Background Low-level laser treatment (LLLT) is used to treat low back pain (LBP) however, its effects on lumbar disc herniation (LDH) remain unclear. The safety and effectiveness of LLLT for LDH was determined using a systematic review of randomized clinical trials.

Methods Studies on LLLT in adults with LDH were identified from 12 worldwide databases. A risk of bias assessment and a meta-analysis with categorization according to the type of control used (inactive, active, or add-on) was performed. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation.

Results The quantitative analyses included five studies. LLLT was significantly more effective at treating LDH [leg pain visual analog scale (VAS) mean difference (MD): −1.90, 95% confidence interval (CI): −2.01, −1.80, I2 80%; LBP VAS MD: −0.79, 95% CI: −0.87, −0.71, I2 80%] than inactive controls (placebo or sham). The quality of the evidence ranged from “low” to “very low.” As an add-on to usual care, LLLT significantly improved pain intensity and disability compared with usual care (leg pain VAS MD: −2.52, 95% CI: −2.65, −2.40, I2 97%; LBP VAS MD: −1.47, 95% CI: −1.58, −1.36; Oswestry Disability Index MD: −4.10, 95% CI: −4.55, −3.65, I2 6%). However, the quality of the evidence ranged from “moderate” to “low.”

Conclusion LLLT significantly improved outcomes compared with the inactive controls, but was not more effective than usual care for LDH. In combination with usual care, LLLT was significantly more effective than usual care alone highlighting the potential of LLLT.

Keywords: chronic pain, disc herniation, meta-analysis, low back pain, systematic review

https://www.integrmed.org/journal/view.php?doi=10.56986/pim.2023.10.003