Effects of high-intensity laser therapy in patients with De Quervain's tenosynovitis: A systematic review and meta-analysis.

Abstract

Background: De Quervain's tenosynovitis (QT) is common among individuals performing repetitive manual tasks and significantly affects daily activities due to pain. While traditional treatments often provide limited relief, high-intensity laser therapy (HILT) shows as a potential analgesic resource.

Purpose: This systematic review aimed to evaluate the analgesic effects of HILT in patients with QT.

Study design: This study is a systematic review with meta-analysis with an observational, retrospective, and secondary design.

Methods: The search was conducted in PubMed, Web of Science, Scopus, EBSCOhost, Embase, Cochrane Library, Physiotherapy Evidence Database (PEDro), and Google Scholar (last updated September 17, 2024) to identify clinical trials comparing HILT with other treatments for QT. Pain intensity, measured with a Visual Analog Scale (VAS), was the main outcome. Disability and handgrip strength, measured with the quick disabilities of the arm, shoulder and hand (Q-DASH) and patient-rated wrist and hand evaluation (PRWE) questionnaires and dynamometry, were the secondary outcomes. Study quality was assessed using the Cochrane Risk of Bias Tool 2 (RoB2), and a meta-analysis was performed using mean difference (MD) or standardized mean difference (SMD). The GRADE approach guided evidence-based recommendations for statistically significant outcomes.

Results: Three studies were included, demonstrating an overall low bias (66%), with outcome measurements being the principal sources of bias. The meta-analysis did not reveal statistically significant advantages for HILT in terms of pain intensity and disability (VAS MD=0.21 cm; 95% CI: -1.43,1.86) (SMD=-0.31; 95% CI: -0.75,0.13). Despite individual studies reporting significant differences favoring HILT, the meta-analysis lacks statistical significance, preventing definitive recommendations.

Conclusions: Despite the potential benefits of HILT in managing QT, the current evidence does not support its superiority over conventional treatments like splinting or splinting combined with exercise. Further clinical trials are necessary to confirm HILT's efficacy and refine treatment guidelines in line with the dosage proposed by the included studies.