Laser acupuncture in musculoskeletal disorders: A systematic review of randomized clinical trials
DOI:
https://doi.org/10.33448/rsd-v14i2.48244Keywords:
Musculoskeletal Diseases, Low-Level Light Therapy, Acupuncture, Pain.Abstract
Musculoskeletal disorders (MSDs) are typically characterized by pain (often persistent) and limitations in mobility, decrease in the level of functioning and reduction in the quality of life and alternative therapeutical interventions have been studied to manage symptomatology such as laser in acupuncture points (LA). The aim of this study is to systematically review the literature of the use of LA in MSDs in pain and functional capacity. PubMed and EMBASE were systematically searched using the following terms: low-level laser therapy (LLLT) and acupuncture and ten randomized clinical trials (RCTs) that used LA in MSDs were selected. All the studies used the near-infrared PBMT irradiation, with an energy per point from 1J to 72J, power from 30 mW to 400 mW, number of sessions from 4 to 24 and application at acupuncture points according to each MSDs. Most studies have shown a significant decrease in pain and symptoms, and an increase of functionality, strength, and mobility after treatment with LA. This review demonstrates that LA produced positive effects in pain and functionality of patients with MSDs, although the evidence does not determine an effective dosage window for LA, the possible range of application adjusted and designed to fit specific musculoskeletal conditions.
Downloads
References
Al Rashoud, A. S., Abboud, R. J., Wang, W., & Wigderowitz, C. (2014). Efficacy of low-level laser therapy applied at acupuncture points in knee osteoarthritis: a randomised double-blind comparative trial. Physiotherapy, 100(3), 242–248. https://doi.org/10.1016/j.physio.2013.09.007
Ammendolia, C., Furlan, A. D., Imamura, M., Irvin, E., & van Tulder, M. (2008). Evidence-informed management of chronic low back pain with needle acupuncture. The Spine Journal, 8(1), 160–172. https://doi.org/10.1016/j.spinee.2007.10.014
Antônio Moreira Rodrigues da Silva, M., Luís Botelho, A., Vogt Turim, C., & Maria Bettoni Rodrigues da Silva, A. (2012). Low Level Laser Therapy as an Adjunctive Technique In the Management of Temporomandibular Disorders. CRANIO®, 30(4), 264–271. https://doi.org/10.1179/crn.2012.040
Babatunde, O. O., Jordan, J. L., Van der Windt, D. A., Hill, J. C., Foster, N. E., & Protheroe, J. (2017). Effective treatment options for musculoskeletal pain in primary care: A systematic overview of current evidence. PLOS ONE, 12(6), e0178621. https://doi.org/10.1371/journal.pone.0178621
Baxter, G. D., Bleakley, C., & McDonough, S. (2008). Clinical Effectiveness of Laser Acupuncture: A Systematic Review. Journal of Acupuncture and Meridian Studies, 1(2), 65–82. https://doi.org/10.1016/S2005-2901(09)60026-1
Boonstra, A. M., Schiphorst Preuper, H. R., Reneman, M. F., Posthumus, J. B., & Stewart, R. E. (2008). Reliability and validity of the visual analogue scale for disability in patients with chronic musculoskeletal pain. International Journal of Rehabilitation Research, 31(2), 165–169. https://doi.org/10.1097/MRR.0b013e3282fc0f93
Briggs, A. M., Cross, M. J., Hoy, D. G., Sànchez-Riera, L., Blyth, F. M., Woolf, A. D., & March, L. (2016). Musculoskeletal Health Conditions Represent a Global Threat to Healthy Aging: A Report for the 2015 World Health Organization World Report on Ageing and Health. The Gerontologist, 56(Suppl 2), S243–S255. https://doi.org/10.1093/geront/gnw002
Cabýoglu, m. T., ergene, n., & tan, u. (2006). The mechanism of acupuncture and clinical applications. International Journal of Neuroscience, 116(2), 115–125. https://doi.org/10.1080/00207450500341472
Chang, W.-D., Wu, J.-H., Chang, N.-J., Lee, C.-L., & Chen, S. (2019). Effects of Laser Acupuncture on Delayed Onset Muscle Soreness of the Biceps Brachii Muscle: A Randomized Controlled Trial. Evidence-Based Complementary and Alternative Medicine, 2019, 1–10. https://doi.org/10.1155/2019/6568976
