Placebo-Controlled Investigation of Low-Level Laser Therapy to Treat Carpal Tunnel Syndrome

Lazović, Milica; Ilic-Stojanovic, Olivera; Kocić, Miodrag; Živković, Vesna; Hrkovic, Marija; Radosavljevic, Natasa

doi:10.1089/pho.2013.3563

Cited by 35 publications

(20 citation statements)

References 49 publications

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“…One RCT by Lazovic was excluded because no available data can be pooled to calculate together. [ 29 ] No additional studies were obtained after the reference review. The search strategy ultimately identified 7 randomized clinical trials satisfying the predefined inclusion criteria; there were 270 wrists in the laser group and 261 wrists in the control group.…”

Section: Resultsmentioning

confidence: 99%

Effectiveness of low-level laser on carpal tunnel syndrome

Wang

Zhang

et al. 2016

Medicine

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Background:Low-level laser therapy (LLLT) has been applied in the treatment of carpal tunnel syndrome (CTS) for an extended period of time without definitive consensus on its effectiveness. This meta-analysis was conducted to evaluate the effectiveness of low-level laser in the treatment of mild to moderate CTS using a Cochrane systematic review.Methods:We conducted electronic searches of PubMed (1966–2015.10), Medline (1966–2015.10), Embase (1980–2015.10), and ScienceDirect (1985–2015.10), using the terms “carpal tunnel syndrome” and “laser” according to the Cochrane Collaboration guidelines. Relevant journals or conference proceedings were searched manually to identify studies that might have been missed in the database search. Only randomized clinical trials were included, and the quality assessments were performed according to the Cochrane systematic review method. The data extraction and analyses from the included studies were conducted independently by 2 reviewers. The results were expressed as the mean difference (MD) with 95% confidence intervals (CI) for the continuous outcomes.Results:Seven randomized clinical trials met the inclusion criteria; there were 270 wrists in the laser group and 261 wrists in the control group. High heterogeneity existed when the analysis was conducted. Hand grip (at 12 weeks) was stronger in the LLLT group than in the control group (MD = 2.04; 95% CI: 0.08–3.99; P = 0.04; I2 = 62%), and there was better improvement in the visual analog scale (VAS) (at 12 weeks) in the LLLT group (MD = 0.97; 95% CI: 0.84–1.11; P < 0.01; I2 = 0%). The sensory nerve action potential (SNAP) (at 12 weeks) was better in the LLLT group (MD = 1.08; 95% CI: 0.44–1.73; P = 0.001; I2 = 0%). However, 1 included study was weighted at >95% in the calculation of these 3 parameters. There were no statistically significant differences in the other parameters between the 2 groups.Conclusion:This study revealed that low-level laser improve hand grip, VAS, and SNAP after 3 months of follow-up for mild to moderate CTS. More high-quality studies using the same laser intervention protocol are needed to confirm the effects of low-level laser in the treatment of CTS.

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Section: Resultsmentioning

confidence: 99%

Effectiveness of low-level laser on carpal tunnel syndrome

Wang

Zhang

et al. 2016

Medicine

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“…Conservative treatment is recommended in the mild and moderate stage of CTS245 and should involve splinting, steroid injections, oral steroids, and ultrasounds 5. However, the results of some research studies have showed the beneficial effect of photobiomodulation as well as nerve and tendon gliding exercises in nonoperative treatment 678910111213. It has been assumed that the analgesic, anti-inflammatory, and anti-edematous effects of the application of low-level laser and ultrasound might be caused by stimulation of biochemical and biophysical processes at the cellular and tissue level 1415.…”

Section: Introductionmentioning

confidence: 99%

The Effects of Nerve and Tendon Gliding Exercises Combined with Low-level Laser or Ultrasound Therapy in Carpal Tunnel Syndrome

