In this study PBM is proposed as a treatment for tendinopathies. This was the first systematic review focusing solely on PBM treatment effects in shoulder tendinopathy.
A systematic review with meta-analysis and primary outcome measures pain relief on 100-mm visual analogue scale (VAS) and relative risk for global improvement. Two independent assessors rated the included studies according to the PEDro scale. Intervention quality assessments were performed of PBM dosage and treatment procedures according to World Association for Laser Therapy guidelines. The included trials were sub-grouped by intervention quality and use of other physiotherapy methods.
Seventeen randomised controlled trials (RCTs) met the inclusion criteria. Significant and clinically important pain relief was found with weighted mean differences (WMD) over placebo, for PBM as monotherapy. The WMD when PBM was used in a multimodal physiotherapy treatment regime reached statistical significance over placebo pain reduction on VAS. Relative risks for global improvement were statistically significant for laser as monotherapy or adjunctive in a physiotherapy regime. Secondary outcome measures of shoulder function were only significantly in favour of PBM when used as monotherapy.
This review shows that optimal PBM can offer clinically relevant pain relief and initiate a more rapid course of improvement, both alone and in combination with other physiotherapy interventions.