Chang, W.-H., Tu, L.-W., Pei, Y.-C., Chen, C.-K., Wang, S.-H., & Wong, A. MK. (2021). Comparison of the effects between lasers applied to myofascial trigger points and to classical acupoints for patients with cervical myofascial pain syndrome. Biomedical Journal, 44(6), 739–747. https://doi.org/10.1016/j.bj.2020.05.020
Cheng, K. J. (2014). Neurobiological Mechanisms of Acupuncture for Some Common Illnesses: A Clinician’s Perspective. Journal of Acupuncture and Meridian Studies, 7(3), 105–114. https://doi.org/10.1016/j.jams.2013.07.008
Chon, T. Y., Mallory, M. J., Yang, J., Bublitz, S. E., Do, A., & Dorsher, P. T. (2019). Laser Acupuncture: A Concise Review. Medical Acupuncture, 31(3), 164–168. https://doi.org/10.1089/acu.2019.1343
Chung, H., Dai, T., Sharma, S. K., Huang, Y.-Y., Carroll, J. D., & Hamblin, M. R. (2012). The Nuts and Bolts of Low-level Laser (Light) Therapy. Annals of Biomedical Engineering, 40(2), 516–533. https://doi.org/10.1007/s10439-011-0454-7
Clijsen, R., Brunner, A., Barbero, M., Clarys, P., & Taeymans, J. (2017). Effects of low-level laser therapy on pain in patients with musculoskeletal disorders: a systematic review and meta-analysis. European Journal of Physical and Rehabilitation Medicine, 53(4). https://doi.org/10.23736/S1973-9087.17.04432-X
Erthal, V., Maria-Ferreira, D., de Paula Werner, M. F., Baggio, C. H., & Nohama, P. (2016). Anti-inflammatory effect of laser acupuncture in ST36 (Zusanli) acupoint in mouse paw edema. Lasers in Medical Science, 31(2), 315–322. https://doi.org/10.1007/s10103-015-1845-z
Fernandes, A., Moura, D., Da Silva, L., De Almeida, E., & Barbosa, G. (2017). Acupuncture in Temporomandibular Disorder Myofascial Pain Treatment: A Systematic Review. Journal of Oral & Facial Pain and Headache, 31(3), 225–232. https://doi.org/10.11607/ofph.1719
Ferreira, L. A., de Oliveira, R. G., Guimarães, J. P., Carvalho, A. C. P., & De Paula, M. V. Q. (2013). Laser acupuncture in patients with temporomandibular dysfunction: a randomized controlled trial. Lasers in Medical Science, 28(6), 1549–1558. https://doi.org/10.1007/s10103-013-1273-x
Gendron, D. J., & Hamblin, M. R. (2019). Applications of Photobiomodulation Therapy to Musculoskeletal Disorders and Osteoarthritis with Particular Relevance to Canada. Photobiomodulation, Photomedicine, and Laser Surgery, 37(7), 408–420. https://doi.org/10.1089/photob.2018.4597
Hamblin, M. R., Huang, Y., & Heiskanen, V. (2019). Non‐mammalian Hosts and Photobiomodulation: Do All Life‐forms Respond to Light? Photochemistry and Photobiology, 95(1), 126–139. https://doi.org/10.1111/php.12951
Hancock, G. E., Hepworth, T., & Wembridge, K. (2018). Accuracy and reliability of knee goniometry methods. Journal of Experimental Orthopaedics, 5(1), 46. https://doi.org/10.1186/s40634-018-0161-5
Hanna, R., Dalvi, S., Bensadoun, R. J., & Benedicenti, S. (2021). Role of Photobiomodulation Therapy in Modulating Oxidative Stress in Temporomandibular Disorders. A Systematic Review and Meta-Analysis of Human Randomised Controlled Trials. Antioxidants, 10(7), 1028. https://doi.org/10.3390/antiox10071028
Helianthi, D. R., Simadibrata, C., Srilestari, A., Wahyudi, E. R., & Hidayat, R. (2016). Pain Reduction After Laser Acupuncture Treatment in Geriatric Patients with Knee Osteoarthritis: a Randomized Controlled Trial. Acta Medica Indonesiana, 48(2), 114–121.
Hinarejos, P., Goicoechea, N., Gidi, M., Leal-Blanquet, J., Torres-Claramunt, R., Sánchez-Soler, J., & Monllau, J. C. (2019). Pressure algometry is a suitable tool to assess anterior knee pain in osteoarthritic patients. European Journal of Orthopaedic Surgery & Traumatology, 29(5), 1089–1093. https://doi.org/10.1007/s00590-019-02391-w
Hu, D., van Zeyl, M., Valter, K., & Potas, J. R. (2019). Sex, but not skin tone affects penetration of red‐light (660 nm) through sites susceptible to sports injury in lean live and cadaveric tissues. Journal of Biophotonics, 12(7). https://doi.org/10.1002/jbio.201900010
Huang, C.-H., Yeh, M.-L., Chen, F.-P., & Kuo, M. (2021). A randomised controlled trial of laser acupuncture improves early outcomes of osteoarthritis patients’ physical functional ability after total knee replacement. Complementary Therapies in Clinical Practice, 43, 101340. https://doi.org/10.1016/j.ctcp.2021.101340
