Perspectives on Integrative Medicine

Review Article

Effectiveness and Safety of Low-Level Laser Treatment for Lumbar Disc Herniation: A Systematic Review and Meta-Analysis: Sang Jun Lee, Seung Jin Noh, Jeong Rock Kim, Kyung Bok Park, Sae-rom Jeon, Yejin Hong, Dongwoo Nam; Perspect Integr Med. 2023;2(3):155-163. Published online October 23, 2023; DOI: https://doi.org/10.56986/pim.2023.10.003

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Graphical Abstract Abstract PDF Supplementary Material: Background
Low-level laser treatment (LLLT) is used to treat low back pain (LBP) however, its effects on lumbar disc herniation (LDH) remain unclear. The safety and effectiveness of LLLT for LDH was determined using a systematic review of randomized clinical trials.
Methods
Studies on LLLT in adults with LDH were identified from 12 worldwide databases. A risk of bias assessment and a meta-analysis with categorization according to the type of control used (inactive, active, or add-on) was performed. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation.
Results
The quantitative analyses included five studies. LLLT was significantly more effective at treating LDH [leg pain visual analog scale (VAS) mean difference (MD): -1.90, 95% confidence interval (CI): -2.01, -1.80, I2 80%; LBP VAS MD: -0.79, 95% CI: -0.87, -0.71, I2 80%] than inactive controls (placebo or sham). The quality of the evidence ranged from “low” to “very low.” As an add-on to usual care, LLLT significantly improved pain intensity and disability compared with usual care (leg pain VAS MD: -2.52, 95% CI: -2.65, -2.40, I2 97%; LBP VAS MD: -1.47, 95% CI: -1.58, -1.36; Oswestry Disability Index MD: -4.10, 95% CI: -4.55, -3.65, I2 6%). However, the quality of the evidence ranged from “moderate” to “low.”
Conclusion
LLLT significantly improved outcomes compared with the inactive controls, but was not more effective than usual care for LDH. In combination with usual care, LLLT was significantly more effective than usual care alone highlighting the potential of LLLT.

Editorial

Integration of Acupuncture into UK Healthcare - A NICE Perspective: Why is Acupuncture Now Recommended for Chronic Pain but not for Back Pain or Osteoarthritis: Mike Cummings; Perspect Integr Med. 2023;2(1):3-7. Published online February 21, 2023; DOI: https://doi.org/10.56986/pim.2023.02.002

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In April 2021, the National Institute for Health and Care Excellence (NICE) published a guideline on chronic pain (NG193) with a recommendation to consider a single course of acupuncture treatment in patients with chronic primary pain. This positive recommendation came after the NICE guideline on low back pain and sciatica (NG59) announced in November 2016, that acupuncture treatment did not work for back pain, having previously recommended it in 2009 (CG88). This article attempts to explain this apparent contradiction in recommendations by tracing the history of acupuncture debates in the NICE guidelines over the last 2 decades.

Citations

Citations to this article as recorded by

A Review of Key Research and Engagement in 2022
John McDonald, Sandro Graca, Claudia Citkovitz, Lisa Taylor-Swanson
Journal of Integrative and Complementary Medicine.2023; 29(8): 455. CrossRef

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