Nazari et al.2222 Nazari A, Moezy A, Nejati P, Mazaherinezhad A. Efficacy of high-intensity laser therapy in comparison with conventional physiotherapy and exercise therapy on pain and function of patients with knee osteoarthritis: a randomized controlled trial with 12-week follow-up. Lasers Med Sci. 2019;34(3):505-16. Knee osteoarthritis |
n=93 G1= HIL 3x/week + exercise G2 = Conventional Therapy (TENS and US) + exercise G3 = exercise |
12 weeks |
VAS |
HIL + exercise was more effective for pain reduction than conventional therapy + exercise and exercise alone. |
Angelova and Ilieva2323 Angelova A, Ilieva EM. Effectiveness of high intensity laser therapy for reduction of pain in knee osteoarthritis. Pain Res Manag. 2016;2016:9163618. Knee osteoarthritis |
n=72 G1= HIL 3 sessions: 300 J/ 2 min 4 sessions 3.000 J/ 10 min G2= placebo laser |
12 weeks |
VAS and dolorimetry |
Pain scores were significantly reduced in G1 after 7 days of treatment and were better when compared to G2. |
Kheshie, Alayat and Ali2424 Kheshie AR, Alayat MSM, Ali MME. High intensity versus low-level laser therapy in the treatment of patients with knee osteoarthritis: a randomized controlled trial. Lasers Med Sci. 2014;29(4):1371-6. Knee osteoarthritis |
n=53 G1=HIL+exercise 1250 J/ 15 min G2=LIL+exercise 1250 J/32min and 33 seconds G3=placebo laser + exercise |
6 weeks |
VAS |
HIL and LIL associated with exercise are more effective than exercise alone in reducing VAS scores. HIL + exercise was more effective than LIL + exercise |
Stiglicć-Rogoznica et al.2525 Stiglicć-Rogoznica N, Stamenkovicć D, Frlan-Vrgoc L, Avancini-Dobrovicć V, Vrbanicć TS. Analgesic effect of high intensity laser therapy in knee osteoarthritis. Coll Antropol. 2011;35(Suppl 2):183-5. Knee osteoarthritis |
n=96 G1= HIL 20 min/day - 10 days |
2 weeks |
VAS |
HIL significantly reduced pain, from 45-70mm to 10-30mm (p>0.001) |
Alayat et al.3737 Alayat MSM, Atya AM, Ali MME, Shosha TM. Long-term effect of highintensity laser therapy in the treatment of patients with chronic low back pain: a randomized blinded placebocontrolledtrial. Lasers Med Sci. 2014;29(3):1065-73. Low back pain |
n=72 G1= HIL+exercise 3x/week, 15 min by 4 weeks G2: placebo laser + exercise 3x/week by 4 weeks G3= HIL |
12 weeks |
VAS |
G1 significantly reduced VAS scores when compared to G2, with the smallest effect experienced by G3 at both 4 and 12 weeks |
Authors |
Protocol for intervention |
Duration |
Pain assessment method |
Outcome |
Fiore et al.3838 Fiore P, Panza F, Cassatella G, Russo A, Frisardi V, Solfrizzi V, Ranieri M, Di Teo L, Santamato A. Short-term effects of high-intensity laser therapy versus ultrasound therapy in the treatment of low back pain: a randomized controlled trial. Eur J Phys Rehabil Med. 2011;47(3):367-73. Low back pain |
n=30 G1= HIL by 10 min, 15 sessions G2= US 10 min, 15 sessions. Both 3 weeks 5x/week |
3 weeks |
VAS and OLBPDQ |
HIL significantly reduced pain when compared to US. |
Boyraz et al.3939 Boyraz I, Yildiz A, Koc B, Sarman H. Comparison of high-intensity laser therapy and ultrasound treatment in the patients with lumbar discopathy. Biomed Res Int. 2015;2015:304328. Discopathy |
n=65 G1= 10 sessions HIL G2= 10 sessions US G3= isometric exercises |
12 weeks |
VAS |
HIL significantly reduced pain at the 3-month assessment when compared to groups 2 and 3, but there were no significant differences after 10 days of treatment |
Chen et al.4040 Chen L, Liu D, Zou L, Huang J, Chen J, Zou Y, Lai J, Chen J, Li H, Liu G. Efficacy of high intensity laser therapy in treatment of patients with lumbar disc protrusion: a randomized controlled trial. J Back Musculoskelet Rehabil. 2018;31(1):191-6. Low back pain |
n=63 G1= HIL+ decompression (1 session 10 min) G2= decompression |
6 weeks |
VAS |
