Effectiveness of 1064-nm high-power laser therapy combined with thumb spica splinting in De Quervain's tenosynovitis: a randomized double-blind sham-controlled trial.

BACKGROUND: De Quervain’s tenosynovitis (DQT) is an inflammatory condition of the first dorsal compartment of the wrist that causes pain and impaired thumb function. High-power laser therapy (HPLT) has been proposed as a non-invasive modality for musculoskeletal pain management; however, evidence supporting its effectiveness in DQT remains limited. This study aimed to evaluate the effectiveness of 1064-nm HPLT combined with thumb spica splinting in reducing pain and improving hand function in patients with DQT. DESIGN: A randomized, double-blind, sham-controlled clinical trial. METHODS: Twenty-six patients with DQT were randomly assigned to receive either 1064-nm HPLT (8 W, 150 J/cm2, total energy 1,580 J per session) combined with thumb spica splinting or sham laser therapy with splinting. Treatments were delivered three times per week for three weeks (nine sessions). Outcomes included pain intensity measured using the Visual Analogue Scale (VAS), lateral pinch strength (LPS), and hand function assessed with the Patient-Rated Wrist/Hand Evaluation Thai version (PRWHE-Thai). Assessments were performed at baseline, immediately after treatment (week 3), and at follow-up (week 6). RESULTS: Both groups showed significant reductions in VAS scores at weeks three and six compared with baseline, with no significant between-group differences. LPS slightly increased in both groups without statistical significance. PRWHE-Thai scores improved significantly in the sham group, while the HPLT group showed no significant functional gains. Splint compliance was comparable between groups. CONCLUSIONS: The 1064-nm HPLT (8 W, 150 J/cm2, total energy 1,580 J) combined with thumb spica splinting did not provide superior benefits compared with splinting alone in reducing pain or improving hand function in patients with DQT. Further studies are needed to determine optimal laser parameters and clinical indications. TRIAL REGISTRATION: This study was registered with Thai Clinical Trials Registry on 12/07/2021. (TCTR20210712004)