Articles

Can LLLT Substitute NSAIDS, Analgesics and Steroid Injections in Arthritis, Tendinopathies and Muscle Pain? A Comparison of Patient Samples, Efficacy and Safety in Randomized Placebo-Controlled Trials

Aim: To assess scientific evidence for treatment efficacy and safety of LLLT and standard pharmacological therapies in various patient samples with musculoskeletal pain.

Methods: Systematic reviews of randomized placebo-controlled trials (RCTs).

Results: The statistical power of evidence for LLLT in each diagnostic category were similar to, or significantly higher than, osteoarthritis (26 trials). For LLLT administered according to WALT guidelines, short-term pain relief in neck (9 trials) and knee osteoarthritis pain (5 trials) were superior to any pharmacological agent. LLLT had similar short-term pain relief as NSAIDS in low back pain (4 trials) and in tendinopathies (11 trials), but only pain relief from LLLT remained significant during 2-6 weeks follow-up. Follow-up data were available after NSAIDS or paracetamol therapies were sparse. The effect of steroid injections waned to non-significance within 2-6 weeks and was significantly poorer than tendinopathy controls at 3 months. In trials with pharmacological agents, most trials were performed in patients with short symptom duration, no previous treatment failures and avoidance of other potentially effective co-interventions. In LLLT trials, patients had frequently experienced previous treatment failures from pharmacological agents and they were often subject to potentially effective co-interventions which may have deflated effect size. In safety assessments, LLLT was superior to any pharmacological agent.

Conclusion: Due to superior safely and similar, or better, effect size than standard pharmacological agents, LLLT should be first-line treatment for short-term pain relief in low back and neck pain, arthritis and tendinopathy.

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