Effect of low-level laser therapy on pain and disability in patients with plantar fasciitis: A systematic review and meta-analysis

Abstract

Objective: We performed a systematic review to investigate the effects of low-level laser therapy (LLLT) on pain and disability in patients with plantar fasciitis (PF).

Methods: We searched Pubmed, PEDro database, Scielo, and Cochrane Central for randomized controlled trials that evaluated the effects of LLLT for patients with PF. The methodological aspects of the studies included were scored using the PEDro scale. Three comparisons were made: LLLT compared with placebo, LLLT combined with conventional rehabilitation (CR) compared with CR and LLLT compared with extracorporeal shock wave therapy.

Results: Fourteen studies (817 patients) met the study criteria. Compared to the placebo group, LLLT improved pain (MD, -2.3; 95% CI: 2.6 to -2, I² = 0%; 4 studies, N = 234: moderate-quality evidence) in the short term (0-6 weeks). No significant difference in short-term disability was found for participants in the LLLT group compared to the placebo group. Compared to the CR group, LLLT combined with CR improved pain (MD, -2.0; 95% CI: 2.9 to -1.1, I² = 0%; 2 studies, N = 90: moderate-quality evidence) in the short term (0-6 weeks). Compared to extracorporeal shock wave therapy, LLLT did not significantly reduce pain intensity in the short term (MD, 0.5; 95% CI: 2.0 to 2.9, I² = 96%; 4 studies, N = 175: low-quality evidence).

Conclusions: LLLT may improve pain in the short term and can be considered as a component of care of patients with PF. However, this superiority disappeared compared to extracorporeal shock wave therapy.

Level of evidence: Therapeutic level I.

Keywords: Disability; Laser therapy; Pain; Plantar fasciitis.