The Lancet systematic review and meta-analysis of LLLT for Neck Pain

This landmark study establishes that there is now more evidence for the use of laser for neck pain than any other medical procedure. For comment and to hear an interview with the lead author click here: The Lancet publishes that laser therapy helps neck pain

Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials

Roberta T Chow, Mark ‘Johnson, Rodrigo A B Lopes-Martins, Jan M Bjordal

Summary
Background Neck pain is a common and costly condition for which pharmacological management has limited evidence of efficacy and side-effects. Low-level laser therapy (LLLT) is a relatively uncommon, non-invasive treatment for neck pain, in which non-thermal laser irradiation is applied to sites of pain. We did a systematic review and metaanalysis of randomised controlled trials to assess the efficacy ofLLLT in neck pain.

Methods

We searched computerised databases comparing efficacy ofLLLT using any wavelength with placebo or with active control in acute or chronic neck pain. Effect size for the primary outcome, pain intensity, was defined as a pooled estimate of mean difference in change in mm on 100 mm visual analogue scale.

Findings

We identified 16 randomised controlled trials including a total of820 patients. In acute neck pain, results of two trials showed a relative risk (RR) of1·69 (95% CI 1· 22-2.33) for pain improvement ofLLLT versus placebo. Five trials of chronic neck pain reporting categorical data showed an RR for pain improvement of 4·05 (2.74-5.98) of LLLT. Patients in 11 trials reporting changes in visual analogue scale had pain intensity reduced by 19·86 mm (10.04-29.68). Seven trials provided follow-up data for 1-22 weeks after completion of treatment, with short-terIll pain relief persisting in the medium tenn with a reduction of22· 07 mm (17.42-26.72). Side-effects from LLLT were mild and not different from those of placebo.

Interpretation We show that LLLT reduces pain immediately after treatment in acute neck pain and up to 22 weeks after completion of treatment in patients with chronic neck pain.

Listen to the interview with Roberta Chow on using laser therapy for chronic neck pain.