Laser therapy evidence unclear for low-back pain

Some clinicians, such as physiotherapists, use low-level laser therapy (LLLT) to treat patients with low-back pain or disability. Low-level laser therapy is a non-invasive light-source treatment that has no heat, sound or vibration. This systematic review explored whether low-level laser therapy is effective in treating patients with non-specific low-back pain.

The reviewers searched for clinical trials of low-level laser therapy to treat low-back pain in several electronic databases. Reviewers only included trials in which patients were randomly assigned to either receive low-level laser therapy or to belong to a comparison group receiving sham (or fake) treatments, no treatment or another treatment. Seven such randomized controlled trials were included in the review, involving 384 patients with non-specific low-back pain.

There was insufficient evidence to either support or disprove the effectiveness of low-level lasers. In three studies, low-level laser therapy did show benefits in providing pain relief and improving disability in low-back pain patients compared with a sham laser treatment. However, the effects were small. Also, the types of laser, dose, frequency and number of treatments varied. In another three studies, the effect of low-level laser therapy combined with exercise was no better than exercise alone. Based on the small number of studies and differences in patient populations and laser characteristics, the evidence is considered insufficient. The reviewers do not recommend substituting low-level laser therapy for other beneficial treatments.

The reviewers examined several databases that captured all randomized controlled trials looking at low-level laser therapy. However, individual studies were quite different in terms of the patient population and the laser characteristics. In addition, the sample sizes were small.