Condition Focus: Rheumatoid Arthritis — Cochrane Systematic Review

In evidence-based medicine, a Cochrane systematic review sits at the top of the evidence hierarchy — above individual trials, above narrative reviews, above expert opinion. This Cochrane review of low-level laser therapy for rheumatoid arthritis, conducted by Brosseau and colleagues, analysed 18 double-blind clinical trials and remains one of the most cited references in the PBM literature.

The findings were striking: LLLT achieved up to 90% pain relief in RA patients across the pooled trials, with improvements in hand grip strength and reductions in morning stiffness duration. All included studies used double-blind methodology — meaning neither the patients nor the treating clinicians knew who was receiving real versus sham laser therapy — eliminating both placebo effect and observer bias.

For gout, the relevance of this review extends beyond the shared “inflammatory joint disease” label. Rheumatoid arthritis and gout involve many of the same inflammatory mediators (IL-1β, TNF-α, PGE₂), affect the same tissue structures (synovium, cartilage, periarticular soft tissue), and produce the same clinical symptoms (pain, swelling, stiffness, loss of function). If PBM can achieve 90% pain relief in one inflammatory arthritis, the mechanistic basis for expecting similar results in the other is strong.

The Cochrane methodology also addresses a common concern about PBM research: study quality. By including only double-blind trials and systematically assessing risk of bias, this review provides the level of evidence rigour that clinicians and informed patients expect before adopting a new therapy.

G.O.A.T. for Gout Alignment:
The LLLT wavelengths and parameters reviewed here span the range that includes the G.O.A.T.’s output specifications. The Cochrane-level confirmation of pain relief in inflammatory arthritis provides the strongest available evidence framework for PBM in joint disease. The G.O.A.T.’s dual-wavelength approach builds on this foundation with more targeted delivery.

Link to original research here

Editor’s note: This Cochrane review sets the evidence standard for PBM in inflammatory joint disease. For the specific NSAID-comparison evidence in musculoskeletal conditions, see PBM for Musculoskeletal Disorders 2019. A broader musculoskeletal pain meta-analysis is provided by Clijsen et al 2017. For PBM’s effects on the shared autoimmune and inflammatory pathways across RA and other conditions, see Wickenheisser et al 2023. The synoviocyte-specific evidence for RA joints is detailed in Ryu et al 2023.

Related Articles

• PBM for Musculoskeletal Disorders and OA with NSAID Comparison – 2019
• Effects of LLLT on Pain in Musculoskeletal Disorders: Meta-Analysis – Clijsen et al 2017
• PBM Ameliorates Inflammatory Parameters in Fibroblast-Like Synoviocytes – Ryu et al 2023
• PBM in Inflammatory, Musculoskeletal, and Autoimmune Disorders – Wickenheisser et al 2023
• PBM on Pain and Return to Play of Injured Athletes – Morgan et al 2022

Key Takeaways

• Cochrane systematic review — the highest tier of evidence-based medicine
• Up to 90% pain relief across 18 double-blind trials in rheumatoid arthritis
• Improvements in hand grip strength and morning stiffness duration
• RA and gout share inflammatory mediators (IL-1β, TNF-α, PGE₂) and affected tissues
• Double-blind methodology eliminates placebo effect and observer bias concerns

Study Overview

Full Citation

Brosseau L, Welch V, Wells G, de Bie R, Gam A, Harman K, Morin M, Shea B, Tugwell P. (2000). Low level laser therapy for treating rheumatoid arthritis. Cochrane Database of Systematic Reviews, (2). View Publication