In chronic low back pain, low level laser therapy combined with exercise is more beneficial than exercise alone in the long term: a randomised trial.
OBJECTIVE
Is low level laser therapy an effective adjuvant intervention for chronic low back pain?


METHODS
Randomised trial with concealed allocation, blinded assessors and intention-to-treat analysis.


METHODS
Sixty-one patients who had low back pain for at least 12 weeks.


METHODS
One group received laser therapy alone, one received laser therapy and exercise, and the third group received placebo laser therapy and exercise. Laser therapy was performed twice a week for 6 weeks.


METHODS
Outcomes were pain severity measured using a 10-cm visual analogue scale, lumbar range of motion measured by the Schober Test and maximum active flexion, extension and lateral flexion, and disability measured with the Oswestry Disability Index on admission to the study, after 6 weeks of intervention, and after another 6 weeks of no intervention.


RESULTS
There was no greater effect of laser therapy compared with exercise for any outcome, at either 6 or 12 weeks. There was also no greater effect of laser therapy plus exercise compared with exercise for any outcome at 6 weeks. However, in the laser therapy plus exercise group pain had reduced by 1.8 cm (95% CI 0.1 to 3.3, p = 0.03), lumbar range of movement increased by 0.9 cm (95% CI 0.2 to 1.8, p < 0.01) on the Schober Test and by 15 deg (95% CI 5 to 25, p < 0.01) of active flexion, and disability reduced by 9.4 points (95% CI 2.7 to 16.0, p = 0.03) more than in the exercise group at 12 weeks.


CONCLUSIONS
In chronic low back pain low level laser therapy combined with exercise is more beneficial than exercise alone in the long term.
Djavid
Gholamreza Esmaeeli
GE
Academic Center for Education, Culture and Research, Iran.
Mehrdad
Ramin
R
Ghasemi
Mohammad
M
Hasan-Zadeh
Hormoz
H
Sotoodeh-Manesh
Akbar
A
Pouryaghoub
Gholamreza
G
D000328:Adult; D002908:Chronic Disease; D003131:Combined Modality Therapy; D004185:Disability Evaluation; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000503:physiopathology / Q000532:radiotherapy*; D028022:Low-Level Light Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D016059:Range of Motion, Articular / Q000502:physiology; D016896:Treatment Outcome