Speakers - 2026

Title: Laser for complex regional pain syndrome (CRPS): A systematic review and meta-analysis

Abstract

Background: Complex Regional Pain Syndrome (CRPS) is characterized by regional pain, autonomic dysregulation, and inflammatory symptoms. Its pathogenesis is multifactorial, involving an abnormal immune-mediated inflammatory response and sympathetic nervous system upregulation, leading to catecholamine release, persistent edema, and central sensitization. While conventional treatments include nonsteroidal anti-inflammatory drugs (NSAIDs), bisphosphonates, or steroids, laser therapy or photobiomodulation (PBM) has emerged as a promising treatment due to its ability to modulate inflammation, reduce edema, and improve microcirculation. By targeting the underlying inflammatory and vasomotor dysfunction, laser therapy may disrupt the maladaptive cycle of CRPS.

Objectives: This systematic review was to evaluate the efficacy of laser therapy in patients with complex regional pain syndrome

Methods: A systematic search of seven databases (PubMed, MEDLINE, Embase, Cochrane, CNKI, Airiti Library, ClinicalTrials.gov) was performed from their inception dates to March 28, 2026. Clinical trials investigating laser therapy, including both intravenous and extravenous approaches, were included. The primary outcome was pain intensity, while secondary outcomes included the Fugl-Meyer Assessment (FMA) and Activities of Daily Living (ADL). Risk of bias was assessed using the RoB 2.0 tool.

Results: Five studies involving 241 participants were included. Compared with control groups, laser therapy showed no statistically significant differences in pain reduction (SMD = −1.81; 95% CI: −4.20 to 0.58), Fugl-Meyer Assessment (MD = 1.07; 95% CI: −0.90 to 3.05), or ADL outcomes (SMD = −1.65; 95% CI: −2.69 to 5.99).

Conclusions: Current evidence suggests that laser therapy does not provide a statistically significant benefit over conventional care for CRPS. However, given the substantial heterogeneity and variability in laser parameters across studies, these results should be interpreted with caution. Further well-designed, high-quality randomized controlled trials focusing on optimal dosage and specific CRPS stages are warranted.

What will the audience take away from presentation?

• Laser therapy is a promising modality in physical therapy. Based on the mechanisms of photobiomodulation, it may help reduce inflammation and improve vasomotor dysfunction in CRPS.

• Clinicians should consider that laser therapy, whether invasive or non-invasive, remains an optional adjunct rather than a standard treatment.