treatment consisted of education, upper extremity range of motion (ROM) techniques, strengthening, soft tissue mobilization, stretching, and various modalities – primarily class IV, high intensity therapeutic laser.Outcomes: Following the interventions, the patient demonstrated an increase of 20 points on the Focus on Therapeutic Outcomes (FOTO) questionnaire representing improved functional status. The patient also demonstrated improved pain free active ROM, raised her perceived level of improvement score by 60%, and had a notable decrease in pain levels. Discussion: A literature review using PubMed and UpToDate on the efficacy of class IV, high intensity therapeutic laser for treating musculoskeletal injuries was performed. Further research is needed to determine the optimal parameters of high intensity laser in treating musculoskeletal conditions; however, the randomized controlled trials (RCTs) mentioned in this case report show HILT as an effective treatment modality. This case report supports the use of high intensity laser therapy in conjunction with physical therapy intervention to improve ROM, pain levels, and overall functional status