Low-energy helium neon laser treatment of thumb osteoarthritis

Eighty-one patients with symptomatic osteoarthritis of the thumb took part in a blinded, controlled study to assess the effectiveness of 0.9mw continuous wave HeNe laser treatment. The subjects were randomly placed in either a control group or a treatment group. In each group the carpometacarpal (CMC), metacarpophalangeal (MCP), and interphalangeal (IP) joints of the most symptomatic thumb were 'treated' with 15 sec irradiations at four equally spaced intervals around each joint three times a week for three weeks. The same protocol was used for both groups except that a hidden switch on the laser was placed in the 'on' position for the treated group and in the 'off' position for the control group. Although the laser-treated group noted slightly lessened tenderness of the treated MCP and IP joints (p < 0.01 and 0.05, respectively, Wilcoxon signed-rank test), and a small increase in three-finger chuck pinch strength (p < 0.04, paired t-test), changes in ROM, pain, joint tenderness, grip and pinch strength, activity level, and medication use, did not significantly differ between the groups. Adverse effects were rare (one in each group), minimal, and subjective. We conclude that HeNe laser irradiation at 0.9mw is safe, but that it is not an effective treatment of osteoarthritis of the thumb.