Bartkowiak

Eliks

Zgorzalewicz-Stachowiak

et al. 2019

IJOO

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Background:Carpal tunnel syndrome (CTS) is a common medical condition that doctors and physiotherapists come across in clinical practice. There are no explicit recommendations concerning which physical therapy methods should be applied in its treatment; however, there have also been no studies on the effects of combining low-level laser therapy (LLLT) or ultrasound with nerve and tendon gliding exercises. The purpose of this study was to evaluate the therapeutic efficacy of ultrasound and LLLT combined with gliding exercises.Materials and Methods:A total of seventy patients with mild to moderate CTS, divided into two groups, were included in this study. Group 1 received ultrasound treatment, whereas Group 2 underwent LLLT. The treatment lasted 2 weeks (5 sessions/week). In addition, both groups were treated with nerve and tendon gliding exercises three times daily. The clinical evaluation involved an interview on subjective and objective sensory abnormalities, the intensity of pain, the measurement of grip strength, Phalen's test, Tinel's sign, and the Boston Carpal Tunnel Questionnaire. The assessment was performed before and after the treatment.Results:A decrease in sensory impairments, improvement in visual analog scale, hand grip strength and the Boston Questionnaire results were significant in all patients after therapy. No meaningful differences between groups were noted in any of the examined variables after treatment. No adverse effects were observed.Conclusions:The results of this study may suggest the clinical efficacy of LLLT or ultrasound combined with gliding exercises in patients with mild to moderate CTS.

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“…There were significantly fewer cases with positive Tinel's sign (a clinical indicator of median nerve entrapment) in the active laser group, although a decrease in the presence of Tinel's sign was seen in both LLLT and control groups. There was also a significant decrease in the wrist to digit 2 median sensory nerve conduction velocity as compared with control [22]. This study indicates that LLLT may be beneficial for the treatment of both symptoms and nerve pathology in carpal tunnel syndrome.…”

Section: Carpal Tunnel Syndromementioning

confidence: 54%

Laser Light Therapy in Inflammatory, Musculoskeletal, and Autoimmune Disease

Wickenheisser

Zywot

Rabjohns

et al. 2019

Curr Allergy Asthma Rep

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Purpose of Review-The goal of this review is to summarize the field to date and to discuss strengths and limitations of low-level laser (light) therapy (LLLT) for the future investigation as a treatment of inflammatory disease. Recent Findings-LLLT is a promising therapeutic, particularly for those diseases of skin and joints because they are most accessible to treatment. Indeed, the known mechanisms of LLLT support its use for anti-inflammatory purposes, as well as stimulation of tissue growth and repair. Although the standard of care for the majority of inflammatory diseases is immunosuppressive agents such as corticosteroids with undesirable toxicities, LLLT offers a unique approach by being non-invasive and incurring minimal side effects. It is also relatively inexpensive and accessible and even has the possibility to be patient directed at home. Summary-There is evidence that LLLT is able to modulate the immune system at the skin and joint, and it has been shown to be efficacious in humans by affecting bacterial colonization as it may pertain to chronic rhinosinusitis. However, there is variability in the methods of laser application as well as a lack of evidence for laser type, dose-ranging studies, and wavelength selection that create barriers to the implementation of LLLT without further more rigorous and standardized study. The heterogeneity makes it difficult to draw strong conclusions about the efficacy of LLLT and its mechanisms.

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Placebo-Controlled Investigation of Low-Level Laser Therapy to Treat Carpal Tunnel Syndrome

Abstract: This study has observed and documented the statistically significant short-term effects of LLLT on CTS patients in comparison with a placebo group. The results support this conclusion, especially if the LLLT is applied in the earlier stages of CTS, and with mild to moderate cases.

Cited by 35 publications

References 49 publications

Effectiveness of low-level laser on carpal tunnel syndrome

Effectiveness of low-level laser on carpal tunnel syndrome

The Effects of Nerve and Tendon Gliding Exercises Combined with Low-level Laser or Ultrasound Therapy in Carpal Tunnel Syndrome

Laser Light Therapy in Inflammatory, Musculoskeletal, and Autoimmune Disease

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