Is low-level laser therapy in relieving neck pain effective? Systematic review and meta-analysis

Kadhim-Saleh, Amjed; Maganti, Harinad; Ghert, Michelle; Singh, Sheila K.; Farrokhyar, Forough

doi:10.1007/s00296-013-2742-z

Cited by 27 publications

(12 citation statements)

References 25 publications

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“…Also, for those with shoulder and/or neck pain, evidence suggests ultrasound does not confer significant or added benefit over placebo or other treatments [47, 55, 101, 140, 153, 157]. The evidence on effectiveness of laser therapy for shoulder pain [59, 159], or acute or chronic neck pain was inconclusive [151]. With regards to knee pain, other treatments including ultrasound, electromagnetic fields, low level laser therapy, TENS, biofeedback, neuromuscular electrical stimulation may confer added benefits to exercise and / or surgical treatment but empirical and clinical effect sizes are small and only supported by weak evidence [16, 47, 48, 112, 129, 143, 146, 147].…”

Section: Resultsmentioning

confidence: 99%

Effective treatment options for musculoskeletal pain in primary care: A systematic overview of current evidence

Babatunde¹,

Jordan²,

Windt³

et al. 2017

PLoS ONE

311

226

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Background & aimsMusculoskeletal pain, the most common cause of disability globally, is most frequently managed in primary care. People with musculoskeletal pain in different body regions share similar characteristics, prognosis, and may respond to similar treatments. This overview aims to summarise current best evidence on currently available treatment options for the five most common musculoskeletal pain presentations (back, neck, shoulder, knee and multi-site pain) in primary care.MethodsA systematic search was conducted. Initial searches identified clinical guidelines, clinical pathways and systematic reviews. Additional searches found recently published trials and those addressing gaps in the evidence base. Data on study populations, interventions, and outcomes of intervention on pain and function were extracted. Quality of systematic reviews was assessed using AMSTAR, and strength of evidence rated using a modified GRADE approach.ResultsModerate to strong evidence suggests that exercise therapy and psychosocial interventions are effective for relieving pain and improving function for musculoskeletal pain. NSAIDs and opioids reduce pain in the short-term, but the effect size is modest and the potential for adverse effects need careful consideration. Corticosteroid injections were found to be beneficial for short-term pain relief among patients with knee and shoulder pain. However, current evidence remains equivocal on optimal dose, intensity and frequency, or mode of application for most treatment options.ConclusionThis review presents a comprehensive summary and critical assessment of current evidence for the treatment of pain presentations in primary care. The evidence synthesis of interventions for common musculoskeletal pain presentations shows moderate-strong evidence for exercise therapy and psychosocial interventions, with short-term benefits only from pharmacological treatments. Future research into optimal dose and application of the most promising treatments is needed.

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Section: Resultsmentioning

confidence: 99%

Effective treatment options for musculoskeletal pain in primary care: A systematic overview of current evidence

Babatunde¹,

Jordan²,

Windt³

et al. 2017

PLoS ONE

311

226

View full text Add to dashboard Cite

show abstract

“…However, this meta-analysis has been criticized for betweenstudy heterogeneity and publication bias [17,18]. In a recent review, Kadhim-Saleh et al [19] stated that their findings provide inconclusive evidence of the benefits of LLLT in patients with cervical MPS because of significant betweenstudy heterogeneity and a potential risk of bias. LLLT, also known as "low-energy" or "low-power" laser therapy, is performed at low radiation intensities.…”

