REVIEW PAPER
The effects of low-level laser therapy in De Quervain tenosynovitis: evidence from a systematic review and meta-analysis
 
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1
Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
 
2
Physiotherapeutic Resources Research Laboratory, Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Paulo, Brazil
 
 
Submission date: 2024-06-06
 
 
Acceptance date: 2024-08-21
 
 
Online publication date: 2025-07-14
 
 
Corresponding author
Hernán Andrés de la Barra Ortiz   

Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, 7591538, Chile
 
 
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
De Quervain tenosynovitis (QT), a painful and inflammatory wrist condition, presents challenges in its conservative treatment. Although low-level laser therapy (LLLT) is considered an attractive option, the evidence of its effectiveness requires evaluation. This systematic review aimed to assess the analgesic effects of LLLT in QT patients.

Methods:
The search used the PubMed, Scopus, Web of Science, Embase, EBSCOhost, Physiotherapy Evidence Database (PEDro), and Google Scholar (last updated on March 10, 2025) databases to identify clinical trials comparing the effects of LLLT to other physical therapy or medical treatments in patients with QT. The primary outcomes evaluated were pain intensity, grip strength, and disability. The Cochrane Risk of Bias Tool 2 (RoB2) assessed study quality, and the meta-analysis used weighted mean difference (WMD) or standardised mean difference (SMD). Evidence-based recommendations for statistically significant outcomes were presented following the GRADE approach.

Results:
Eight studies were included, with an overall low risk of bias (RoB) (25%). Deviations from intended interventions and outcome measurement were sources of bias. Post-treatment pain intensity was statistically significant for LLLT (WMD = –0.98 cm; 95% CI: –1.91, –0.04; p = 0.04; LLLT group [107],control group [124]). RoB and heterogeneity rated the evidence certainty as very low yet important. Handgrip strength and synovial sheath thickness were not statistically significant between groups (p > 0.05).

Conclusions:
LLLT reduces pain effectively. Prioritising LLLT or ultrasound (US) over invasive treatments may optimise clinical management and minimise postsurgical complications.
REFERENCES (56)
1.
Fakoya AO, Tarzian M, Sabater EL, Burgos DM, Maldo­nado Marty GI. De Quervain’s disease: a discourse on etiology, diagnosis, and treatment. Cureus. 2023;15(4):e38079; doi: 10.7759/cureus.38079.
 
2.
Ilyas AM, Ast M, Schaffer AA, Thoder J. De Quervain tenosynovitis of the wrist. J Am Acad Orthop Surg. 2007;15(12):757–64; doi: 10.5435/00124635-200712000-00009.
 
3.
Challoumas D, Ramasubbu R, Rooney E, Seymour-Jackson E, Putti A, Millar NL. Management of de Quervain tenosynovitis: a systematic review and network meta-analysis. JAMA Netw Open. 2023;6(10):e2337001; doi: 10.1001/jamanetworkopen.2023.37001.
 
4.
Stahl S, Vida D, Meisner C, Lotter O, Rothenberger J, Schaller H-E, Stahl AS. Systematic review and meta-analysis on the work-related cause of de Quervain tenosynovitis: a critical appraisal of its recognition as an occupational disease: a critical appraisal of its recognition as an occupational disease. Plast Reconstr Surg. 2013;132(6):1479–91; doi: 10.1097/01.prs.0000434409.32594.1b.
 
5.
Wolf JM, Sturdivant RX, Owens BD. Incidence of de Quervain’s tenosynovitis in a young, active population. J Hand Surg Am. 2009;34(1):112–5; doi: 10.1016/j.jhsa.2008.08.020.
 
6.
Larsen CG, Fitzgerald MJ, Nellans KW, Lane LB. Management of de Quervain tenosynovitis: a critical analysis review. JBJS Rev. 2021;9(9):e21.00069; doi: 10.2106/jbjs.rvw.21.00069.
 
7.
Goel R, Abzug JM. De Quervain’s tenosynovitis: a review of the rehabilitative options. Hand. 2015;10(1):1–5; doi: 10.1007/s11552-014-9649-3.
 
8.
Ferrara PE, Codazza S, Cerulli S, Maccauro G, Ferriero G, Ronconi G. Physical modalities for the conservative treatment of wrist and hand’s tenosynovitis: a systematic review. Semin Arthritis Rheum. 2020;50(6):1280–90; doi: 10.1016/j.semarthrit.2020.08.006.
 
