low-level laser therapy for treating Achilles tendinopathy

Introduction: Achilles tendinopathy is a painful condition affecting the Achilles tendon, which attaches the calf muscles to the heel bone. In most cases, Achilles tendinopathy is a type of overuse injury and is more common in younger people.

Objective: The purpose of this study was to determine the benefits and harms of low-level laser therapy for Achilles tendinopathy.

Review methods: This study was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The risk of bias was assessed using the Cochrane Risk of bias table. Meta-analyses were performed on dependence of homogeneity, otherwise results were reported narratively. The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

Results: Four trials (119 participants) were analyzed. Laser therapy associated to eccentric exercises when compared to eccentric exercises and sham had very low to low certainty of evidence in pain and function assessment. Despite one trial favored laser therapy at two months (mean difference (MD) -2.55, 95% confidence interval (95% CI) -3.87 to -1.23), the Cls did not include important differences between groups at 3 and 13 months. The function assessment showed an improvement favoring the placebo group at one month (MD 9.19, 95% CI -16.16 to -2.23) and non-significant difference between groups at 3 and 13 months. Adverse events were poorly reported but restricted to minor events related to the exercises. 

Conclusion: The certainty of evidence was low to very low, and the results are insufficient to support the routine use laser therapy for Achilles tendinopathy.  We still believe LLLT is a good choice when dealing with Achilles Tendinopathy.