CAN LOW REACTIVE-LEVEL LASER THERAPY BE USED IN THE TREATMENT OF NEUROGENIC FACIAL PAIN? A DOUBLE-BLIND, PLACEBO CONTROLLED INVESTIGATION OF PATIENTS WITH TRIGEMINAL NEURALGIA

Arne Eckerdal and Lehmann Bastian

Department of Oral and Maxillofacial Surgery and Oral Medicine, Odense University Hospital, Denmark

Neurogenic facial pain has been one of the more difficult conditions to treat, but the introduction of laser therapy now permits a residual group of patients hitherto untreatable to achieve a life free from or with less pain. The present investigation was designed as a double blind; placebo controlled study to determine whether low reactive-level laser therapy (LLLT) is effective for the treatment of trigeminal neuralgia. Two groups of patients (14 and 16) were treated with two probes. Neither the patients nor the dental surgeon were aware of which was the laser probe until the investigation had been completed. Each patient was treated weekly for five weeks. The results demonstrate that of 16 patients treated with the laser probe, 10 were free from pain after completing treatment and 2 had noticeably less pain, while in 4 there was little or no change. After a one year follow-up, 6 patients were still entirely free from pain. In the group treated with the placebo system, i.e. the non-laser probe, one was free from pain, 4 had less pain, and the remaining 9 patients had little or no recovery. After one year only one patient was still completely free from pain. The use of analgesics was recorded and the figures confirmed the fact that LLLT is effective in the treatment of trigeminal neuralgia. It is concluded that the present study clearly shows that LLLT treatment, given as described, is an effective method and an excellent supplement to conventional therapies used in the treatment of trigeminal neuralgia.

Addressee for Correspondence: Arne Eckerdal DDS DOS Consultant, Department of Oral and Maxillofacial Surgery & Oral Medicine, Odense University Hospital, DK-5000 Odense' Denmark.

12/96 Rep. US X 8-10-12

LASER THERAPY, 1996:: 8: 247-252

 

 

 

 

 

 

 

Successful management of female office workers with "repetitive stress injury" or "carpal tunnel syndrome" by a new treatment modality- application of low level laser

E. Wong G LEE J. Zu CHERMAN and D. P. MASON

Western Heart Institute and St. Mary's Spine Center St. Mary's Medical Center--San Francisco. CA. USA and Head and Neck Pain Center, Honolulu HL. USA

Abstract. Female office workers with desk jobs who are incapacitated by pain and tingling in the hands and fingers are often diagnosed by physicians as "repetitive stress injury'' (RSI) or "carpal tunnel syndrome'' (CTS). These patients usually have poor posture with their head and neck stooped forward and shoulders rounded. Upon palpation they have pain and tenderness at the spinous processes C5 - T1 and the medial angle of the scapula. In 35 such patients we focused the treatment primarily at the posterior neck area and not the wrists and hands. A low-level laser (100mw) was used and directed at the tips of the spinous processes C5 - Tl. The laser rapidly alleviated the pain and tingling in the arms, hands and fingers and diminished tenderness at the involved spinous processes. Thereby, it has become apparent that many patients labeled as having RSI or CTS have predominantly cervical radicular dysfunction resulting in pain to the upper extremities which can be managed by low level laser. Successful long-term management involves treating the soft tissue lesions in the neck combined with correcting the abnormal head, neck and shoulders posture by taping, cervical collars, and clavicle harnesses as well as improved work ergonomics.

LASER THERAPY, 1997:9: 131- 136

 

 

 

 

 

 

 

 

 

 

 

 

PHYSIOLOGICAL RESPONSES IN CHRONIC PAIN PATIENTS LLLT PROTOCOL

Scott D. Fender and David Diffee

Pain Research Group, Arvada, Colorado, U.S.A.

Use of Low Reactive Level Laser Therapy (LLLT) utilizing helium-neon lasers has increased lately especially in pain control. New protocols are being developed aimed at a complex of primary and secondary symptomologies. One of these protocols Stellate Ganglion Stimulation has shown in our research a unique set of developments. Targeting the area of the stellate ganglion is showing great promise in the rehabilitation of patients with a history of chronic musculoskeletal pain syndromes, but several patients with preexisting psychological symptomology have exacerbated during the initial stages of utilization of this protocol. Patients with a history of psychological diagnosis for dysthymia, anxiety, post traumatic stress disorder or minor diffuse brain injury have shown an exacerbation of these symptomologies during the initial phases of stimulation treatment. Overall, response to this form of therapy seems to be positive but some patients require dermatomal and/or site-specific therapy to maximize outcome. With specific psychological treatment combined with a more conservative amount of stimulation initially the increase in these symptoms shows a tendency to remit with the pain response. Our continued research is currently focusing on the mechanisms for this type of response as well as protocol refinement to maximize its effectiveness.

Addressee for correspondence: Scott D. Fender DDS DAPM, 5275Marshall Street, Suite 203, Arvada, CO 80002, U.S.A.

 

 

 

 

 

 

 

 

 

 

DOUBLE BLIND CROSSOVER TRIAL OF LOW LEVEL LASER THERAPY IN THE TREATMENT OF POST HERPETIC NEURALGIA

Kevin C Moore Naru Hira Parswanath S. Kramer, Copparam S.Jayakumar and Toshio Ohshiro

Post herpetic neuralgia can he an extremely painful condition which in many cases proves resistant to all the accepted forms of treatment. II 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 tour consecutive laser treatments. The results demonstrate a significant reduction in troth pain intensity and distribution following a course of low level laser therapy.

by John Wiley & Sons. Ltd.

LOW LEVEL LASER THERAPY (LLLT) OF TENDINITIS AND MYOFASCIAL PAINS A RANDOMIZED, DOUBLE-BLIND, CONTROLLED STUDY

Mimmi Logdberg-Anderssont1, Sture Mutzell2, and Ake Hazel3

1: Akersberga Health Care Centre, 2: Danderyd University Hospital, Danderyd, and

3: Vaxholm Health Care Centre, Stockholm, Sweden.

The purpose of this randomized, double-blind study was to examine the effect of GaAs laser therapy for Tendonitis and myofascial pain in a sample from the general population of Akersbergain the northern part of Greater Stockholm. 176 patients (of an original group of 200) completed the scheduled course of treatment. The patients were assigned randomly to either a laser group (92patients, of whom 74 had Tendonitis, completed the study) or a placebo group (84 patients, of whom 68 had Tendonitis, completed the study). All 176 patients received six treatments during a period of 3-4 weeks. Their pain was estimated objectively using a pain threshold meter, and subjectively with a visual analogue scale before, at the end of, and four weeks after the end of treatment. Laser therapy had a significant, positive effect compared with placebo measured from the first assessment to the third assessment, four weeks after the end of treatment. Laser treatment was most effective on acute Tendonitis.