Paper 3/2012

Lasers Surg Med. 2005 Mar;36(3):210-9.

Randomized controlled trial on low level laser therapy (LLLT) in the treatment of osteoarthritis (OA) of the hand.

Brosseau L, Wells G, Marchand S, Gaboury I, Stokes B, Morin M, Casimiro L, Yonge K, Tugwell P.
School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario K1H 8M5, Canada.
Lucie.Brosseau@uottawa.ca
Comment in: Lasers Surg Med. 2006 Apr;38(4):343.

BACKGROUND AND OBJECTIVES: Low level laser therapy (LLLT) offers promising symptomatic relief of osteoarthritic (OA) pain. We examined efficacy of active LLLT versus sham LLLT on finger joints and three superficial nerves.

STUDY DESIGN/MATERIALS AND METHODS: OA-patients randomly assigned, received three treatments per week for 6 weeks of LLLT (n = 42) or sham LLLT (n = 46).

RESULTS: Pain relief, morning stiffness, and functional status did not significantly improve for LLLT versus placebo. No significant differences were found in finger range of motion, except carpometacarpal opposition (P = 0.011), grip strength, and patient global assessment which improved for active LLLT participants (P = 0.041).

CONCLUSIONS: LLLT is no better than placebo at reducing pain, morning stiffness, or improving functional status for OA-hand patients.

Annal Comments:

Total energy per finger joint (30 mW x 4 seconds per joint) is 0.12 J. Dose is 3 J/cm^2 which appears to be fair, but here again, the energy is very low. The “high” value for J/cm^2 is obtained by using a small beam spot. Dose and energy, again, need to be within the therapeutic window [1, 2]. Dosage recommendation of The World Association for Laser Therapy is 4 J per joint, 1-2 points [3].

References:

1.   Bjordal JM, Couppe C, Chow RT, Tunér J, Ljunggren AE. A systematic review of low level laser therapy with location-specific doses for pain from chronic joint disorders. Austr J Physiotherapy 2003;49:107–116.

2.   Bjordal JM, Couppe C, Ljunggren A. Low level laser therapy for tendinopathy. Evidence of a dose-response pattern. Phys Ther Rev 2001;6(2):91–100.

3.   http://www.walt.nu/dosage-recommendations.html