Laser Therapy for Musculoskeletal Disorders: Carpal Tunnel Syndrome and Tendinopathy
Low-Level Laser Therapy (LLLT) is now becoming a mainstream treatment modality in the medical world. Chiropractors, physical therapists, and athletes are using LLLT to treat a variety of disorders ranging from musculoskeletal problems to joint disorders. This FDA-cleared treatment method is becoming popular due to its non-invasive nature and anti-inflammatory and analgesic properties.
What is LLLT?
Also called photobiomodulation and biostimulation, Low-Level Laser Therapy is the use of monochromatic light to initiate photochemical reactions in the cells. These reactions may alter tissue function, resulting in enhanced collagen production, improved blood circulation, and decreased edema.[1] Here are some other beneficial effects of LLLT as documented in scientific research[2]:
- Increases ATP production, resulting in rapid healing
- Improves oxygen consumption leading to muscle relaxation
- Enhances the production of serotonin and endorphins
- Anti-inflammatory and analgesic effects
- Improves blood circulation
Why are Health Practitioners Choosing LLLT for Musculoskeletal Conditions?
Musculoskeletal disorders are typically either addressed by medicines, such as NSAIDs and acetaminophen, or by surgery in extreme cases. Both these treatment methods pose complications such as dependence and side effects in the case of medication, whereas surgery doesn’t always guarantee satisfactory results and can be frightening.[3]
Due to these concerns, both healthcare practitioners and patients are now turning to LLLT as it is largely found to be effective for musculoskeletal disorders and has no reported side effects.[4] LLLT has been shown to decrease pain, accelerate healing, decrease inflammation, and can be used for both acute and chronic conditions.[5]
Laser Therapy for Carpal Tunnel Syndrome (CTS)
CTS is one of the most common entrapment neuropathies characterized by pain or numbness in the median nerve distribution territory. The pain associated with CTS can be managed with anti-inflammatory drugs. In severe cases, surgical treatment might be recommended, but evidence suggests that surgery may not be able to produce the desired clinical effects. Around one-third of the patients who undergo surgery are reported to have continued pain and functional loss after surgery, while 5% of them reported having their symptoms get worse after surgery.[6]
The effectiveness of Laser Therapy for the treatment of pain and limited functionality for patients with CTS is well-documented. Patients who were treated with LLLT over the long term reported a 30% decrease in pain.[7] They also reported significant improvements in hand grip and overall movements.[8]
Another important study was conducted by Weintraub.[9] This case series consisted of 30 patients with CTS who received 15 treatments of Laser Therapy. The results concluded that around 77% of the cases were able to experience a complete absence of symptoms associated with CTS.
Laser Therapy for Tendinopathy
Tendinopathy is the development of inflammation in and around tendons, characterized by pain and discomfort. It can lead to musculoskeletal diseases and a sedentary lifestyle. The most common type, especially experienced by athletes, is Achilles tendinopathy. Studies have suggested that the use of Laser Therapy can be useful in the treatment of a variety of tendinopathies.[10] It creates biological actions in tendon tissue. Patients who received Laser Therapy with the recommended dosage reported a significant effect of around 32% improvement in pain, mobility, and other problems.[11]
A systematic review and meta-analysis of randomized controlled trials investigated the efficacy of Laser Therapy in lower extremity tendinopathy.[12] Overall, the analysis showed that LLLT significantly reduced pain and disability without any adverse effects. Another randomized controlled trial with 52 athletes who experienced Achilles tendinopathy reported similar results.[13] The study showed that LLLT accelerates clinical recovery with continuous sessions lasting up to four weeks.
LLLT has been found effective in the treatment of a variety of other musculoskeletal disorders, including joint disorders[14], lateral and medial epicondylitis[15], osteoarthritis[16], low back pain[17], and ankle sprains[18]. This nonpharmacological, non-invasive treatment method is safe to use and has no reported side effects.
We, at Berman Partners, have crafted excellent lasers that can be customized according to your use. One laser device can be used for a variety of conditions to aid in pain, muscle tension, and stiffness. Get your FDA-cleared lasers today, or contact us if you have more questions.
References
[1] Hamblin, Michael R., Tanupriya Agrawal, and Marcelo de Sousa, eds. Handbook of low-level laser therapy. CRC Press, 2016.
[2] Fulop AM, Dhimmer S, Deluca JR, Johanson DD, Lenz RV, Patel KB, Douris PC, Enwemeka CS. A meta-analysis of the efficacy of laser phototherapy on pain relief. Clin J Pain. 2010 Oct;26(8):729-36. doi: 10.1097/AJP.0b013e3181f09713. PMID: 20842007.
[3] Beckerman H, de Bie RA, Bouter LM, De Cuyper HJ, Oostendorp RA. The efficacy of laser therapy for musculoskeletal and skin disorders: a criteria-based meta-analysis of randomized clinical trials. Phys Ther. 1992 Jul;72(7):483-91. doi: 10.1093/ptj/72.7.483. PMID: 1409881.