Section: Discussionmentioning

confidence: 98%

Effect of high-intensity laser therapy in the management of myofascial pain syndrome of the trapezius: a double-blind, placebo-controlled study

et al. 2014

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Myofascial pain syndrome (MPS) of the trapezius muscle is one of the main causes of neck pain. In this randomized, double-blind study, we evaluated the effects of high-intensity laser therapy (HILT) in female patients with chronic MPS of the trapezius muscle. The patients were assigned to two groups. The HILT group was treated with HILT and exercise, and the sham therapy group was treated with placebo HILT and exercise. The patients were assessed for pain, cervical active range of motion, disability, and quality of life. Evaluations were performed before treatment (week 0) and after treatment (weeks 4 and 12). Both groups showed significant improvement in all parameters at weeks 4 and 12. However, in a comparison of the percentage changes in the parameters at weeks 4 and 12 relative to pretreatment values, the HILT group showed greater improvement in pain scores, the neck disability index, and several subparts of the short-form 36 health survey (SF-36) (physical functioning, role limitations due to physical functioning, bodily pain, general health perceptions, social functioning, and role limitations due to emotional problems) than did the sham therapy group. We conclude that HILT is an effective therapeutic method in the treatment of patients with chronic MPS of the trapezius muscle.

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“…In a recent review 42 , the authors stated that LLLT has only short-term benefits (versus sham) in treating rotator cuff disease; however, HILT was effective in minimizing pain and disability and increasing range of motion in patients with shoulder pain 108 . Similarly, in a 2013 systematic review of LLLT in treating chronic neck pain, the authors reported that although the benefits observed were statistically significant, the differences failed to achieve a “minimally-important clinical difference” 109 . In contrast, Alayat et al found that HILT combined with exercise in patients with chronic low back 110 and neck 111 pain was more effective than exercise therapy alone and also had a more sustained effect in decreasing pain and functional disability (for example, improving range of motion), and beneficial effects lasted for up to 3 months.…”

Section: Laser Therapymentioning

confidence: 99%

Use of electroanalgesia and laser therapies as alternatives to opioids for acute and chronic pain management

White

Elvir-Lazo

Galeas³

et al. 2017

F1000Res

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The use of opioid analgesics for postoperative pain management has contributed to the global opioid epidemic. It was recently reported that prescription opioid analgesic use often continued after major joint replacement surgery even though patients were no longer experiencing joint pain. The use of epidural local analgesia for perioperative pain management was not found to be protective against persistent opioid use in a large cohort of opioid-naïve patients undergoing abdominal surgery. In a retrospective study involving over 390,000 outpatients more than 66 years of age who underwent minor ambulatory surgery procedures, patients receiving a prescription opioid analgesic within 7 days of discharge were 44% more likely to continue using opioids 1 year after surgery. In a review of 11 million patients undergoing elective surgery from 2002 to 2011, both opioid overdoses and opioid dependence were found to be increasing over time. Opioid-dependent surgical patients were more likely to experience postoperative pulmonary complications, require longer hospital stays, and increase costs to the health-care system. The Centers for Disease Control and Prevention emphasized the importance of finding alternatives to opioid medication for treating pain. In the new clinical practice guidelines for back pain, the authors endorsed the use of non-pharmacologic therapies. However, one of the more widely used non-pharmacologic treatments for chronic pain (namely radiofrequency ablation therapy) was recently reported to have no clinical benefit. Therefore, this clinical commentary will review evidence in the peer-reviewed literature supporting the use of electroanalgesia and laser therapies for treating acute pain, cervical (neck) pain, low back pain, persistent post-surgical pain after spine surgery (“failed back syndrome”), major joint replacements, and abdominal surgery as well as other common chronic pain syndromes (for example, myofascial pain, peripheral neuropathic pain, fibromyalgia, degenerative joint disease/osteoarthritis, and migraine headaches).

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Is low-level laser therapy in relieving neck pain effective? Systematic review and meta-analysis

Cited by 27 publications

References 25 publications

Effective treatment options for musculoskeletal pain in primary care: A systematic overview of current evidence

Effective treatment options for musculoskeletal pain in primary care: A systematic overview of current evidence

Effect of high-intensity laser therapy in the management of myofascial pain syndrome of the trapezius: a double-blind, placebo-controlled study

Use of electroanalgesia and laser therapies as alternatives to opioids for acute and chronic pain management

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