Objective: To evaluate the treatment effectiveness of laser acupuncture (LA) in patients with musculoskeletal pain.
Methods: Major electronic databases, including Medline, PubMed, Embase, Cochrane Library, CINAHL, and Scopus were searched to identify double-blind, randomized controlled trials of LA in musculoskeletal disorders. The primary outcome was the treatment efficacy for pain. The secondary outcomes included the comparison of disability, functional impairment, and dropout rate between LA and sham treatment, as well as the effect of sham treatment for pain. The results from included studies were synthesized with the random effects model.
Results: In total, 20 articles comprising 568 patients receiving LA and 534 patients receiving sham treatment were included in the current study. Our analysis showed LA significantly reduced pain (g=0.88, 95% confidence interval [CI]=0.35 to 1.42, p=0.001), disability (g=0.68, 95% CI=0.29 to 1.08, p<0.001), and functional impairment (g=0.67, 95% CI=0.32 to 1.03, p<0.001). Through meta-regression analysis, we found these effects were not moderated by mean age, the percentage of females, or treatment duration. Additionally, there was no significant difference between the two groups in dropout rate (risk ratio=0.73, p=0.08), and the sham treatment significantly reduced only pain intensity (g=0.54, 95% CI=0.32 to 0.77, p<0.001).
Conclusion: Our findings supported that LA significantly reduced pain, disability, and functional impairment in patients with musculoskeletal disorders. Further researches are required to determine the optimal therapeutic parameters and the suitable patients for receiving LA.
Protocol Registration: CRD42020190919.
|Rehab Clinician (OT/PT)|
Most of the studies included in this review have been published in journals targeting laser, acupuncture, or complementary medicine, and appear to suffer from methodological flaws (e.g., 12/20 have an unclear risk of bias in the outcome measurement, and these studies usually report the highest positive effect of acupuncture laser). I would have expected the authors be more cautious in their conclusions.
I could see no formal address of study design, including a methodology that sought to remove chance, bias, and confounding. I struggle somewhat with the notion of causality in the absence of biologic plausibility given the nature of the intervention.