HIL reduced pain (lower back and lower limbs) non-significantly (p>0.05) at week 2, and significantly at week 4 |
Cantero-Téllez et al.4141 Cantero-Téllez R, Villafañe JH, Valdes K, García-Orza S, Bishop MD, Medina- Porqueres I. Effects of high-intensity laser therapy on pain sensitivity and motor performance in patients with thumb carpometacarpal joint osteoarthritis: a randomized controlled trial. Pain Med. 2020;21(10):2357-65. thumb OA |
n=43 G1: HIL 3x/week- 4 weeks G2: placebo laser |
12 weeks |
VAS |
HIL reduced pain significantly after a period of 4 weeks when compared to G2. |
Atan and Bahar-Ozdenir4242 Atan T, Bahar-Ozdemir Y. Efficacy of high-intensity laser therapy in patients with adhesive capsulitis: a sham-controlled randomized controlled trial. Lasers Med Sci. 2021;36(1):207-17. Adhesive Capsulitis |
n=36 G1= HIL+ exercise G2= placebo laser+ exercise G3= exercise 5x/week |
3 weeks |
VAS SPAID |
HIL + exercise was more beneficial than placebo laser + exercise, and than exercise alone (p<0.05) |
Korkmaz et al.4343 Korkmaz N, Gurcay E, Demir Y, Tezen Ö. Korkmaz Iï, Atar MÖ, Yaşar E. The effectiveness of high-intensity laser therapy in the treatment of post-stroke patients with hemiplegic shoulder pain a prospec. Lasers Med Sci, 2022;37(1):645-53. Post-stroke shoulder |
n=44 G1= HIL, + exercise G2= exercises only |
3 weeks |
VAS SPAID |
HIL associated with exercise was better at relieving pain, reducing dysfunction, and improving quality of life than exercise alone (p<0.05) |
Aceituno-Gómez et al.4444 Aceituno-Gómez J, Avendaño-Coy J, Gómez-Soriano J, García-Madero VM, Ávila-Martín G, Serrano-Muñoz D, González-González J, Criado-Álvarez JJ. Efficacy of high-intensity laser therapy in subacromial impingement syndrome: a three-month follow-up controlled clinical trial. Clin Rehabil. 2019;33(5):894-903. Impaction syndrome |
n=46 G1- HIL G2= placebo laser G3= exercise 5 sessions/week by 3 weeks |
3 weeks |
VAS and ECM |
HIL + exercise was no more effective than exercise alone in reducing pain and improving function |
Ezzati et al.4545 Ezzati K, Laakso EL, Saberi A, Yousefzadeh Chabok S, Nasiri E, Bakhshayesh Eghbali B. A comparative study of the dose-dependent effects of low level and high intensity photobiomodulation (laser) therapy on pain and electrophysiological parameters in patients with carpal tunnel syndrome. Eur J Phys Rehabil Med. 2020;56(6):733-40. Carpal tunnel |
n=98 G1= exercise + LIL (8J/cm2) G2= exercise + LIL (20J/cm2) G3= exercise + HIL (8J/cm2) G4= exercise + HIL (20J/cm2) G5= exercise |
3 weeks |
VAS |
All groups had significant pain reduction. HIL + exercise was superior to all other groups LIL with low fluence (8J/cm2) obtained the most significant pain reduction |
Venosa et al.4646 Venosa M, Romanini E, Padua R, Cerciello S. Comparison of high-intensity laser therapy and combination of ultrasound treatment and transcutaneous nerve stimulation in patients with cervical spondylosis: a randomized controlled trial. Lasers Med Sci. 2019;34(5):947-53. Cervical spondylosis |
n=84 G1= HIL + exercise G2= US, TENS and exercise |
4 weeks |
VAS |
Pain reduction was observed in all groups. HIL was more effective than US+TENS+exercise in reducing pain (p<0.05) |
Thabet and Alshehri4747 Thabet AAE, Alshehri MA. Effect of pulsed high-intensity laser therapy on pain, adhesions, and quality of life in women having endometriosis: a randomized controlled trial. Photomed Laser Surg. 2018;36(7):363-9. Endometriosis |
n=40 G1= HIL, 3x/week G2= placebo laser 3x/week |
8 weeks |
VAS and NRS |
HIL significantly reduced pain when compared to the placebo laser |
Ordahan, Karahan and Kaydok4848 Ordahan B, Karahan AY, Kaydok E. The effect of high-intensity versus low-level laser therapy in the management of plantar fasciitis: a randomized clinical trial. Lasers Med Sci. 2018;33(6):1363-9. Faceitis plantaris |