9.
Rabin A, Israeli T, Kozol Z. Physiotherapy management of people diagnosed with de Quervain’s disease: a case series. Physiother Can. 2015;67(3):263–7; doi: 10.3138/ptc.2014-47.
 
10.
Cotler HB, Chow RT, Hamblin MR, Carroll J. The use of low level laser therapy (LLLT) for musculoskeletal pain. MOJ Orthop Rheumatol. 2015;2(5):188–94; doi: 10.15406/mojor.2015.02.00068.
 
11.
Clijsen R, Brunner A, Barbero M, Clarys P, Taeymans J. Effects of low-level laser therapy on pain in patients with musculoskeletal disorders: a systematic review and meta-analysis. Eur J Phys Rehabil Med. 2017;53(4):603–10; doi: 10.23736/S1973-9087.17.04432-X.
 
12.
Chow R. EBM in action: is laser treatment effective and safe for musculoskeletal pain?. Med J Aust. 2002;176(4):194–5; doi: 10.5694/j.1326-5377.2002.tb04366.x.
 
13.
de la Barra Ortiz HA, Avila MA, Miranda LG, Liebano RE. Effect of high-intensity laser therapy in patients with non-specific chronic neck pain: study protocol for a randomized controlled trial. Trials. 2023;24(1):563; doi: 10.1186/s13063-023-07599-0.
 
14.
Reddy GK. Photobiological basis and clinical role of low-intensity lasers in biology and medicine. J Clin Laser Med Surg. 2004;22(2):141–50; doi: 10.1089/104454704774076208.
 
15.
Chow RT, Johnson MI, Lopes-Martins RAB, Bjordal JM. Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials. Lancet. 2009;374(9705):1897–908; doi: 10.1016/S0140-6736(09)61522-1.
 
16.
Sharma R, Thukral A, Kumar S, Bhargava SK. Effect of low level lasers in de Quervains tenosynovitis. Physiotherapy. 2002;88(12):730–4; doi: 10.1016/s0031-9406(05)60716-x.
 
17.
Sharma R, Aggarwal AN, Bhatt S, Kumar S, Bhargava SK. Outcome of low level lasers versus ultrasonic therapy in de Quervain’s tenosynovitis. Indian J Orthop. 2015;49(5):542–8; doi: 10.4103/0019-5413.164050.
 
18.
Elsawy D, Magda M, Mohamed M. Efficacy of low-level laser therapy on DE quervain’s tenosynovitis after delivery. Med J Cairo Univ. 2021;89(9):1715–9; doi: 10.21608/mjcu.2021.197223.
 
19.
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Rev Panam Salud Publica. 2022;46:e112; doi: 10.26633/RPSP.2022.112.
 
20.
Schiavo JH. PROSPERO: an international register of systematic review protocols. Med Ref Serv Q. 2019;38(2):171–80; doi: 10.1080/02763869.2019.1588072.
 
21.
Paez A. Gray literature: an important resource in systematic reviews. J Evid Based Med. 2017;10(3):233–40; doi: 10.1111/jebm.12266.
 
22.
Valizadeh A, Moassefi M, Nakhostin-Ansari A, Hosseini Asl SH, Saghab Torbati M, Aghajani R, Ghorbani ZM, Faghani S. Abstract screening using the automated tool Rayyan: results of effectiveness in three diagnostic test accuracy systematic reviews. BMC Med Res Methodol. 2022;22(1):160; doi: 10.1186/s12874-022-01631-8.
 
23.
Cashin AG, McAuley JH. Clinimetrics: physiotherapy evidence database (PEDro) scale. J Physiother. 2020;66(1):59; doi: 10.1016/j.jphys.2019.08.005.
 
24.
Flemyng E, Moore TH, Boutron I, Higgins JP, Hróbjar­tsson A, Nejstgaard CH, Dwan K. Using Risk of Bias 2 to assess results from randomised controlled trials: guidance from Cochrane. BMJ Evid Based Med. 2023;28(4):260–6; doi: 10.1136/bmjebm-2022-112102.
 