J. Eaton-Evans. (2013). Encyclopedia of Human Nutrition (B. Caballero, Ed.; Third edition). Academic Press.
Juan, C.-W., Chang, M.-H., Lin, T.-H., Hwang, K.-L., Fu, T.-C., Shih, P.-H., Chang, C.-M., & Yang, C.-P. (2019). Laser Acupuncture for Carpal Tunnel Syndrome: A Single-Blinded Controlled Study. The Journal of Alternative and Complementary Medicine, 25(10), 1035–1043. https://doi.org/10.1089/acm.2019.0169
Kane, N. M., & Oware, A. (2012). Nerve conduction and electromyography studies. Journal of Neurology, 259(7), 1502–1508. https://doi.org/10.1007/s00415-012-6497-3
Kibar, S., Konak, H. E., Evcik, D., & Ay, S. (2016). Laser Acupuncture Treatment Improves Pain and Functional Status in Patients with Subacromial Impingement Syndrome: A Randomized, Double-Blind, Sham-Controlled Study. Pain Medicine, pnw197. https://doi.org/10.1093/pm/pnw197
Law, D., McDonough, S., Bleakley, C., Baxter, G. D., & Tumilty, S. (2015). Laser Acupuncture for Treating Musculoskeletal Pain: A Systematic Review with Meta-analysis. Journal of Acupuncture and Meridian Studies, 8(1), 2–16. https://doi.org/10.1016/j.jams.2014.06.015
Liao, F.-Y., Lin, C.-L., Lo, S.-F., Chang, C.-C., Liao, W.-Y., & Chou, L.-W. (2020). Efficacy of Acupoints Dual‐Frequency Low‐Level Laser Therapy on Knee Osteoarthritis. Evidence-Based Complementary and Alternative Medicine, 2020(1). https://doi.org/10.1155/2020/6979105
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009). The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration. PLoS Medicine, 6(7), e1000100. https://doi.org/10.1371/journal.pmed.1000100
Litscher, G. (2018). Definition of Laser Acupuncture and All Kinds of Photo Acupuncture. Medicines (Basel, Switzerland), 5(4). https://doi.org/10.3390/medicines5040117
Madani, A., Ahrari, F., Fallahrastegar, A., & Daghestani, N. (2020). A randomized clinical trial comparing the efficacy of low-level laser therapy (LLLT) and laser acupuncture therapy (LAT) in patients with temporomandibular disorders. Lasers in Medical Science, 35(1), 181–192. https://doi.org/10.1007/s10103-019-02837-x
Mitova, S. G. M. A. M. A. D. (2020). A complex approach to musculoskeletal dysfunction in the spine. Journal of Physical Education and Sport, 20(6), 3316-3322.
Mohammed, N., Allam, H., Elghoroury, E., Zikri, E. N., Helmy, G. A., & Elgendy, A. (2018). Evaluation of serum beta-endorphin and substance P in knee osteoarthritis patients treated by laser acupuncture. Journal of Complementary and Integrative Medicine, 15(2). https://doi.org/10.1515/jcim-2017-0010
Peres e Serra, A., & Ashmawi, H. A. (2010). Influence of Naloxone and Methysergide on the Analgesic Effects of Low-Level Laser in an Experimental Pain Model. Brazilian Journal of Anesthesiology, 60(3), 302–310. https://doi.org/10.1016/S0034-7094(10)70037-4
Petrucci, A., Sgolastra, F., Gatto, R., Mattei, A., & Monaco, A. (2011). Effectiveness of low-level laser therapy in temporomandibular disorders: a systematic review and meta-analysis. Journal of Orofacial Pain, 25(4), 298–307.
Podogrodzki, J., Lebiedowski, M., Szalecki, M., Kępa, I., Syczewska, M., & Jóźwiak, S. (2016). [Impact of low level laser therapy on skin blood flow]. Developmental Period Medicine, 20(1), 40–46.
