Lasers in Medical Science

, Volume 29, Issue 2, pp 749–755 | Cite as

Effect of low-level laser therapy in patients with chronic knee osteoarthritis: a single-blinded randomized clinical study

  • Ahmad Alghadir
  • Mohammed Taher Ahmed Omar
  • Abeer Bashier Al-Askar
  • Naser Khwietm Al-Muteri
Original Article


The aim of this study was to investigate the effect of low-level laser therapy (LLLT) on pain relief and functional performance in patients with chronic knee osteoarthritis (OA). Forty patients with knee OA were randomly assigned into active laser group (n = 20) and placebo laser group (n = 20). The LLLT device used was a Ga–As diode laser with a power output of 50 mW, a wavelength of 850 nm, and a diameter beam of 1 mm. Eight points were irradiated and received dosage of 6 J/point for 60 s, with a total dosage of 48 J/cm2 in each session. The placebo group was identical but treated without emission of energy. LLLT was applied two times per week over the period of 4 weeks. Outcome measurements included pain intensity at rest and at movement on visual analog scale, knee function using Western Ontario McMaster Universities Osteoarthritis Index scale, and ambulation duration. These measurements were collected at baseline and post-intervention. The results showed significant improvements in all assessment parameters in both groups compared to baseline. Active laser group showed significant differences in pain intensity at rest and movement, knee function, and ambulation duration when compared with the placebo group. Therefore, LLLT seemed to be an effective modality for short-term pain relief and function improvement in patients with chronic knee OA.


Low-level laser therapy Knee Osteoarthritis Pain 



The authors extend their appreciation to the Deanship of Scientific Research at King Saud University for funding the work through the research group project NO RGP-VPP-209.

Conflict of interest

The authors have no conflict of interest to declare in this study.


