Laser acupuncture in the treatment of musculoskeletal disorders: systematic review and meta-analysis

Laser acupuncture, which involves laser stimulation of acupuncture points including traditional acupoints, Ashi, and trigger points, combines the benefits of photobiomodulation and acupuncture effects. Evidence from randomized controlled trials and systematic reviews suggests that laser acupuncture and lowlevel laser therapy can reduce pain, improve functional outcomes, and decrease disability in patients with musculoskeletal disorders. However, the field is relatively new and involves complex mechanisms, leading to varied opinions on its benefits. Standardized, condition-specific stimulation protocols for laser acupuncture have not yet been established, as existing studies report heterogeneous parameters and lack consistent reporting practices. One major challenge in validating the clinical effects of laser acupuncture is the inconsistency in nomenclature and the lack of consensus on critical parameters and clinical guidelines.

This study aims to provide a descriptive synthesis of existing clinical evidence on laser acupuncture for musculoskeletal disorders and to describe the range and reporting quality of laser-related parameters used in these studies. In doing so, it offers a basis for future efforts to harmonize reporting and clinical practice.

We reviewed 28 randomized controlled trials focused on laser acupuncture for musculoskeletal disorders and conducted a meta-analysis on 14 of these studies. Key variables included laser type, wavelength, mode, duration, frequency, irradiance, power density, area, density/probe, total exposure energy, exposure time, treatment frequency and duration, and clinical outcomes.

Our findings revealed that many studies did not distinguish terms like Low-Intensity Laser Therapy from laser acupuncture, and lacked detailed descriptions of laser parameters, which could affect outcomes. The complexity of laser acupuncture mechanisms and its diverse variables make it challenging to understand which factors impact therapeutic effects.

Therefore, it is crucial to detail all possible variables in future research to clarify the relationship between dosage and treatment effects. Finally, due to challenges in applying current guidelines, new guidelines specifically for laser acupuncture research may be necessary.

https://osf.io/es9k2.