25.
Gonzalez GZ, Moseley AM, Maher CG, Nascimento DP, Costa L da CM, Costa LO. Methodologic quality and statistical reporting of physical therapy randomized controlled trials relevant to musculoskeletal conditions. Arch Phys Med Rehabil. 2018;99(1):129–36; doi: 10.1016/j.apmr.2017.08.485.
 
26.
McHugh ML. Interrater reliability: the kappa statistic. Biochem Med. 2012;22(3):276–82; doi: 10.11613/bm.2012.031.
 
27.
Stogiannis D, Siannis F, Androulakis E. Heterogeneity in meta-analysis: a comprehensive overview. Int J Biostat. 2023;20(1):169–99; doi: 10.1515/ijb-2022-0070.
 
28.
Ioannidis JPA. Interpretation of tests of heterogeneity and bias in meta-analysis: heterogeneity and bias in meta-analysis. J Eval Clin Pract. 2008;14(5):951–7; doi: 10.1111/j.1365-2753.2008.00986.x.
 
29.
Austin TM, Richter RR, Sebelski CA. Introduction to the GRADE approach for guideline development: considerations for physical therapist practice. Phys Ther. 2014;94(11):1652–9; doi: 10.2522/ptj.20130627.
 
30.
Spineli LM, Pandis N. Publication bias: graphical and statistical methods. Am J Orthod Dentofacial Orthop. 2021;159(2):248–51; doi: 10.1016/j.ajodo.2020.11.005.
 
31.
Armagan O, Ekim A, Oner C. 823 treatment of DE Quervain’s tenosynovitis with low level laser theraphy. Eur J Pain. 2006;10(S1):214a–214; doi: 10.1016/s1090-3801(06)60826-4.
 
32.
Kumar A, Mittal P. Invasive vs non invasive treatment in stenosing tenosynovitis. Indian J Physiother Occup Ther. 2018;12(1):70–5; doi: 10.5958/0973-5674.2018.00013.8.
 
33.
Kamalakannan M. Efficacy of Kinesio taping and low-level laser therapy versus conventional therapy for De Quervains’s tenosynovitis. Biomedicine. 2020;40:89–93; doi: 10.51248/.V40I1.112.
 
34.
Armağan O, Ortanca B, Özgen M, Berkan F, Öner S. Effect of low-level laser treatment in de Quervains tenosynovitis patients. Osman J Med. 2021:106–116; doi: 10.20515/otd.731806.
 
35.
Upadhyay KA, Tank PM, Patel HN, Damor HN, Katara DL. Observational study of management of stenosing tenosynovitis at wrist. J Orthop Spine. 2023;11(1):8–13; doi: 10.4103/JOASP.JOASP_4_23.
 
36.
Gallagher EJ, Liebman M, Bijur PE. Prospective validation of clinically important changes in pain severity measured on a visual analog scale. Ann Emerg Med. 2001;38(6):633–8; doi: 10.1067/mem.2001.118863.
 
37.
Bird SB, Dickson EW. Clinically significant changes in pain along the visual analog scale. Ann Emerg Med. 2001;38(6):639–43; doi: 10.1067/mem.2001.118012.
 
38.
Huang Y-Y, Nagata K, Tedford CE, McCarthy T, Hamblin MR. Low-level laser therapy (LLLT) reduces oxidative stress in primary cortical neurons in vitro. J Biophotonics. 2013;6(10):829–38; doi: 10.1002/jbio.201200157.
 
39.
Wickenheisser VA, Zywot EM, Rabjohns EM, Lee HH, Lawrence DS, Tarrant TK. Laser light therapy in inflammatory, musculoskeletal, and autoimmune disease. Curr Allergy Asthma Rep. 2019;19(8):37; doi: 10.1007/s11882-019-0869-z.
 
40.
Tobore TO. Towards a comprehensive theory of non-cancer acute and chronic pain management: the critical role of reactive oxygen and nitrogen species in pain, and opioid dependence, addiction, hyperalgesia, and tolerance. Adv Redox Res. 2021;2:100003; doi: 10.1016/j.arres.2021.100003.
 
41.
Fabre HSC, Navarro RL, Oltramari-Navarro PVP, Oliveira RF, Pires-Oliveira DAA, Andraus RAC, Fuirini N, Fernandes KBP 5. Anti-inflammatory and analgesic effects of low-level laser therapy on the postoperative healing process. J Phys Ther Sci. 2015;27(6):1645–8; doi: 10.1589/jpts.27.1645.
 