  1. 1.
    Gupta S, Hawker GA, Laporte A, Croxford R, Coyte PC (2005) The economic burden of disabling hip and knee osteoarthritis (OA) from the perspective of individuals living with this condition. Rheumatology (Oxford) 44:1531–7CrossRefGoogle Scholar
  2. 2.
    Felson DT, Lawrance RC, Dieppe PA et al (2000) Osteoarthritis: new insight. Part I: the disease and its risk factors. Ann Intern Med 133:635–646PubMedCrossRefGoogle Scholar
  3. 3.
    Al-Shammari SA, Khoja TA, Alballa SR, Kremlin M (1995) Obesity and clinical osteoarthritis of the knee in primary health care, Riyadh, Saudi Arabia. Med Sci Res 23:255–6Google Scholar
  4. 4.
    Al-Arfaj A, Al-Boukai AA (2002) Prevalence of radiographic knee osteoarthritis in Saudi Arabia. Clin Rheumatol 21:142–145PubMedCrossRefGoogle Scholar
  5. 5.
    Rajapakse CA (1987) The spectrum of rheumatic diseases in Saudi Arabia. Br J Rheumatol 26:22–23PubMedCrossRefGoogle Scholar
  6. 6.
    Agunwa W (1989) Low incidence of osteoporosis of hips in contrast with osteoarthritis of knees among rural Saudis. Why? Ann Rheum Dis 48:351–352Google Scholar
  7. 7.
    Silverstein FE, Faich G, Goldstein JL et al (2000) Gastrointestinal toxicity with celecoxib vs nonsteroidal anti-inflammatory drugs for osteoarthritis and rheumatoid arthritis. JAMA 284:1247–1255PubMedCrossRefGoogle Scholar
  8. 8.
    Jordan KM, Arden NK, Doherty M et al (2003) Standing committee for international clinical studies including therapeutic trials ESCISIT: EULAR recommendations 2003: an evidence based approach to the management of knee osteoarthritis: report of a task force of the standing committee for international clinical studies including therapeutic trials (ESCISIT). Ann Rheum Dis 62(12):1145–1155PubMedCentralPubMedCrossRefGoogle Scholar
  9. 9.
    Adedoyin RA, Olaogun MOB, Fagbeja OF (2002) Effects of interferential current stimulation in management of osteoarthritis knee pain. Physiother 88:493–9CrossRefGoogle Scholar
  10. 10.
    Sherma L, Dunlop DD, Cahue S et al (2003) Quadriceps strength and osteoarthritis progression in malaligned and lax knees. Osteoarthr Cartil 11:252–9CrossRefGoogle Scholar
  11. 11.
    Kazanoglu E, Basaran S, Guzel R, Guler-Uysal F (2003) Short term efficacy of ibuprofen Phonphoresis versus continuous ultrasound therapy in knee osteoarthritis. Swiss Med Wakly 133:333–338Google Scholar
  12. 12.
    Jackson BD, Wluka AE, Teichtahl AJ et al (2004) Reviewing knee osteoarthritis—a biomechanical perspective. J Sci Med Sport 7(3):347–357PubMedCrossRefGoogle Scholar
  13. 13.
    Hegedus B, Viharos L, Gervain M, Galfi M (2009) The effect of low-level laser in knee osteoarthritis: a double blind, randomized, placebo-controlled trial. Photomed Laser Surg 27(4):577–584PubMedCentralPubMedCrossRefGoogle Scholar
  14. 14.
    Ozdemir F, Birtane M, Kokino S (2001) The clinical efficacy of low power laser therapy on pain and function in cervical osteoarthritis. Clin Rheumatol 20:181–4PubMedCrossRefGoogle Scholar
  15. 15.
    Simunovic Z, Trobonjaca T, Trobonjaca Z (1998) Treatment of medial and lateral epicondylitis—tennis and golfer's elbow—with low laser therapy: a multicenter double-blind, placebo-controlled study on 324 patients. J Clin Laser Med Surg 16:145–51PubMedGoogle Scholar
  16. 16.
    Gur A, Karakoc M, Cevik R, Nas K, Sarac AJ (2003) Efficacy of low power laser therapy and exercise on pain and functions in chronic low back pain. Lasers Surg Med 32(3):233–238PubMedCrossRefGoogle Scholar
  17. 17.
    Haker EH, Lundeberg TC (1991) Lateral epicondylalgia: report of non effective mid laser treatment. Arch Phys Med Rehabil 72:984–8PubMedGoogle Scholar
  18. 18.
    Vecchio P, Cave M, King V, Adebajo AO, Smith M, Hazleman BL (1993) A double-blind study of the effectiveness of low-level laser treatment of rotator cuff tendinitis. Br J Rheumatol 32:740–2PubMedCrossRefGoogle Scholar
  19. 19.
    Goats G, Flett E, Hunter JA, Stirling A (1996) Low intensity laser and phototherapy for rheumatoid arthritis. Physiotherapy 82:311–20CrossRefGoogle Scholar
  20. 20.
    Krasheninnikoff M, Ellitsgaard N, Rogvi-Hansen B, Zeuthen A (1994) No effect of power laser in lateral epicondylitis. Scand J Rheumatol 23(5):260–263PubMedCrossRefGoogle Scholar
  21. 21.
    Bjordal JM, Johnson MI, Lopes-Martins RA (2007) Short-term efficacy of physical interventions in osteoarthritic knee pain: a systematic review and meta-analysis of randomized placebocontrolled trials. BMC Musculoskeletal Disord 8:51–64CrossRefGoogle Scholar
  22. 22.
    Brosseau L, Welch V, Wells G et al (2003) Low level laser therapy (Classes I, II, and III) for treating osteoarthritis. Cochrane Database Syst Rev, OxfordGoogle Scholar
  23. 23.
    Altman R, Asch E, Bloch D et al (1986) Development of criteria for the classification and reporting of osteoarthritis of the knee. Arthritis Rheum 29(8):1039–1049PubMedCrossRefGoogle Scholar
  24. 24.
    Kellgren JH, Lawrence JS (1957) Radiological assessment of osteoarthritis. Ann Rheum Dis 16:494–502PubMedCentralPubMedCrossRefGoogle Scholar
  25. 25.
