Laser Therapy and Musculoskeletal Pain Syndromes (Chronic and Acute)
Musculoskeletal Pain Syndromes (Chronic and Acute)
Low-Level Light Therapy (LLLT) has been shown to be effective in a variety of musculoskeletal conditions and associated pain presentations.
In Rheumatoid Arthritis, LLLT can benefit not only the pain of acute small joint inflammation but also chronic pain. In a review article on rheumatology (3), some 18 papers were considered. All studies involved double-blind trials with LLLT in chronic rheumatoid and reported significant improvement in pain (80% success rate in relieving pain). Upon comparing LLLT to a similar rate of pain attenuation using anti-inflammatory drugs (NSAIDs), the LLLT was free of any side-effects while 20% of patients treated with NSAIDs suffered unacceptable side-effects of medication. In another study of 170 patients with rheumatoid arthritis using LLLT (4), pain attenuation of up to 90% was noted.
Trellis et al (6) used LLLT for osteoarthritis of the knee in 40 patients. He reported a significant reduction of 82% of the patients with improved joint mobility. Among 36 randomized patients, with pain caused by cervical osteoarthritis, those who received Infra-Red and Low-Level Laser treatment improved 75% compared with the group receiving mock treatment (31%). Similarly, a study of 60 patients with Cervical Osteoarthritis, Low Pulsed Laser was successful in relieving pain and in improving function.
The results of a study show that cervical myofascial pain is significantly improved at 3-month with Diode laser. A similar successful LLLT treatment has been described for whiplash injuries.
In a randomized study with 30 patients with supraspinatus or bicipital tendonitis, the results demonstrated the effectiveness of laser therapy in tendonitis of the shoulder. Another study with a patient population (n = 324), with either medial epicondylitis (Golfer’s elbow; n = 50) or lateral epicondylitis (Tennis elbow; n = 274), and randomly allocated, provides further evidence of the efficacy of LLLT in the management of lateral and medial epicondylitis.
Treatment with low-level laser therapy (LLLT) was shown effective in treating Carpal Tunnel Syndrome pain. Another study, significant decreases in McGill Pain Questionnaire scores, median nerve sensory latency, and Phalen and Tinel signs were observed after treatment series with Low-Level Laser Therapy. Patients could perform their previous work (computer typist, handyman) and be stable for 1 to 3 years.
In acute trauma, there is a soft tissue injury comprising swelling, hematoma, pain and reduced mobility. Sporting injuries and domestic accidents usually involve damage to muscles, joint ligaments, and tenclass. In the absence of bone fracture or other injury demanding priority treatment, LLLT should be instituted at the earliest opportunity. Kumar reported a comparative study in 50 patients with inversion injuries of the ankle. He found that compared to conventional physiotherapy, the LLLT treated patients showed a more rapid resolution of symptoms and an earlier return to full weight-bearing.
Fibromyalgia (FM) is characterized by widespread pain in the body, associated with particular tender points. It is often accompanied by disturbed sleep patterns, fatigue, headaches, irritable bowel, and bladder syndrome, morning stiffness, anxiety, and depression. FM can cause a high level of functional disability and have a significantly negative effect on the quality of life. One study suggests that “Laser Therapy is effective on pain, muscle spasm, morning stiffness, fatigue, depression and total tender point number in Fibromyalgia”.
A randomized controlled study with 63 with non-radiating low back pain showed that LLLT significantly improved pain and function.
In summary, the bulk of published work to date supports the use of LLLT for the treatment of a variety of musculoskeletal conditions and associated pain. Moreover, the LLLT proved to be not only more effective than conventional methods but more economical as well. The added advantage of the absence of side effects, non-invasive nature of therapy and the ease of application ensure good patient acceptance of the treatment modality.