Low-level laser therapy effective option for knee osteoarthritis: BMJ study

Delhi: Low-level laser therapy (LLLT) (at 4–8 J with 785–860 nm wavelength and at 1–3 J with 904 nm wavelength) significantly reduces pain and disability in knee osteoarthritis (KOA) patients compared with placebo, according to findings from a new systematic review and meta-analysis published in the BMJ Open journal.

Osteoarthritis is the most common form of arthritis in the knee which has become one of the leading causes of disability in older adults. Presently there is no cure for knee osteoarthritis besides knee replacement.

Low-level laser therapy is not recommended in major knee osteoarthritis treatment guidelines. Martin Bjørn Stausholm, University of Bergen, Bergen, Norway, and colleagues investigated whether an LLLT dose-response relationship exists in KOA.

The researchers examined data from 22 trials involving 1063 individuals. Randomized placebo-controlled trials involving participants with KOA according to the American College of Rheumatology and/or Kellgren/Lawrence criteria, in which LLLT was applied to participants’ knee(s) were included. There were no language restrictions.

The trials were also subgrouped by adherence and non-adherence to the World Association for Laser Therapy recommendations for laser dose per treatment spot.

Key findings of the study include:

• Overall, pain was significantly reduced by LLLT compared with placebo at the end of therapy (14.23 mm Visual Analogue Scale (VAS)) and during follow-ups 1–12 weeks later (15.92 mm VAS).


• The subgroup analysis revealed that pain was significantly reduced by the recommended LLLT doses compared with placebo at the end of therapy (18.71 mm) and during follow-ups 2–12 weeks after the end of therapy (23.23 mm VAS).


• The pain reduction from the recommended LLLT doses peaked during follow-ups 2–4 weeks after the end of therapy (31.87 mm VAS significantly beyond placebo.


• Disability was also statistically significantly reduced by LLLT.


• No adverse events were reported.

"Our principal finding is that the recommended LLLT doses offer clinically relevant pain relief in KOA. The non-recommended LLLT doses provided no or little positive effect," wrote the authors.

More Information: "Efficacy of low-level laser therapy on pain and disability in knee osteoarthritis: systematic review and meta-analysis of randomised placebo-controlled trials" published in the BMJ Open journal.

DOI: http://dx.doi.org/10.1136/bmjopen-2019-031142

Journal Information: BMJ Open