[4] Clijsen R, Brunner A, Barbero M, Clarys P, Taeymans J. Effects of low-level laser therapy on pain in patients with musculoskeletal disorders: a systematic review and meta-analysis. Eur J Phys Rehabil Med. 2017 Aug;53(4):603-610. doi: 10.23736/S1973-9087.17.04432-X. Epub 2017 Jan 30. PMID: 28145397.
[5] White, Brandon. “Effectiveness of Laser Therapy on Musculoskeletal Conditions: A Literature Review.” (2012).
[6] Naerser, MA, et al. “Carpal Tunnel Syndrome Pain Treated with Low-Level Laser and Microamperes Transcutaneous Electric Nerve Stimulation: A Controlled Study.” Archives of Physical Medicine and Rehabilitation. 2002 July; 83: 978-988.
[7] Lazovic M, Ilic-Stojanovic O, Kocic M, Zivkovic V, Hrkovic M, Radosavljevic N. Placebo-controlled investigation of low-level laser therapy to treat carpal tunnel syndrome. Photomed Laser Surg. 2014 Jun;32(6):336-44. doi: 10.1089/pho.2013.3563. PMID: 24905929.
[8] Li ZJ, Wang Y, Zhang HF, Ma XL, Tian P, Huang Y. Effectiveness of low-level laser on carpal tunnel syndrome: A meta-analysis of previously reported randomized trials. Medicine (Baltimore). 2016 Aug;95(31):e4424. doi: 10.1097/MD.0000000000004424. PMID: 27495063; PMCID: PMC4979817.
[9] Weintraub MI. Noninvasive laser neurolysis in carpal tunnel syndrome. Muscle Nerve. 1997 Aug;20(8):1029-31. doi: 10.1002/(sici)1097-4598(199708)20:8<1029::aid-mus14>3.0.co;2-q. PMID: 9236795.
[10] Tumilty S, Munn J, McDonough S, Hurley DA, Basford JR, Baxter GD. Low level laser treatment of tendinopathy: a systematic review with meta-analysis. Photomed Laser Surg. 2010 Feb;28(1):3-16. doi: 10.1089/pho.2008.2470. PMID: 19708800.
[11] Jan Magnus Bjordal, Christian Couppe & Anne Elisabeth Ljunggren (2001) Low Level Laser Therapy for Tendinopathy. Evidence of A Dose–Response Pattern, Physical Therapy Reviews, 6:2, 91-99, DOI: 10.1179/ptr.2001.6.2.91
[12] Naterstad IF, Joensen J, Bjordal JM, Couppé C, Lopes-Martins RAB, Stausholm MB. Efficacy of low-level laser therapy in patients with lower extremity tendinopathy or plantar fasciitis: systematic review and meta-analysis of randomised controlled trials. BMJ Open. 2022 Sep 28;12(9):e059479. doi: 10.1136/bmjopen-2021-059479. PMID: 36171024; PMCID: PMC9528593.
[13] Stergioulas A, Stergioula M, Aarskog R, Lopes-Martins RA, Bjordal JM. Effects of low-level laser therapy and eccentric exercises in the treatment of recreational athletes with chronic achilles tendinopathy. Am J Sports Med. 2008 May;36(5):881-7. doi: 10.1177/0363546507312165. Epub 2008 Feb 13. PMID: 18272794.
[14] Momenzadeh S. Low level laser therapy for painful joints. J Lasers Med Sci. 2013 Spring;4(2):67-9. PMID: 25606309; PMCID: PMC4281983.
[15] Simunovic Z, Trobonjaca T, Trobonjaca Z. Treatment of medial and lateral epicondylitis–tennis and golfer’s elbow–with low level laser therapy: a multicenter double blind, placebo-controlled clinical study on 324 patients. J Clin Laser Med Surg. 1998 Jun;16(3):145-51. doi: 10.1089/clm.1998.16.145. PMID: 9743652.
[16] Brosseau L, Welch V, Wells G, Tugwell P, de Bie R, Gam A, Harman K, Shea B, Morin M. Low level laser therapy for osteoarthritis and rheumatoid arthritis: a metaanalysis. J Rheumatol. 2000 Aug;27(8):1961-9. PMID: 10955339.
[17] Gur A, Karakoc M, Cevik R, Nas K, Sarac AJ, Karakoc M. Efficacy of low power laser therapy and exercise on pain and functions in chronic low back pain. Lasers Surg Med. 2003;32(3):233-8. doi: 10.1002/lsm.10134. PMID: 12605431.
[18] Stergioulas A. Low-level laser treatment can reduce edema in second degree ankle sprains. J Clin Laser Med Surg. 2004 Apr;22(2):125-8. doi: 10.1089/104454704774076181. PMID: 15165387.
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