n=75 G1= LIL (3 sessions/ week) G2= HIL (3 sessions/ week) |
3 weeks |
VAS |
Both lasers improved pain, but in the HIL group the reductions were significant (p<0.05) |
El-Shamy e Abdelaal49 Hemophilic arthropathy |
n=30 G1= HIL + physiotherapy G2= placebo laser + physiotherapy Both 3x/week |
12 weeks |
VAS |
HIL was shown to be more effective in improving pain, functional capacity, and gait when compared to the placebo group |
Thabet et al.5050 Thabet AAE, Elsodany AM, Battecha KH, Alshehri MA, Refaat B. High-intensity laser therapy versus pulsed electromagnetic field in the treatment of primary dysmenorrhea. J Phys Ther Sci. 2017;29(10):1742-8. Primary dysmenorrhea |
n=52 G1= HIL G2= PEMF Both 3 cycles of 3 sessions |
6 months |
VAS and NRS |
Both therapies promoted pain relief, but HIL was the one that generated the most significant result (p<0.05) |
Ebid et al.5151 Ebid AA, Ibrahim AR, Omar MT, El Baky AMA. Long-term effects of pulsed high-intensity laser therapy in the treatment of post-burn pruritus: a double-blind, placebo-controlled, randomized study. Lasers Med Sci. 2017;32(3):693-701. Burned |
n=49 G1= HIL 3x/week by 6 weeks G2= placebo laser |
18 weeks |
VAS |
HIL significantly reduced pain and pruritus compared to the placebo group |
Alayat et al.5252 Alayat MS, Mohamed AA, Helal OF, Khaled OA. Efficacy of high-intensity laser therapy in the treatment of chronic neck pain: a randomized double-blind placebocontrol trial. Lasers Med Sci. 2016;31(4):687-94. Chronic cervical pain |
n=60 G1= HIL + exercise G2= placebo laser + exercise |
6 weeks |
VAS |
There was pain reduction in both groups, but significant pain reduction in the HIL group after 6 weeks of treatment |
Authors |
Protocol for intervention |
Duration |
Pain assessment method |
Outcome |
Ebid and El-Sodany5353 Ebid AA, El-Sodany AM. Long-term effect of pulsed high-intensity laser therapy in the treatment of post-mastectomy pain syndrome: a double blind, placebocontrol, randomized study. Lasers Med Sci. 2015;30(6):1747-55. Post-mastectomy |
n=61 G1= HIL 3x/week G2= HIL 3x/week |
12 weeks |
VAS |
Pain was significantly reduced in the HIL group when compared to the placebo group. |
Kim et al.5454 Kim SH, Kim YH, Lee HR, Choi YE. Short-term effects of high-intensity laser therapy on frozen shoulder: A prospective randomized control study. Man Ther. 2015;20(6):751-7. Frozen shoulder syndrome |
n= 63 G1= HIL 3x/week by 3 weeks G2= placebo laser |
12 weeks |
VAS |
HIL group had significantly lower VAS scores at 3 and 8 weeks, but this difference was not maintained at week 12 |
Dundar et al.5555 Dundar U, Turkmen U, Toktas H, Ulasli AM, Solak O. Effectiveness of highintensity laser therapy and splinting in lateral epicondylitis; a prospective, randomized, controlled study. Lasers Med Sci. 2015;30(3):1097-107. Lateral epicondylitis |
n=93 15 days in a row: G2= HIL 1 sessions/day G2= placebo laser 1 sessions/day G3= use of counterforce belt |
12 weeks |
VAS |
HIL and counterforce belt reduced pain at 4 and 12 weeks with significance compared to G2. |
Dundar et al.5656 Dundar U, Turkmen U, Toktas H, Solak O, Ulasli AM. Effect of high-intensity laser therapy in the management of myofascial pain syndrome of the trapezius: a double-blind, placebo-controlled study. Lasers Med Sci. 2015;30(1):325-32. Trapezium |
n=76 G1= HIL 1x/day by 15 days + exercise G2= placebo laser + exercise |
12 weeks |
VAS |
HIL reduziu os escores da VAS na 4ª e 12ª semanas de forma significante em comparação com o grupo placebo |
Nouri et al.5757 Nouri F, Raeissadat SA, Eliaspour D, Rayegani SM, Rahimi MS, Movahedi B. Efficacy of high-power laser in alleviating pain and improving function of patients with patellofemoral pain syndrome: a single-blind randomized controlled trial. J Lasers Med Sci. 2019;10(1):37-43. Patellofemoral pain |
