Effectiveness of Low-Level Laser Therapy Including Laser Acupuncture in Carpal Tunnel Syndrome: A Systematic Review of Randomized Controlled Trials

Carpal tunnel syndrome (CTS) is commonly managed with nonsurgical interventions, including low-level laser therapy (LLLT) and laser acupuncture (LA), which have gained attention due to their noninvasive nature and neuromodulatory potential. This systematic review analyzed 18 randomized controlled trials (RCTs) published between January 2000 and December 2024 to evaluate their therapeutic efficacy and safety. The outcomes included pain (visual analog scale, VAS), symptom severity and functional status (Boston Carpal Tunnel Questionnaire, BCTQ), electrodiagnostic parameters, and grip strength. VAS and BCTQ results generally showed improvement within intervention groups, although between-group comparisons were inconsistent, with some studies showing similar or greater improvements in controls. Electrodiagnostic parameters and grip strength also improved within intervention groups, but between-group differences remained unclear. The level of evidence was rated as very low for all outcomes due to risk of bias and imprecision. Reported adverse events were mild and infrequent. Overall, LLLT and LA may provide some therapeutic benefits for CTS patients; however, strong recommendations cannot be made. Future high-quality RCTs with standardized protocols, objective outcome measures, and comprehensive reporting are needed to clarify their clinical efficacy.