An evaluation of the application of laser therapy and combined laser/phototherapy in podiatry

Low powered lasers have been in use as therapeutic devices since the 1970s for the treatment of a wide range of conditions including wounds, pain syndromes, musculo-skeletal injuries and skin infections. This study aims to determine whether laser therapy can be usefully applied to these conditions of the foot and ankle.;A review of the literature three areas where existing podiatric therapies are inadequate, and for which there is empirical evidence of the efficacy of laser therapy. The conditions arising from this review were verruca pedis (planta warts), plantar heel pain syndrome, and foot and ankle wounds (neuropathic, venous and ischaemic).;Three separate RCTs were established to determine the effectiveness of laser therapy/phototherapy in the management of these conditions. Subjects randomised to receive laser (820nm) therapy and phototherapy (660nm) received laser irradiation/phototherapy at the site of their condition. Subjects randomised to receive control received sham irradiation. Both groups also received a concurrent conventional therapy for their condition. Visual analogue pain scores using a 100mm line and presence/absence of the lesion/wound/pain syndrome were used as outcome measures.;At the conclusion of the trial significant laser/phototherapy effects for the reduction of pain of verruca pedis (p<0.005), plantar heel pain (p<0.005), and ischaemic foot wounds (p<0.05) were seen. No significant benefit of laser/phototherapy could be identified for reduction in wound surface area when compared to the control (p<0.05), A significant increase in lesion cures were seen in the verruca pedis group receiving laser/phototherapy (p<0.05), and a significant difference between laser and control cure rate for plantar heel pain (p<0.05) was identified. It is therefore concluded that laser therapy/phototherapy has a number of clinical applications in podiatry. Suggestions for further study are made.