Positive effects of low level laser therapy (LLLT) on Bouchard's and Heberden's osteoarthritis

Abstract

Background and objective: Osteoarthritis (OA) is a common chronic disorder. While research usually focuses on OA of the large joints, OA of the hand receives relatively little attention resulting in a lack of a therapeutic gold standard. Low level laser therapy (LLLT)/photobiomodulation therapy has been successfully used to treat a variety of medical conditions. Nevertheless, its merits in the treatment of (hand) OA remain controversial. The aim of the present study was to examine the longitudinal effect of LLLT on the three major hand OA symptoms-pain, swelling, reduced joint mobility-in patients suffering from Bouchard's and Heberden's OA.

Study design/materials and methods: Thirty-four patients (32 females) aged 61.21 ± 2.13 years were administered 5-10 LLLT sessions to 85 joints (47 proximal and 38 distal interphalangeal joints). Therapy took place twice a week. Pain (Visual Analogue Scale), ring size (perimeter in mm), and range of motion (extension/flexion) were measured at baseline and after five treatments for all patients, and additionally after seven sessions and 8 weeks after treatment ended for patients who received more than five and seven treatments, respectively. Eighteen patients (37 joints) received only five treatments, 10 patients (29 joints) were administered seven treatments, and six patients (19 joints) were administered 10 LLLT sessions.

Results: LLLT significantly reduced pain and ring size and increased range of motion after five and seven treatments (all P's < 0.001). The effects were very large (all η(2) 's > 0.14). No further significant change occurred between 7 and 10 treatments. The effects achieved after seven sessions persisted for 8 weeks.

Conclusions: LLLT is a safe, non-invasive, efficient and efficacious means to reduce pain and swelling and to increase joint mobility in patients suffering from Heberden's and Bourchard's OA. Further randomized controlled studies are needed to examine medium- to long-term effects as well as the ideal LLLT parameters. Lasers Surg. Med. 48:498-504, 2016. © 2016 Wiley Periodicals, Inc.

Keywords: conservative treatment; distal interphalangeal joint; low-power laser; osteoarthritis of the hand; photobiomodulation therapy; proximal interphalangeal joint.