    Schulz KF, Grimes DA (2002) Allocation concealment in randomized trials: defending against deciphering. Lancet 359:614–8PubMedCrossRefGoogle Scholar
  26. 26.
    Portney LG, Watkins MP (2000) Foundations of clinical research: applications to Practice, 2nd edn. Prentice Hall, Upper Saddle River, New JerseyGoogle Scholar
  27. 27.
    Bolognese JA, Schnitzer TJ, Ehrich EW (2003) Response relationship of VAS and Likert scales in osteoarthritis efficacy measurement. Osteoarthr Cartil 11(7):499–507PubMedCrossRefGoogle Scholar
  28. 28.
    Carlsson A, Anna M (1983) Assessment of chronic pain. I. Aspects of the reliability and validity of the Visual Analogue Scale. Pain 16:87–101PubMedCrossRefGoogle Scholar
  29. 29.
    Bellamy N, Buchanan WW, Goldsmith CH, Campbell L (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 15:1833–1840PubMedGoogle Scholar
  30. 30.
    Choquette D, Bellamy N, Raynauld JP (1994) A French-Canadian version of the WOMAC osteoarthritis index. Arthritis Rheum 37:S226Google Scholar
  31. 31.
    Faik A, Benbouazza K, Amine B, Maarou W et al (2008) Translation and validation of Moroccan Western Ontario and Mc Master Universities (WOMAC) osteoarthritis index in knee osteoarthritis. Rheumatol Int 28:677–683PubMedCrossRefGoogle Scholar
  32. 32.
    Guermazi M, Poiraudeau S, Yahia M, Mezganni M, Fermanian J, Habib Elleuch Revel M (2004) Translation, adaptation and validation of the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) for an Arab population: the Sfax modified WOMAC. Osteoarthr Cartil 12:459–468PubMedCrossRefGoogle Scholar
  33. 33.
    Grace EM, Gerecz EM, Kaassam YB et al (1988) 50-foot walking time: a critical assessment of an outcome measure in clinical therapeutic trials of antirheumatic drugs. Br J Rheumatol 27:372–374PubMedCrossRefGoogle Scholar
  34. 34.
    Ay S, Dogans K, Evcik D (2010) Is low level laser therapy effective in acute or chronic low back pain? Clin Rhumatol 29(8):905–910CrossRefGoogle Scholar
  35. 35.
    Fukuda VO, Fukuda TY, Guimarães M et al (2011) Short-term efficacy of low-level laser therapy in patients with knee osteoarthritis: a randomized placebo controlled, double-blind clinical trial. Rev Bras Ortop 46(5):526–33CrossRefGoogle Scholar
  36. 36.
    Montes-Molina R, Madroñero-Agreda MA et al (2009) Efficacy of interferential low-level laser therapy using two independent sources in the treatment of knee pain. Photomed Laser Surg 27(3):467–71PubMedCrossRefGoogle Scholar
  37. 37.
    Gur A, Cosut A, Sarac AJ, Cevik R, Nas K, Uyar A (2003) Efficacy of different therapy regimes of low-power laser in painful osteoarthritis of the knee: a double-blind and randomized-controlled trial. Lasers Surg Med 33(5):330–8PubMedCrossRefGoogle Scholar
  38. 38.
    Stelian J, Gil I, Habot B et al (1992) Improvement of pain and disability in elderly patients with degenerative osteoarthritis of the treated with narrow-band light therapy. J Am Geriatr Soc 40:23–6PubMedGoogle Scholar
  39. 39.
    Hsieh RL, Lo MT, Liao WC, Lee WC (2012) Short-term effects of 890-nanometer radiation on pain physical activity, and postural stability in patients with Knee osteoarthritis: A double-blind, randomized placebo-controlled study. Arch Phys Med Rehabil 93:757–764PubMedCrossRefGoogle Scholar
  40. 40.
    Tascioglu F, Armagan O, Tabak Y, Corapci L, Oner C (2004) Low power laser treatment in patients with knee osteoarthritis. Swiss Med Wkly 134:254–258PubMedGoogle Scholar
  41. 41.
    Dominguez-Carrilo LG (2001) Comparación de la electroestimulación transcutánea vs laser de bajonivel en la analgesia de pacientes con gonartrosis. Cir Cir 69(1):13–7Google Scholar
  42. 42.
    Bülow PM, Hensen J, Danneskiold-Samsoe B (1994) Low power Ga–Al–As laser treatment of painful osteoarthritis of the knee. Scand J Rehab Med 26:155–9Google Scholar
  43. 43.
    Reed SC, Jackson RW, Glossop N, Randle J (1994) An in vivo study of the effect of excimer laser irradiation on degenerate rabbit articular cartilage. Arthroscopy 10(1):78–84PubMedCrossRefGoogle Scholar
  44. 44.
    Bassleer C, Datchy M, Reginster JY (1985) Human articular chondrocytes cultivated in three dimensions: effects of IR laser irradiation. Proceedings of the International Congress on Lasers in Medicine and Surgery, October 15, 1985. Bologna: Monduzzi Editor. pp 381–385Google Scholar
  45. 45.
    Skinner SM, Gage JP, Wilce PA, Saw RM (1996) A preliminary study of the effects of laser radiation on collagen metabolism in cell culture. Aust Dent J 41(3):188–192PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 2013

Authors and Affiliations

  • Ahmad Alghadir
    • 1
    • 3
  • Mohammed Taher Ahmed Omar
    • 2
    • 3
  • Abeer Bashier Al-Askar
    • 4
  • Naser Khwietm Al-Muteri
    • 4
  1. 1.Department of Rehabilitation Health Sciences, College of Applied Medical SciencesKing Saud UniversityRiyadhSaudi Arabia
  2. 2.Faculty of Physical TherapyCairo UniversityGizaEgypt
  3. 3.Rehabilitation Research ChairKing Saud UniversityRiyadhSaudi Arabia
  4. 4.Physical Therapy DepartmentKing Saud Medical CityRiyadhSaudi Arabia

Personalised recommendations