42.
Chow RT, David MA, Armati PJ. 830 nm laser irradiation induces varicosity formation, reduces mitochondrial membrane potential and blocks fast axonal flow in small and medium diameter rat dorsal root ganglion neurons: implications for the analgesic effects of 830 nm laser. J Peripher Nerv Syst. 2007;12(1):28–39; doi: 10.1111/j.1529-8027.2007.00114.x.
 
43.
Heijmans L, Mons MR, Joosten EA. A systematic review on descending serotonergic projections and modulation of spinal nociception in chronic neuropathic pain and after spinal cord stimulation. Mol Pain. 2021;17:17448069211043965; doi: 10.1177/17448069211043965.
 
44.
Bjordal JM, Lopes-Martins RAB, Joensen J, Iversen VV. The anti-inflammatory mechanism of low level laser therapy and its relevance for clinical use in physiotherapy. Phys Ther Rev. 2010;15(4):286–93; doi: 10.1179/1743288x10y.0000000001.
 
45.
Okita S, Sasaki R, Kondo Y, Sakamoto J, Honda Y, Oki­ta M. Effects of low-level laser therapy on inflammatory symptoms in an arthritis rat model. J Phys Ther Sci. 2023;35(1):55–9; doi: 10.1589/jpts.35.55.
 
46.
Oh JK, Messing S, Hyrien O, Hammert WC. Effectiveness of corticosteroid injections for treatment of de Quervain’s tenosynovitis. Hand. 2017;12(4):357–61; doi: 10.1177/1558944716681976.
 
47.
Evangelista L, De Meo B, Bernabei G, Belloni G, D’An­gelo G, Vanzini M, Calzà L, Gallamini M. Ultra-low-level laser therapy and acupuncture Libralux: what is so special?. Medicines. 2019;6(1):40; doi: 10.3390/medicines6010040.
 
48.
Zeng Y-J, Lin Y-H, Wang Y-C, Chang J-H, Wu J-H, Hsu S-F, Tsai S-Y, Lin C-H, Wen Y-R. Laser acupuncture-induced analgesic effect and molecular alterations in an incision pain model: a comparison with electroacupuncture-induced effects. Lasers Med Sci. 2018;33(2):295–304; doi: 10.1007/s10103-017-2367-7.
 
49.
Graven-Nielsen T, Arendt-Nielsen L. Impact of clinical and experimental pain on muscle strength and activity. Curr Rheumatol Rep. 2008;10(6):475–81; doi: 10.1007/s11926-008-0078-6.
 
50.
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; doi: doi.org/10.1093/pm/pnz297.
 
51.
Van Wilgen CP, Akkerman L, Wieringa J, Dijkstra PU. Muscle strength in patients with chronic pain. Clin Rehabil. 2003;17(8):885–9; doi: 10.1191/0269215503cr693oa.
 
52.
Zale EL, Lange KL, Fields SA, Ditre JW. The relation between pain-related fear and disability: a meta-analysis. J Pain. 2013;14(10):1019–30; doi: 10.1016/j.jpain.2013.05.005.
 
53.
Moore A, Tumin D. Overlap of pain-related and general measures of disability among adults with chronic pain. Pain Pract. 2024;24(1):62–71; doi: 10.1111/papr.13281.
 
54.
Churruca K, Pomare C, Ellis LA, Long JC, Henderson SB, Murphy LED, Leahy CJ, Braithwaite J. Patient-reported outcome measures (PROMs): a review of generic and condition-specific measures and a discussion of trends and issues. Health Expect. 2021;24(4):1015–24; doi: 10.1111/hex.13254.
 
55.
McBain B, Rio E, Cook J, Sanderson J, Docking S. Isometric thumb extension exercise as part of a multimodal intervention for de Quervain’s syndrome: a randomised feasibility trial. Hand Ther. 2023;28(2):72–84; doi: 10.1177/17589983231158499.
 
56.
Rutkowski M, Rutkowski K. Potential effects, diagnosis, and management of de Quervain tenosynovitis in the aesthetics community: a brief review, case example, and illustrative exercises. J Clin Aesthet Dermatol. 2023;16(9 Suppl 2):28–31.
 
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