Background: Lateral epicondylitis (LE), commonly known as tennis elbow, is a degenerative tendinopathy of the common extensor origin characterized by pain, reduced grip strength, and functional disability. The condition is especially prolonged in older adults due to age-related tendon degeneration, reduced vascularity, and slower collagen turnover. Manual therapy techniques such as Mill’s manipulation aim to restore tendon mobility, while Class IV high-intensity laser therapy (HILT) provides deeper photobiomodulatory effects that may accelerate tendon healing.

Objective: To evaluate the combined effects of Mill’s manipulation and Class IV HILT on pain, range of motion (ROM), grip strength, and functional outcomes in an older woman diagnosed with chronic lateral epicondylitis.

Methodology: This single-case, pre–post intervention study involved a 66-year-old woman with 7-month chronic right lateral epicondylitis. The intervention included Mill’s manipulation (3 sessions/week), Class IV HILT (3 sessions/week), wrist extensor stretching, progressive eccentric loading, isometric strengthening, grip training, and ergonomic retraining over four weeks. Outcome measures included the Visual Analog Scale (VAS), active wrist ROM, and grip strength assessed at baseline and week 4.

Results: After 4 weeks, the patient demonstrated substantial improvement: VAS pain reduced from 8/10 to 2/10; wrist extension improved from 35° to 70°; wrist flexion increased from 55° to 75°; and grip strength improved from 9 kg to 18 kg. Functionally, she returned to daily household tasks with minimal discomfort.