The Problem Submitted for ARIF to Advise Upon:

What is the effectiveness of laser acupuncture in patients with chronic pain, relative to other forms of pain relief.

Laser acupuncture is defined as the stimulation of traditional acupuncture points with low-intensity, non-thermal laser irradiation.  Low-intensity, non-thermal laser irradiation (also known as low level laser therapy LLLT) can also be used at the site of pain or at trigger points. Acupuncture is described as a “therapy that involves the stimulation of defined points on the skin typically by inserting needles; however, related techniques such as manual (acupressure) electrical or laser stimulation of acupuncture points are also often summarized under this term”.  The underlying belief of acupuncture is that it restores and balances an energy (called Qi) which flows through the body along defined paths.  Any disturbance in the flow can result in ill health, but by stimulating certain defined points (acupuncture points) along these Qi pathways health is restored.

Reviews Identified

• Bjordal JM, Lopes-Martins RA, Joensen J, Couppe C, Ljunggren AE, Stergioulas A, et al. A systematic review with procedural assessments and meta-analysis of low level laser therapy in lateral elbow tendinopathy (tennis elbow). BMC Musculoskeletal Disorders 2008;9:75
• Green S, Buchbinder R, Barnsley L, Hall S, White M, Smidt N, Assendelft W. Acupuncture for lateral elbow pain. Cochrane Database of Systematic Reviews 2002, Issue 1. Art. No.: CD003527. DOI: 10.1002/14651858.CD003527.
• Piazzini DB, Aprile I, Ferrara PE, Bertolini C, Tonali P, Maggi L, et al. A systematic review of conservative treatment of carpal tunnel syndrome. Clinical Rehabilitation 2007;21(4):299-314.
• White AR, Ernst E. A systematic review of randomized controlled trials of acupuncture for neck pain. Rheumatology (Oxford) 1999;38(2):143-147

Randomised Controlled Trials

• Ebneshahidi NS, Heshmatipour M, Moghaddami A, Eghtesadi-Araghi P. The effects of laser acupuncture on chronic tension headache--a randomised controlled trial. Acupuncture in  Medicine 2005;23(1):13-18
• Aigner N, Fialka C, Radda C, Vecsei V. Adjuvant laser acupuncture in the treatment of whiplash injuries: a prospective, randomized placebo-controlled trial. Wiener Klinische  Wochenschrift 2006; 118(3-4):95-99
• Yurtkuran M, Alp A, Konur S, Ozcakir S, Bingol U. Laser acupuncture in knee osteoarthritis: a double-blind, randomized controlled study. Photomedicine and  Laser Surgery 2007;25(1):14-20

Other Evidence

• Whittaker P. Laser acupuncture: past, present, and future. Lasers Medical Science 2004; 19(2):69-80
• Linde K, Vickers A, Hondras M, ter Riet G, Thormahlen J, Berman B, et al. Systematic reviews of complementary therapies - an annotated bibliography. Part 1: acupuncture. BMC Complementary and  Alternative Medicine 2001;1:3

Back to Top

Comments

The only review that concentrated on laser acupuncture was the narrative review by Whittaker.   We identified four systematic reviews that incorporated trials using laser acupuncture for specific painful conditions (6 relevant trials in total),  two for ‘tennis elbow' , one for carpal tunnel syndrome, and one for neck pain.  Of these, one focused on low level light therapy per se and one focused on acupuncture per se.  All of the systematic reviews were reasonably well conducted.  We also identified three RCTs  that investigated laser acupuncture.

None of the RCTs compared laser acupuncture with other pain relieving treatments.  Against placebo treatment, four trials reported that laser acupuncture had a positive effect on pain relief, four reported no difference between laser acupuncture and placebo, and one reported a negative effect.  This is an oversimplification and doesn’t reflect the heterogeneity of the trials.   Factors such as cause of pain and duration as well as type of laser acupuncture used (e.g. wavelength, power and length of treatments as well as acupuncture sites) could also affect the results.

In conclusion, the evidence base for laser acupuncture is sparse and its effectiveness is open to debate and judgement. 

Request Carried Out:  July 2008

Back to Top

Return to A-Z List of Requests for Information - Completed

Back to the ARIF Homepage