R Hamblin, M. (2017). Mechanisms and applications of the anti-inflammatory effects of photobiomodulation. AIMS Biophysics, 4(3), 337–361. https://doi.org/10.3934/biophy.2017.3.337
Romero-Franco, N., Jiménez-Reyes, P., & Montaño-Munuera, J. A. (2017). Validity and reliability of a low-cost digital dynamometer for measuring isometric strength of lower limb. Journal of Sports Sciences, 35(22), 2179–2184. https://doi.org/10.1080/02640414.2016.1260152
Salgueiro, M. da C. C., Kobayashi, F. Y., Motta, L. J., Gonçalves, M. L. L., Horliana, A. C. R. T., Mesquita-Ferrari, R. A., Fernandes, K. P. S., Gomes, A. O., Junior, A. B., & Bussadori, S. K. (2021). Effect of Photobiomodulation on Salivary Cortisol, Masticatory Muscle Strength, and Clinical Signs in Children with Sleep Bruxism: A Randomized Controlled Trial. Photobiomodulation, Photomedicine, and Laser Surgery, 39(1), 23–29. https://doi.org/10.1089/photob.2019.4778
Sammaritano, L. R., Bermas, B. L., Chakravarty, E. E., Chambers, C., Clowse, M. E. B., Lockshin, M. D., Marder, W., Guyatt, G., Branch, D. W., Buyon, J., Christopher‐Stine, L., Crow‐Hercher, R., Cush, J., Druzin, M., Kavanaugh, A., Laskin, C. A., Plante, L., Salmon, J., Simard, J., … D’Anci, K. E. (2020). 2020 American College of Rheumatology Guideline for the Management of Reproductive Health in Rheumatic and Musculoskeletal Diseases. Arthritis Care & Research, 72(4), 461–488. https://doi.org/10.1002/acr.24130
Stausholm, M. B., Naterstad, I. F., Joensen, J., Lopes-Martins, R. Á. B., Sæbø, H., Lund, H., Fersum, K. V., & Bjordal, J. M. (2019). Efficacy of low-level laser therapy on pain and disability in knee osteoarthritis: systematic review and meta-analysis of randomised placebo-controlled trials. BMJ Open, 9(10), e031142. https://doi.org/10.1136/bmjopen-2019-031142
Taylor, D. N., Winfield, T., & Wynd, S. (2020). Low-Level Laser Light Therapy Dosage Variables vs Treatment Efficacy of Neuromusculoskeletal Conditions: A Scoping Review. Journal of Chiropractic Medicine, 19(2), 119–127. https://doi.org/10.1016/j.jcm.2020.06.002
Torres-Torrillas, M., Rubio, M., Damia, E., Cuervo, B., del Romero, A., Peláez, P., Chicharro, D., Miguel, L., & Sopena, J. (2019). Adipose-Derived Mesenchymal Stem Cells: A Promising Tool in the Treatment of Musculoskeletal Diseases. International Journal of Molecular Sciences, 20(12), 3105. https://doi.org/10.3390/ijms20123105
Tsai, S.-R., & Hamblin, M. R. (2017). Biological effects and medical applications of infrared radiation. Journal of Photochemistry and Photobiology B: Biology, 170, 197–207. https://doi.org/10.1016/j.jphotobiol.2017.04.014
Wendt, A. D. S., Chaves, A. D. O., Urtado, C. B., Macedo, A. R., Reis, F. J. J. dos, & Nogueira, L. A. C. (2017). FUNCIONALIDADE E INCAPACIDADE EM PACIENTES COMPROMETIMENTO MUSCULOESQUELÉTICO. Revista Brasileira de Ciência e Movimento, 25(4), 15. https://doi.org/10.31501/rbcm.v25i4.6563
World Health Organization (WHO). (2020). Chronic diseases and health promotion. http://www.who.int/chp/topics/rheumatic/en/
Wu, J.-Y., Zhang, C., Xu, Y.-P., Yu, Y.-Y., Peng, L., Leng, W.-D., Niu, Y.-M., & Deng, M.-H. (2017). Acupuncture therapy in the management of the clinical outcomes for temporomandibular disorders. Medicine, 96(9), e6064. https://doi.org/10.1097/MD.0000000000006064
Yang, J., Mallory, M. J., Wu, Q., Bublitz, S. E., Do, A., Xiong, D., Chen, C. Y. Y., Dorsher, P. T., Chon, T. Y., & Bauer, B. A. (2020). The Safety of Laser Acupuncture: A Systematic Review. Medical Acupuncture, 32(4), 209–217. https://doi.org/10.1089/acu.2020.1419
Yuan, Q., Wang, P., Liu, L., Sun, F., Cai, Y., Wu, W., Ye, M., Ma, J., Xu, B., & Zhang, Y. (2016). Acupuncture for musculoskeletal pain: A meta-analysis and meta-regression of sham-controlled randomized clinical trials. Scientific Reports, 6(1), 30675. https://doi.org/10.1038/srep30675
Zhang, Y., & Wang, C. (2020). Acupuncture and Chronic Musculoskeletal Pain. Current Rheumatology Reports, 22(11), 80. https://doi.org/10.1007/s11926-020-00954-z
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Ana Beatriz Balão; Patricia Gabrielli Vassão; Mirian Bonifacio; Homero Garcia-Motta; Beatriz Mendes Credidio; Giovanna Caroline Aparecida do Vale; Adriane Marie Angri Burek; Ana Cláudia Rennó
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
