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Three Part Question

[In patients with acute simple low back pain] is [percutaneous laser therapy better than placebo] at [reducing pain, increasing mobility and speeding a return to normal function]

Clinical Scenario

A 35 year old man presents to the emergency department with acute lower back pain. He has a normal neurological examination and no symptoms to suggest a serious cause. You discharge him from the emergency department with some NSAIDs and advice to stay active. He returns to the department 5 days later still complaining of ongoing back pain. You ask one of your emergency department physios to have a look and he offers to take him on for out-patient physio and Laser therapy. You wonder if there is any evidence to support the use of Laser in back pain patients.

Search Strategy

Medline via OVID interface on ATHENS 1966-Feb 2005
Cochrane Edition 1 2005 online via NELH
EMBASE via OVID interface on ATHENS 1996-Feb 2005
CinAHL via OVID interface on ATHENS 1982-Feb 2005
Medline, Embase, CinAHL.
[exp Low Back Pain/ or lumbar pain.mp. or exp Back Pain/ or back pain.mp. or exp Back Pain/ ] and [laser.mp or exp LASERS] Limit to humans, english and abstracts
Cochrane
back-pain and laser

Search Outcome

Medline
55 citations. No relevant papers found.
Embase
60 citations. No new papers found.
CinAHL
12 citations. No new papers found.
Cochrane
11 citations. One uncompleted protocol registered.

Comment(s)

Although a number of citations were found with reference to the use of laser therapy in the management of chronic low back pain there was no evidence for it's use in the management of the acute patient.

Editor Comment

See http://www.bestbets.org/cgi-bin/bets.pl?BetID=864 for laser therapy in chronic back pain.

Clinical Bottom Line

There is no evidence to support laser therapy in the management of acute simple low back pain