Efficacy and safety of laser acupuncture on osteoarthritis: a systematic review and meta-analysis

Osteoarthritis is one of the leading causes of pain and disability in older adults, affecting millions of people worldwide. This degenerative disease compromises the joints, especially the knees, causing persistent pain, stiffness, and functional limitations that significantly affect patients' quality of life. With population aging and the rise of obesity, osteoarthritis has become a growing public health problem. Although it is not possible to fully restore damaged joint cartilage, different treatments aim to relieve symptoms and improve joint function.

Among these options, laser acupuncture has emerged as a promising alternative, combining the traditional benefits of acupuncture with modern laser technology.

This scientific research performed a systematic review and meta-analysis to evaluate the efficacy and safety of laser acupuncture in the treatment of osteoarthritis. The researchers searched for randomized controlled trials in major medical databases through December 2023. Only studies comparing treatment with true laser acupuncture versus placebo or sham laser in patients with a confirmed diagnosis of osteoarthritis were included. The strict selection criteria resulted in the analysis of 11 scientific studies, involving 931 patients from different countries, including China, the United Kingdom, Australia, Turkey, and others.

The researchers used advanced statistical methods to combine the results of these studies and evaluate different aspects such as pain intensity, joint function, and knee stiffness.

The results demonstrated that laser acupuncture produced significant improvements compared with placebo treatment. In pain assessment using the Visual Analog Scale, patients treated with real laser showed substantially greater pain reduction than those who received sham treatment. In addition, when measured by the WOMAC questionnaire, a tool specific to arthritis evaluation, laser acupuncture proved superior in reducing pain, improving joint function, and decreasing stiffness. The researchers also observed improvements in patients' quality of life, including reduction in physical pain and improvement in physical function.

An important finding was that therapeutic benefits were more pronounced when lasers with power greater than 100 milliwatts and wavelength greater than 1,000 nanometers were used. CO2 and solid-state lasers were particularly effective in the results.

Clinically, these results suggest that laser acupuncture may be a valuable option for patients with osteoarthritis seeking alternatives to traditional medications or wishing to use complementary treatments. The technique offers several advantages over conventional acupuncture, including the absence of pain during application, elimination of the risk of infection or needle breakage, and greater acceptance by patients afraid of needles. Clinicians can consider this therapeutic modality especially for patients who do not respond adequately to other treatments or who experience significant side effects with medications. The study provides specific guidance on technical parameters that can optimize results, orienting clinical practice toward greater therapeutic efficacy.

However, it is important to recognize the limitations of this research. The main limitation was that the therapeutic benefits were shown to be temporary, disappearing eight weeks after the end of treatment. This suggests that laser acupuncture may be more suitable as regular maintenance treatment or in combination with other therapies for lasting results. In addition, the number of included studies was relatively small, and most had short follow-up periods, limiting our understanding of long-term effects.

Only one study reported minimal adverse effects, consisting of transient redness at the application site, which resolved spontaneously within a few hours. Although the results are promising, especially for high-power lasers, more research is needed with larger samples and prolonged follow-up to confirm long-term safety and efficacy. Interested patients should discuss this therapeutic option with their clinicians, considering their individual needs and other coexisting health conditions.