This double-blind randomised and placebo-controlled trial evaluated the effect of low intensity laser light combined with phototherapy on the articular, systemic and functional manifestations of rheumatoid arthritis. Either an active or placebo low intensity laser/phototherapy was given to 35 subjects twice-weekly for four weeks. Only the knee and metatarsophalangeal joints were irradiated and all treated joints showed an active synovitis. The laser/phototherapy device emitted light at six wavelengths in the range 660 to 950 nm. Each application lasted 240 seconds and delivered an energy density of 8.1 joules/cm2. Each subject was assessed at one, three and six months after the initial treatment. Measures of outcome included range of joint movement, articular index, suprapatellar swelling, morning stiffness, walking speed, joint pain, HAQ Disability Index and several haematological and serological indicators. There were no significant differences observed between the active or placebo cohorts although range of movement at the knee improved slightly in the active treatment group. Combined low intensity laser and phototherapy, used under these conditions, does not appear useful for altering the course of rheumatoid arthritis.

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