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Chronic Pain Research



Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials. Chow, R.T., Johnson, M.I., Lopes-Martins, R.A.B and Bjordal, J.M. (2009).   The Lancet 374 (9705):1897-1908. 

Abstract: BACKGROUND: Neck pain is a common and costly condition for which pharmacological management has limited evidence of efficacy and side-effects. Low-level laser therapy (LLLT) is a relatively uncommon, non-invasive treatment for neck pain, in which non-thermal laser irradiation is applied to sites of pain. We did a systematic review and meta-analysis of randomised controlled trials to assess the efficacy of LLLT in neck pain.  METHODS: We searched computerised databases comparing efficacy of LLLT using any wavelength with placebo or with active control in acute or chronic neck pain. Effect size for the primary outcome, pain intensity, was defined as a pooled estimate of mean difference in change in mm on 100 mm visual analogue scale.  FINDINGS: We identified 16 randomised controlled trials including a total of 820 patients. In acute neck pain, results of two trials showed a relative risk (RR) of 1.69 (95% CI 1.22-2.33) for pain improvement of LLLT versus placebo. Five trials of chronic neck pain reporting categorical data showed an RR for pain improvement of 4.05 (2.74-5.98) of LLLT. Patients in 11 trials reporting changes in visual analogue scale had pain intensity reduced by 19.86 mm (10.04-29.68). Seven trials provided follow-up data for 1-22 weeks after completion of treatment, with short-term pain relief persisting in the medium term with a reduction of 22.07 mm (17.42-26.72). Side-effects from LLLT were mild and not different from those of placebo.  INTERPRETATION: We show that LLLT reduces pain immediately after treatment in acute neck pain and up to 22 weeks after completion of treatment in patients with chronic neck pain.FUNDING: None.

A systematic review of low level laser therapy with location-specific doses for pain from chronic joint disorders. Bjordal, J., Couppe,C., Chow, R., Tuner, J., Ljunggren, E. (2003).Australian Journal of Physiotherapy 49(2):107-16.

Foot problems in rheumatology. Woodburn, J., Helliwell, P.S. (1997). British Journal of Rheumatology 36(9):932-4.

What else can I do but take drugs: The future of research on nonpharmacological treatment in early inflammatory arthritis. Li, L. (2005). Journal of Rheumatology Supplement 72:21-4.

Clinical Studies

A Double Blind Crossover Trial of Low Level Laser Therapy in the Treatment of Post Herpetic Neuralgia. Moore K C, Hira N, Kumar P S, Jaykumar C S & Ohshiro T (1989). Laser Therapy 1 (1):7-9. 

Abstract: Post herpetic neuralgia can be an extremely painful condition which in many cases proves resistant to all the accepted forms of treatment. It is frequently most severe in the elderly and may persist for years with no predictable course. This trial was designed as a double blind assessment of the efficacy of low level laser therapy in the relief of the pain of post herpetic neuralgia with patients acting as their own controls. Admission to the trial was limited to patients with established post herpetic neuralgia of at least six months duration and who had shown little or no response to conventional methods of treatment. Measurements of pain intensity and distribution were noted over a period of eight treatments in two groups of patients each of which received four consecutive laser treatments. The results demonstrate a significant reduction in both pain intensity and distribution following a course of low level laser therapy.

Combination Therapy Comprising Low Level Laser Therapy (LLLT) and Brace Therapy for Chronic Lower Back Pain Patients. Ohkuni I, Ushigome N, Harada T, Oshiro T, Musya Y, Mizutani K, Takahashi H, Suguro T, and Tsuchiya K (2009).   Laser Therapy 18.4: 187-192. 

Abstract: Low Level Laser Therapy (LLLT) in combination with a sacroiliac brace was used on 33 patients with chronic lower back pain to examine the effectiveness of this combination therapy.  A semiconductor laser (1000mW, CW, 830nm) was used.  Due to the short duration effect of LLLT previously reported, we tested the effect of combination therapy using LLLT and a sacroliliac brace.  Our results showed that the number of patients who had lower back pain in their activities of daily living (ADL) or work decreased, and this combination therapy improved both their ADL and quality of life (QOL).   Chronic lower back pain patients who had just started visiting our hospital obtained satisfactory results with LLLT but the latency period was short.  In order to maintain the effects of LLLT, we controlled the patients' posture with a sacroiliac brace, which was able to prevent chronic pain for a longer period.  The combination treatment was well-tolerated, side-effect free and offered good efficacy in improving pain and range of motion of the lumbar spine.