n=40 G1=placebo laser + exercise G2= HIL 5 sessions + exercise |
12 weeks |
VAS and WOMAC |
The reductions in VAS with HIL were more significant than those in the placebo group. The reductions in WOMAC scale were not different between groups (p>0.05) |
Yesil et al.5858 Yesil H, Dundar U, Toktas H, Eyvaz N, Yeşil M. The effect of high intensity laser therapy in the management of painful calcaneal spur: a double blind, placebocontrolled study. Lasers Med Sci. 2020;35(4):841-52 Heel pain |
n=42 G1=HIL+exercise G2= placebo laser+ exercise |
12 weeks |
VAS and RMS |
Both VAS and RMS were significantly reduced in both groups at weeks 4 and 12 compared to pre-treatment measurements, however there was no difference between groups at any time point. |
Song et al.2626 Song HJ, Seo HJ, Lee Y, Kim SK. Effectiveness of high-intensity laser therapy in the treatment of musculoskeletal disorders: a systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore). 2018;97(51):e13126. Musculoskeletal pain |
n=736(12 studies) GL= HIL GC= placebo, exercise, US, TENS, bandages |
2-12 weeks |
VAS |
In 11 studies HIL significantly reduced pain when compared to the control groups. The quality of the included studies was moderate; however, there was significant heterogeneity. |
Ezzati et al.2828 Ezzati K, Laakso EL, Salari A, Hasannejad A, Fekrazad R, Aris A. The beneficial effects of high-intensity laser therapy and co-interventions on musculoskeletal pain management: a systematic review. J Lasers Med Sci. 2020;11(1):81-90. Musculoskeletal pain |
n= 19 studies G1= HIL (11 studies) G2= other interventions (8 studies) |
|
VAS |
It has been observed that the addition of HIL-related co-interventions can enhance the beneficial effects of laser therapy |
Starzec-Prosepio et al.2929 Starzec-Proserpio M, Grigol Bardin M, Fradette J, Tu LM, Bérubè-Lauzière Y, Paré J, Carroll MS, Morin M. High-Intensity Laser Therapy (HILT) as an emerging treatment for vulvodynia and chronic musculoskeletal pain disorders: a systematic review of treatment efficacy. J Clin Med. 2022;11(13):3701. Vulvodynia and chronic muscle pain |
n=726(13 studies) GL= HIL GP= placebo laser, LIL, US, PEMF or exercise |
Up to 12 weeks |
VAS |
There was pain reduction in all 13 HIL groups in all 13 studies, with only 1 study showing no statistically significant difference (HIL vs. LIL). However, the findings on LIL in vulvodynia are insufficient to recommend its use in clinical settings |
Wyszynska and Bal-Bochenska3030 Wyszyńska J, Bal-Bocheńska M. Efficacy of high-intensity laser therapy in treating knee osteoarthritis: a first systematic review. Photomed Laser Surg. 2018;36(7):343-53. Knee osteoarthritis |
n=395 (6 studies) GL= HIL GC=placebo, other rehabilitation therapies, pharmacotherapies |
2-6 weeks |
VAS, WOMAC, Fisher’s dolorimeter |
HIL showed favorable results in pain relief, more than the other interventions, and is efficient in pain reduction and functional improvement in patients with knee OA. However, the quality assessment indicated a high risk of bias in four of the six studies |
Alayat et al.2727 Alayat MSM, Alshehri MA, Shousha TM, Abdelgalil AA, Alhasan H, Khayyat OK, Al-Attar WS. The effectiveness of high intensity laser therapy in the management of spinal disorders: a systematic review and meta-analysis. J Back Musculoskelet Rehabil. 2019;32(6):869-84 Spinal pain |
n=750 (10 studies) G1= HIL G2=conventional therapy (exercise, US, traction, drugs) |
1-12 weeks |
VAS |
The combination of HIL and exercise or conservative physical therapy was superior to placebo, exercise, or physical therapy alone. However, the quality of the body of evidence was rated from “very low” to “low”. |