Is laser therapy effective for pain?

Posted on November 26, 2010 by Dr. Jonathan

An abundance of scientific evidence for the effectiveness of laser therapy in treating pain was examined in a study just published in the Clinical Journal of Pain. This refers to low level laser therapy, also called ‘cold laser’ to distinguish it from ‘cutting’ surgical lasers. The authors state…

“”To ascertain the overall effect of phototherapy on pain, we aggregated the literature and subjected the studies to statistical meta-analysis…Relevant original studies were gathered from every available source and coded. Articles that met preestablished inclusion criteria were subjected to statistical meta-analysis, using Cohen’s d statistic to determine treatment effect sizes.”

22 papers met their inclusion criteria and offered an overall mean effect size that was highly significant, leading to their welcome conclusion:

“These findings warrant the conclusion that laser phototherapy effectively relieves pain of various etiologies; making it a valuable addition to contemporary pain management armamentarium.”

Laser acupuncture lights up the brain for depression

Posted on September 27, 2010 by Dr. Jonathan

A fascinating study published in PLoS One (the Public Library of Science) documents the increase in metabolic activity in specific brain regions related to depression elicited by the application of laser light to acupuncture points (one of the methods for peripheral sensory-based neuromodulation of the brain that we routinely use). The authors state their intent:

“As laser acupuncture is being increasingly used to treat mental disorders, we sought to determine whether it has a biologically plausible effect by using functional magnetic resonance imaging (fMRI) to investigate the cerebral activation patterns from laser stimulation of relevant acupoints.”

They stimulated 4 acupoints (LR14, CV14, LR8 and HT7—indicated for depression in TCM) and a sham point with a fiber-optic infrared laser, alternating the stimulation with a fake laser. The measured the effect on the whole brain by recording changes in the blood oxygenation level-dependent (BOLD) fMRI response with a 3T scanner (and resolved changes in localized metabolic activity—brain cells ‘working’). What did the data show?

“Many of the acupoint laser stimulation conditions resulted in different patterns of neural activity. Regions with significantly increased activation included the limbic cortex (cingulate) and the frontal lobe (middle and superior frontal gyrus). Laser acupuncture tended to be associated with ipsilateral brain activation and contralateral deactivation that therefore cannot be simply attributed to somatosensory stimulation.”

A simple way to think of depression is a failure of the frontal lobes to ‘fire’ adequately. This research adds to the body of evidence that peripheral sensory-based modalities—stimulating sensory nerve endings such as acupoints and trigger points by various methods elicits a brain response. As we have found, this has practical significance in the treatment of depression. The note in their conclusion:

“We found that laser stimulation of acupoints lead to activation of frontal-limbic-striatal brain regions, with the pattern of neural activity somewhat different for each acupuncture point…Differing activity patterns depending on the acupoint site were demonstrated, suggesting that neurological effects vary with the site of stimulation.”

Low-level laser therapy helps breast cancer-related lymphedema

Posted on May 31, 2010 by Dr. Jonathan

Supportive Care in Cancer Lymphedema is swelling due to engorgement with lymph fluid. In the case of breast cancer it occurs after therapies that remove lymph nodes and damage delicate lymph vessels cause a stagnation of the lymph fluid. Breast cancer-related lymphedema is uncomfortable and a risk factor for infection due to impaired lymphatic drainage in the affected arm. A paper just published in the journal Supportive Care in Cancer reports on the effectiveness of low-level laser therapy (LLLT, also known as ‘cold’ laser therapy to distinguish it from cutting surgical lasers) in the treatment of BCRL. The authors begin by observing:

“Breast-cancer-related lymphedema (BCRL) is a chronic disease, and currently there is no definitive treatment for it…Low-level laser therapy (LLLT) has been used in the treatment of post-mastectomy lymphedema since 2007 in the US. The aim of this study is to review our short-term experience with LLLT in the treatment of BCRL.”

The authors assessed the circumferences of both affected and unaffected arms (swelling), pain, restriction due to scars, and range of motion of the affected arm to gauge the impact of LLLT. The outcomes led to this conclusion:

“Patients with BCRL received additional benefits from LLLT when used in conjunction with standard lymphedema treatment. These benefits include reduction in limb circumference, pain, increase in range of motion and scar mobility. Additionally, two cycles of LLLT were found to be superior to one in this study.”

Note: Low-level laser therapy is widely available (including at Lapis Light), comfortable and non-invasive.

Low-intensity laser therapy is an effective treatment for recurrent herpes

Posted on January 29, 2010 by Dr. Jonathan

As the authors of this paper published in the Journal of Investigative Dermatology note, “Recurrent infection with herpes simplex virus is a common disease…low-intensity laser therapy mainly used for the acceleration of wound healing and in pain therapy has previously been shown to be of benefit in herpes zoster infections.” They report on the results of their double-blind placebo-controlled trial that evaluated the effect of laser therapy (like what we use here) in 50 patients with recurrent perioral herpes simplex infection: “In conclusion, we demonstrated that a total of 10 irradiations with low-intensity laser therapy significantly lowers the incidence of local recurrence of herpes simplex infection.”

Low-level laser therapy effective for neck pain

Posted on November 21, 2009 by Dr. Jonathan

It doesn’t feel at the time like anything is happening, but can non-cutting (non-surgical) laser light be therapeutic? The authors of this paper that was recently published in The Lancet reviewed 16 randomised controlled trials of low-level (cold) laser therapy including a total of 820 patients. They conclude: “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.”