Low-level laser therapy for chronic non-specific low back pain: a meta-analysis of randomised controlled trials.
Author: Glazov G1, Yelland M2, Emery J3
Affiliation:
1Hillarys Medical Centre, Hillarys, Western Australia, Australia School of Primary, Aboriginal and Rural Health Care, University of Western Australia, Crawley, Western Australia, Australia.
2Primary Health Care, School of Medicine, Griffith University, Meadowbank, Queensland, Australia.
3General Practice and Primary Care Academic Centre, The University of Melbourne, Melbourne, Victoria, Australia.
Conference/Journal: Acupunct Med.
Date published: 2016 May 20
Other:
Pages: acupmed-2015-011036 , Special Notes: doi: 10.1136/acupmed-2015-011036. [Epub ahead of print] , Word Count: 294
OBJECTIVE: The efficacy of low-level laser treatment (LLLT) for chronic back pain remains controversial due to insufficient trial data. We aimed to conduct an updated review to determine if LLLT (including laser acupuncture) has specific benefits in chronic non-specific low back pain (CNLBP).
METHODS: Electronic databases were searched for randomised trials using sham controls and blinded assessment examining the intervention of LLLT in adults with CNLBP. Primary outcomes were pain and global assessment of improvement with up to short-term follow-up. Secondary outcomes were disability, range of back movement, and adverse effects. A random effects meta-analysis was conducted. Subgroup analyses were based on laser dose, duration of baseline pain, and whether or not laser therapy used an acupuncture approach.
RESULTS: 15 studies were selected involving 1039 participants. At immediate and short-term follow-up there was significant pain reduction of up to WMD (weighted mean difference) -1.40 cm (95% CI -1.91 to -0.88 cm) in favour of laser treatment, occurring in trials using at least 3 Joules (J) per point, with baseline pain <30 months and in non-acupuncture LLLT trials. Global assessment showed a risk ratio of 2.16 (95% CI 1.61 to 2.90) in favour of laser treatment in the same groups only at immediate follow-up.
CONCLUSIONS: We demonstrated moderate quality of evidence (GRADE) to support a clinically important benefit in LLLT for CNLBP in the short term, which was only seen following higher laser dose interventions and in participants with a shorter duration of back pain. Rigorously blinded trials using appropriate laser dosage would provide greater certainty around this conclusion.
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
KEYWORDS: LASER THERAPY, LOW LEVEL; PAIN MANAGEMENT; SYSTEMATIC REVIEWS
PMID: 27207675 [PubMed - as supplied by publisher]
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