Low level laser therapy for patients with cervical disk hernia.

BACKGROUND AND AIMS: In previous studies we have reported the benefits of low level laser therapy (LLLT) for chronic shoulder joint pain, elbow, hand and finger pain, and low back pain. The present study is a report on the effects of LLLT for chronic neck pain. MATERIALS AND METHODS: Over a 3 year period, 26 rehabilitation department outpatients with chronic neck pain, diagnosed as being caused by cervical disk hernia, underwent treatment applied to the painful area with a 1000 mW semi-conductor laser device delivering at 830 nm in continuous wave, 20.1 J/cm(2)/point, and three shots were given per session (1 treatment) with twice a week for 4 weeks. RESULTS: 1. A visual analogue scale (VAS) was used to determine the effects of LLLT for chronic pain and after the end of the treatment regimen a significant improvement was observed (p<0.001). 2. After treatment, no significant differences in cervical spine range of motion were observed. 3. Discussions with the patients revealed that in order to receive continued benefits from treatment, it was important for them to be taught how to avoid postures that would cause them neck pain in everyday life. CONCLUSION: The present study demonstrates that LLLT was an effective form of treatment for neck and back pain caused by cervical disk hernia, reinforced by postural training.

Low level laser therapy (lllt) for chronic joint pain of the elbow, wrist and fingers.

BACKGROUND AND AIMS: In previous studies, we successfully applied Low Level Laser Therapy (LLLT) in patients with non-specific chronic pain of the shoulder joint and lower back. The purpose of the present study was to assess the effectiveness of LLLT for chronic joint pain of the elbow, wrist, and fingers. SUBJECTS AND METHODS: Nine male and 15 female patients with chronic joint pain of the elbow, wrist, or fingers, who were treated at the rehabilitation outpatient clinic at our hospital from April, 2007 to March, 2009 were enrolled in the study. We used a 1000 mW semiconductor laser device. Each tender point and three points around it were irradiated with laser energy. Each point was irradiated twice for 20 s per treatment, giving a total of three minutes for all 4 points. Patients visited the clinic twice a week, and were evaluated after four weeks of treatment. Pain was evaluated with a Visual Analogue Scale (VAS). Statistical analysis of the VAS scores after laser irradiation was performed with Wilcoxon's signed rank sum test, using SPSS Ver.17. RESULTS: All VAS scores were totaled and statistically analyzed. The average VAS score before irradiation was 59.2±12.9, and 33.1±12.2 after the irradiation, showing a significant improvement in VAS score (p<0.001) after treatment. The treatment effect lasted for about one and a half days in the case of wrist pain, epicondylitis lateralis (tennis elbow), and carpal tunnel syndrome. In other pain entities, it lasted for about three to fifteen hours. No change in the range of motion (ROM) was seen in any of the 24 subjects. CONCLUSION: We concluded that LLLT at the wavelength and parameters used in the present study was effective for chronic pain of the elbow, wrist, and fingers.

Low level laser therapy (LLLT) for patients with sacroiliac joint pain.

BACKGROUND AND AIMS: Sacroiliac joint pain not associated with a major etiological factor is a common problem seen in the orthopedic clinical setting, but diagnosis is difficult because of the anatomical area and thus it is sometimes difficult to effect a complete cure. Low level laser therapy (LLLT) has been well-reported as having efficacy in difficult pain types, so the following preliminary study was designed to assess the efficacy of LLLT for sacroiliac pain. MATERIALS AND METHODS: Nine patients participated, 4 males and 5 females, average age of 50.4 yrs, who attended the outpatient department with sacroiliac pain. The usual major disorders were ruled out. Pain was assessed subjectively pre-and post-LLLT on a visual analog scale, and trunk range of motion was examined with the flexion test to obtain the pre- and post-treatment finger to floor distance (FFD). The LLLT system used was an 830 nm CW diode laser, 1000 mW, 30 sec/point (20 J/cm(2)) applied on the bilateral tender points twice/week for 5 weeks. Baseline and final assessment values (after the final treatment session) were compared with the Wilcoxon signed rank test (nonparametric score). RESULTS: All patients completed the study. Eight of the 9 patients showed significant pain improvement and 6 demonstrated significantly increased trunk mobility (P <0.05 for both). CONCLUSIONS: LLLT was effective for sacroiliac pain, and this may be due to improvement of the blood circulation of the strong ligaments which support the sacroiliac joint, activation of the descending inhibitory pathway, and the additional removal of irregularities of the sacroiliac joint articular surfaces. Further larger-scale studies are warranted.

A clinical study on serum prostaglandin E2 with low-level laser therapy.

METHODS: The subjects of this investigation consisted of 83 female patients that were treated in this department during the 2-year period from January 1999 to December 2002. Laser irradiation was applied for 3 min either every day or every other day for a total of 10 times. A diode semi-conductor laser with a wavelength of 830 nm and a photointensity of 1 W was used. Evaluations were performed before and after the series of 10 exposures to laser irradiation. The evaluation included the measurement of pain using the visual analog scale (VAS) and serum prostaglandin E(2) (pg/mL) measured by RIA-PEG. RESULTS: The analgesic effects were observed in 67 of 83 cases, or 80.7%. The VAS scores for the effective cases decreased after the irradiation series from 8.5 +/- 0.2, to 2.8 +/- 0.2 ( p < 0.001). The post-irradiation PGE(2) levels were lower than the pre-irradiation PGE(2) levels in the effective cases, which were 5.8 +/- 0.3 and 7.1 +/- 0.4 pg/mL, respectively ( p < 0.05). The postirradiation PGE(2) levels for the effective cases were lower than those for the ineffective cases, which were 5.8 +/- 0.3 and 7.3 +/- 0.9 pg/mL, respectively ( p < 0.05). CONCLUSIONS: Based on the above findings, the analgesic effects of LLLT were found to be valid. The serum PGE(2) levels are therefore considered to directly reflect nociceptive pain.