Based on the sources, laser therapy can be used in conjunction with shockwave therapy, and in some cases, it is beneficial to do so [1-3]. However, the timing of the therapies in relation to each other is important to consider.
Here's what the sources suggest about the timing of laser therapy and shockwave therapy:
Laser therapy prior to shockwave therapy: Laser therapy can be used before shockwave therapy to provide an analgesic effect, which can reduce the discomfort of the shockwave treatment and allow for a more intensive treatment [2].
Laser therapy after shockwave therapy: Laser therapy can be used after shockwave therapy to encourage tissue remodeling as it heals [2].
No laser immediately before strenuous activity: Because of the rapid analgesic effect of laser therapy, it should not be done immediately before intensive training sessions, as the pain relief may overload the damaged structure and cause injury [4].
Additionally, one source advises against using ice or anti-inflammatory medications (such as ibuprofen) after shockwave therapy, as they may interfere with the healing process [5]. However, this source does not mention laser therapy as a contraindication to shockwave treatment.
One of the sources notes that a combination of laser and shockwave therapy can lead to a rapid reduction in pain in the early stages of therapy [6]. Another suggests that a course of laser therapy before shockwave may be helpful for patients who may struggle to tolerate shockwave, using laser to settle the acute pain [2].
While the sources do not directly address whether laser therapy should be performed within 24 hours of shockwave therapy, they do suggest that the two therapies are compatible and can be used in combination [7, 8]. Furthermore, one of the sources notes that it is recommended to refrain from any activity that stresses the treated area for 24 hours after a shockwave session [9]. Therefore, laser therapy could potentially be used within 24 hours of shockwave therapy, as long as it is not immediately before strenuous activity, but it may be more beneficial to allow the area to rest for 24 hours after the shockwave treatment.
In summary, while the sources do not specifically prohibit laser therapy within 24 hours of shockwave therapy, the suggested protocols in the sources indicate that it may be beneficial to use laser therapy before shockwave to reduce discomfort or after shockwave to promote tissue remodeling, but not immediately before strenuous exercise. It's important to consider the individual patient's needs and tolerance when determining the timing of these therapies [2, 3].
Sources:
Comparative study of shock wave therapy and Laser therapy effect in elimination of symptoms among patients with myofascial pain syndrome in upper trapezius - PMC
Everything You Should NOT Do After Shockwave Therapy | RISM
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