Low Level Laser Therapy in Treatment of Osteoarthritis of the Knee

A double blinded, randomized and controlled trial in patients with knee osteoarthritis was conducted to evaluate the efficacy of infrared low level laser therapy (LLLT) (also known as cold laser or therapeutic laser).  90 patients were randomly assigned to three treatment groups by a non-treating clinician.  The first group was given LLLT consisting of 5 minutes at 3 Joule dose, the second group was given LLLT consisting of 3 minutes at 2 Joule dose, and the third group was given placebo LLLT.  All groups were also given an exercise program.  Patients received 10 treatments and the exercise program was continued during the 14 week study.

Patients were evaluated with respect to pain, degree of active knee flexion, duration of morning stiffness, painless walking distance and duration, WOMAC Osteoarthritis Index scale.  Statistically significant improvements were made in all parameters such as pain, function and quality of life measure post therapy compared to pre therapy in both active laser groups.  Improvements in all parameters of the active laser groups as opposed to the placebo laser group were also statistically significant.  This study demonstrated that different dose and duration of laser therapy regimes were safe and effective for treating osteoarthritis of the knee.

Citation: Lasers in Surgery and Medicine33:330-338 (2003)

Manipulation or Microdiskectomy for Sciatica?

A 2010 clinical study compared the clinical efficacy of spinal manipulation against microdiscectomy in patients secondary to lumbar disc herniation.  Forty patients who met the criteria (failed at least 3 months of nonoperative management including treatments with analgesics, lifestyle modifications, physiotherapy, massage therapy and/or acupuncture) were randomized to either surgical microdiskectomy or standardized chiropractic spinal manipulation. 

Significant improvements in both treatment groups compared to baseline scores were observed in all outcome measures.  After one year follow up, there did not appear to be a difference in outcome based on the original treatment received.  60% of the patients who had failed other medical management benefited from spinal manipulation to the same degree as if they underwent surgical intervention.  Of the 40% left unsatisfied, surgical intervention conferred excellent results. 

The conclusion of the study was patients with lumbar disc herniation failing medical management should consider spinal manipulation followed by surgery if warranted. 

Citation: http://www.jmptonline.org/article/S0161-4754(10)00211-3/abstract