Photobiomodulation of pain and inflammation in microcrystalline arthropathies: experimental and clinical results. Soriano, F., Campana, V., Moya, M., Gavotto, A., Simes, J., Soriano, M., Soriano, R., Spitale, L., Palma, J. (2006).Photomedicine & Laser Surgery 24(2): 140-150.Djavid,G.E., Mehrdad, R.,

Long-term efficacy of low level laser therapy in women with fibromyalgia:  A placebo-controlled study.  Armagan O,  Tascioglu F, Ekim A and Oner C (2006).   Journal of Back and Musculoskeletal Rehabilitation 19: 135-140.

The Effects of Laser Acupuncture on Chronic Tension Headache – A Radomised Controlled Trial. Ebneshahidi N S, Heshmatipour M, Moghaddami A & Eghtesadi-Araghi P (2005). Acupuncture in Medicine, 23 (1): 13-18.

Naeser M A (2006). Photobiomodulation of Pain in Carpal Tunnel Syndrome: Review of Seven Laser Therapy Studies. Photomedicine and Laser Surgery, 24 (2):101-110.

LLLT (Lower Reactive Level Laser Therapy) – A Clinical Study: Relationship between Pain Attenuation and the Serotonergic Mechanism. Mizokami T, Aoki K, Iwabuchi S, Kasai K, Yamazaki Y, Sakurai T, Samejima K & Yoshii N (1993). Laser Therapy, 5:165-168.

In chronic low back pain, low level laser therapy combined with exercise is more beneficial than exercise alone in the long term: a randomised trial. Ghasemi, M., Hasan-Zadeh, H., Sotoodeh-Manesh, A. & Pouryaghoub, G. (2007). Australian Journal of Physiotherapy 53:155-160.

Ainman LH, Ngo M, Ng E T, Nwe T, Gogov S & Bril V (2004). Low-Intensity Laser Therapy for Painful Symptoms of Diabetic Sensorimotor Polyneuropathy. Diabetes Care, 27:921-924.

Gur, A., Karakoc, M., Nas, K. et al (2002). Efficacy of low power laser therapy in fibromyalgia. Lasers Med Sci 17(1):57-61.

Efficacy of 904nm Gallium Arsenide Low Level Laser Therapy in the Management of Chronic Myofascial Pain in the Neck: A Double-Blind and Randomized Controlled Trial. Gur A,  Sarac A J, Cevik R, Altindag O and Sarac S (2004).   Lasers in Surgery and Medicine 35: 229-235.

Laser Acupuncture in Knee Osteoarthritis: A Double-Blind, Randomised Controlled Study. Yurtkuran, M., Konur, S., Ozcakir, S., Bingol, U. (2007). Photomedicine & Laser Surgery 25 (1):14-20.

Low level laser therapy (classes I,II and III) for treating rheumatoid arthritis. Brosseau, L., Gam, A., Harman, K., Morin, M. et al (2005).The Cochrane Library, Issue 1.

Low level laser therapy (classes I,II and III) for treating osteoarthritis. Brosseau, L., Gam, A., Harman, K., Morin, M. et al (2004). The Cochrane Library, Issue 3.

Randomised controlled trial on LLLT in the treatment of osteoarthritis of the hand. Brosseau, L., Wells, G., Marchand, S., Baboury, I. et al (2005).Lasers in Surgery & Medicine 36(3): 210-219.

Double blind, randomised, placebo controlled low level laser therapy study in patients with primary Raynaud’s phenomenon. Hirschl, M., Katzenschlager, R., Ammer, K., Melnizky, P. et al (2002).VASA 31(2):91-4.

Low level laser treatment of primary and secondary Raynaud's phenomenon. Al Awami M, Schillinger M, Gschwandtner M E et al (2001).. VASA 30 (4): 281-284.

Low level laser therapy in primary Raynaud’s phenomenon. Hirschl, M., Katzenschlager, R., Francesconi, C., Kundi, M. (2004). Journal of Rheumatology 31(12):2408-12.

Low Level Laser Therapy in Primary Raynaud's Phenomenon — Results of a Placebo Controlled, Double Blind Intervention Study From the Department of Angiology, Hanusch Hospital, Vienna; and the Institute of Environmental Health, Medical University of Vienna, Vienna, Austria. Mirko Hirschl, Reinhold Katzenschlager, Claudia Francesconi, And Michael Kundi (2004)..

Low level laser therapy for treatment of primary and secondary Raynaud's phenomenon. Al-Awami M, Schillinger M, Maca T, Pollanz S, Minar E. Department of Medical Angiology, University of Vienna, Austria.

In Vitro Studies

The effect of 820nm Laser irradiation upon conduction in the frog ( rana temporaria) sciatic nerve in vitro. Walsh D, Baxter G D, Allen JM (1995). Laser Therapy, 7: 5-10.

Effects of NeNe laser on levels of stress protein and arthritic histopathology in experimental osteoarthritis. .Lin. Y et al (2004). American Journal of Physical Medicine and Rehabilitation 83(10):758-765.

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