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Research Studies on Laser Therapy

 

PAIN RELIEF / ANALGESIA RESEARCH STUDIES

MECHANISMS OF THE ANALGESIC EFFECT OF THERAPEUTIC LASERS IN VIVO

L. Vavratil (1) and I. Dylevsky (2)

(1) Outpatient Department of Radiobiology, Institute of Biophisics, First Medical Faculty

(2) Department of Functional Anatomy, Second medical Faculty and Faculty of Physical Education
Charles University, Prague, Czech Republic

The analgesic effects in the course of application of therapeutic lasers to affected tissue have been described in a number of works in the literature. Although a few scientific-based repors have appeared, those on laser-induced analgesia are mainly clinical works describing the effect of the therapy which, however, do not study the mechanism of the laser action. There are several different possible responses induced by non-invasive low level laser therapy (LLLT).
The purpose of the present communication is to review the arrangement and characterization of these responses. By being aware of these effects, the laser therapist can acquire a physiological and morphological scheme making possible the appropriate choice of the site of application of LLLT, choice of the irradiation technique, and selection of appropriate doses.

Keywords:
Therapeutic laser, non-invasive laser therapy, LLLT, endorphins, analgesic effect, nerve transmission rates.

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A SYSTEMATIC REVIEW OF LOW LEVEL LASER THERAPY WITH LOCATION-SPECIFIC DOSES FOR PAIN FROM CHRONIC JOINT DISORDERS.

Australian J Physiother. 2003; 49: 107-116.
Bjordal J M, Couppè, C, Chow R, Tunér J, Ljunggren A E.

The authors investigated if low level laser therapy of the joint capsule can reduce pain in chronic joint disorders (CJD). A literature search identified 88 randomised-controlled trials, of which 20 trials included patients with CJD. Six trials had to be excluded for not irradiating the joint capsule. Three trials used doses lower than a denominated a priori dose range for reducing inflammation in the joint capsule. These trials found no significant difference between active and placebo treatments. The remaining 11 trials, including 565 patients, were of acceptable methodological quality with an average PEDro score of 6.9 (range 5-9). In these trials, LLLT within the suggested dose-range was administered to the knee, temporomandibular and zygapophyseal joints. The results showed a mean weighted difference in change of pain on VAS by 45.6 % (95 % CI 35.0 to 56.2) in favour of LLLT. Global status was improved for 33.4 % (95% CI 20.9 to 45.9) more patients in the LLLT group. LLLT with the suggested dose range significantly reduces pain in CJD, but the heterogeneity in patient samples, treatment procedures and trial design calls for cautious interpretation of the results.

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THE EFFECT OF INFR-ARED LASER IRRADIATION (LLLT) ON THE DURATION AND SEVERITY OF POSTOPERATIVE PAIN: A DOUBLE BLIND TRIAL

Kevin C. Moore, Naru Hira, Ian J. Broome* and John A. Cruikshank Departments of Anaesthesia and General Surgery, The Royal Oldham Hospital, Oldham, U.K *Department of Anaesthesia, The Royal Hallamshire Hospital, Sheffield, U.K., General Practitioner, Pennymeadow Clinic, Ashton-under-Lyne, U.K.

This trial was designed to test the hypothesis that LLLT reduces the extent and duration of postoperative pain. Twenty consecutive patients for elective cholecystectomy were randomly allocated for either LLLT or as controls. The trial was double blind. Patients for LLLT received 6- 8-min treatment (GaAlAs: 830 nm: 60 mW CW: CM) to the wound area immediately following skin closure prior to emergence from GA. All patients were prescribed on demand postoperative analgesia (IM or oral according to pain severity). Recordings of pain scores (0-10) and analgesic requirements were noted by an independent assessor. There was a significant difference in the number of doses of narcotic analgesic (IM) required between the two groups. Controls n = 5.5: LLLT n = 2.5. No patient in the LLLT group required IM analgesia after 24 h. Similarly the requirement for oral analgesia was reduced in the LLLT group. Controls n = 9: LLLT n = 4. Control patients assessed their overall pain as moderate to severe compared with mild to moderate in the LLLT group. The results justify further evaluation on a larger trial population.

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