Low-level laser therapy in osteoarthritic pain: A narrative review with an approach to integrated clinical use.

Objective: The authors examine how Low-level laser therapy (LLLT) can be used in osteoarthritis (OA) management. LLLT has not, as yet, been widely integrated into OA management, either as a stand-alone modality or in conjunction with standard treatments. Methods: A narrative review of meta-analyses and trials using LLLT in OA treatment was undertaken to establish how it may be used optimally in OA management. Pubmed, Google Scholar and Cochrane databases were interrogated to identify analyses and trials. Results: Meta-analysis and trial results are variable, but improvements of up to 14.23 ​mm are noted in VAS scores following use in knee osteoarthritis (Standardised Mean Difference (SMD) 95 ​% CI: 7.31:21.14), 13.7 ​mm in spinal disease (SMD 95 ​% CI: 9.72; 17.42) and 19.86 ​mm (SMD 95 ​% CI: 10.04:29.68) in cervical disease. Positive effects on function were documented, as was a reduction in use of analgesic medication. Integration of LLLT into OA management programmes produced additional improvements. The side-effect profile is excellent. Issues of trial size, comparability, dosing, and assessment of response, mean that further studies are required. Conclusions: We conclude that LLLT is useful in the management of OA pain, with benefits for stiffness and function. Use as an integral part of an OA management and rehabilitation plan appears to give additional benefits. LLLT has an excellent side effect profile and may reduce need for analgesic medication, making it a potentially valuable adjunct in OA pain management, especially at a time when adverse effects of pharmacological treatment are of increasing concern.