Massage, laser and shockwave therapy improve pain and scar pruritus after burns: a systematic review

Abstract

QuestionsIn adults with a burn injury, do non-invasive therapies improve pain and burn scar pruritus, elasticity and vascularisation? Are any effects maintained beyond the intervention period? Design: Systematic review of randomised trials with meta-analyses. ParticipantsAdults with burn scars. InterventionThe experimental intervention was a non-invasive (ie, non-surgical or non-pharmacological) therapy applied to the burn scar. Outcome measuresPain intensity, pruritus intensity, elasticity and vascularisation. ResultsFifteen trials involving 780 participants were included. The results indicated a beneficial effect on pain intensity on a 0-to-10 scale after massage (MD –1.5, 95% CI –1.8 to –1.1), shockwave therapy (MD –0.8, 95% CI –1.2 to –0.4) and laser (MD –4.0, 95% CI –6.0 to –2.0). The results indicated a beneficial effect on pruritus intensity on a 0-to-10 scale after massage (MD –0.4, 95% CI –0.7 to –0.2), shockwave therapy (MD –1.3, 95% CI –2.3 to –0.3) and laser (MD –4.8, 95% CI –6.1 to –3.5). Massage, shockwave therapy and silicone produced negligible or unclear benefits on scar elasticity and vascularisation. The quality of evidence varied from low to moderate. ConclusionAmong all commonly used non-invasive therapies for the treatment of burn scars, low-to-moderate quality evidence indicated that massage, laser and shockwave therapy reduce pain and the intensity of scar pruritus. Low-to-moderate quality evidence suggested that massage, shockwave therapy and silicone have negligible or unclear effects for improving scar elasticity and vascularisation. Review RegistrationPROSPERO (CRD42021258336).