Low Level Laser

In recent decades, low-level laser therapy (LLLT) has been widely used to relieve pain caused by different musculoskeletal disorders. Though widely used, its reported therapeutic outcomes are varied and conflicting. 

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Essential Literature

THE EFFECTIVENESS OF LOW-LEVEL LASER THERAPY FOR NONSPECIFIC CHRONIC LOW BACK PAIN: A SYSTEMATIC REVIEW AND META-ANALYSIS
Huang et. al. 2015
Conclusion:
Our findings indicate that LLLT is an effective method for relieving pain in NSCLBP patients. However, there is still a lack of evidence supporting its effect on function.
 

EFFECTIVENESS OF LOW-LEVEL LASER THERAPY IN PATIENTS WITH KNEE OSTEOARTHRITIS: A SYSTEMATIC REVIEW AND META-ANALYSIS.
Huang et. al. 2015
Conclusion:
Our findings indicate that the best available current evidence does not support the effectiveness of LLLT as a therapy for patients with Knee Osteoarthritis.

LOW-LEVEL LASER THERAPY AS A TREATMENT FOR CHRONIC PAIN
Kingsley et. al. 2014
Conclusion:
Studies have demonstrated that LLLT may have positive effects on symptomology associated with chronic pain (Fulop et al., 2010; Hsieh and Lee, 2013); however this finding is not universal (Ay et al., 2010). A meta-analysis utilizing 52 effect sizes from 22 articles on LLLT and pain from Fulop et al. (2010) demonstrated an overall effect size of 0.84. This would be classified as a large effect size and suggests a strong inclination for the use of LLLT to reduce chronic pain. Twenty-two studies were utilized with doses ranging from 1 to 30 J/cm². On the other hand, a meta-analysis from Gam et al. (1993) demonstrated no effect of LLLT on musculoskeletal pain but this study was published over 20 years ago when LLLT was just emerging. More recently data from Ay et al. (2010) have reported no difference in chronic pain compared to placebo using twice weekly treatment 5 days a week for 3 weeks. Treatment consisted of a total energy of 40 J/cm² (850 nm, 100 mV, a treatment spot area of 0.07 cm², 4 min over each of the four different points). Taken together, it is hard to assess whether LLLT is an effective modality. However, it is clear that LLLT may be effective in treating chronic pain in many individuals and should not be overlooked as a treatment modality.

EFFICACY OF LOW-LEVEL LASER THERAPY IN THE MANAGEMENT OF NECK PAIN: A SYSTEMATIC REVIEW AND META-ANALYSIS
Chow et. al. 2009
Conclusion:
We show that LLLT reduces pain immediately after treatment in acute neck pain and up to 22 weeks after completion of treatment in patients with chronic neck pain.

LOW LEVEL LASER THERAPY (CLASSES I, II AND III) FOR TREATING RHEUMATOID ARTHRITIS.
Brosseau et. al. 2005
Conclusion:
LLLT could be considered for short-term treatment for relief of pain and morning stiffness for RA patients, particularly since it has few side-effects. Clinicians and researchers should consistently report the characteristics of the LLLT device and the application techniques used. New trials on LLLT should make use of standardized, validated outcomes. Despite some positive findings, this meta-analysis lacked data on how LLLT effectiveness is affected by four important factors: wavelength, treatment duration of LLLT, dosage and site of application over nerves instead of joints. There is clearly a need to investigate the effects of these factors on LLLT effectiveness for RA in randomized controlled clinical trials.