Additive effects of low-level laser therapy with exercise on subacromial syndrome: a randomised, double-blind, controlled trial

Abstract

The subacromial syndrome is the most common source of shoulder pain. The mainstays of conservative treatment are non-steroidal anti-inflammatory drugs and exercise therapy. Recently, low-level laser therapy (LLLT) has been popularized in the treatment of various musculoskeletal disorders. The aim of this study is to evaluate the additive effects of LLLT with exercise in comparison with exercise therapy alone in treatment of the subacromial syndrome. We conducted a randomised clinical study of 80 patients who presented to clinic with subacromial syndrome (rotator cuff and biceps tendinitis). Patients were randomly allocated into two groups. In group I (n = 40), patients were given laser treatment (pulsed infrared laser) and exercise therapy for ten sessions during a period of 2 weeks. In group II (n = 40), placebo laser and the same exercise therapy were given for the same period. Patients were evaluated for the pain with visual analogue scale (VAS) and shoulder range of motion (ROM) in an active and passive movement of flexion, abduction and external rotation before and after treatment. In both groups, significant post-treatment improvements were achieved in all parameters (P = 0.00). In comparison between the two groups, a significant improvement was noted in all movements in group I (P = 0.00). Also, there was a substantial difference between the groups in VAS scores (P = 0.00) which showed significant pain reduction in group I. This study indicates that LLLT combined exercise is more effective than exercise therapy alone in relieving pain and in improving the shoulder ROM in patients with subacromial syndrome.

Effectiveness of low-level laser therapy in patients with subacromial impingement syndrome: a randomized, placebo controlled, prospective study

“…In all these studies conducted for SIS, LLLT was not superior to other interventions. In contrast to these studies, Abrisham et al (23) reported that LLLT combined with exercise was more effective than exercise therapy alone in pain relief and increased shoulder ROM. In a systematic review, Green et al (24) indicated that exercise therapy was effective in recovery from rotator cuff disease, but laser therapy was not effective for rotator cuff tendinitis.…”

Systematic Review of Nondrug, Nonsurgical Treatment of Shoulder Conditions

“…Both used LLLT combined with exercise. One used placebo laser with exercise as the comparison group, 51 and the other used ultrasound and hot packs with exercise. 69 One found significant improvement in pain (VAS) in the active LLLT group, but not in the placebo group.…”

“…69 One found significant improvement in pain (VAS) in the active LLLT group, but not in the placebo group. 51 The other trial found a within-group improvement in pain (VAS) and function (Shoulder Pain and Disability Index [SPADI]) for both LLLT plus exercise and ultrasound plus exercise, but no significant difference between groups. 69 …”

Effectiveness of Low-Level Laser Therapy Combined With an Exercise Program to Reduce Pain and Increase Function in Adults With Shoulder Pain: A Critically Appraised Topic

“…1 Shoulder pain can be caused by any number of underlying conditions including subacromial impingement syndrome, rotator-cuff tendinitis, and biceps tendinitis. 2,3 Regardless of the specific pathology, pain is generally the number 1 symptom associated with shoulder injuries and can severely affect daily activities 4 and quality of life 5,6 of patients with these conditions. Two of the primary goals in the treatment of these conditions is reducing pain and increasing shoulder range of motion (ROM).…”

“…7,8 In addition, these exercise programs have been supplemented with other interventions including nonsteroidal anti-inflammatory drugs, corticosteroid injections, manual therapy, activity modification, and a wide array of therapeutic modalities (eg, cryotherapy, EMS, ultrasound). 2,3,7 Recently, low-level laser therapy (LLLT) has been used as an additional modality in the conservative management of patients with shoulder pain. 3,9,10 However, the true effectiveness of LLLT in decreasing pain and increasing function in patients with shoulder pain is unclear.…”