Laser Therapy for Arthritis, From The Lancet Review for (LLLT)

Pain Relief for Rheumatoid Arthritis, Cervical Spine Osteoarthritis, Injuries and inflammatory Conditions.

Low Level Laser Therapy (LLLT) also known as Cold Laser therapy, Research on the Clinical application of GaAIAs 830/808 NM diode laser in the treatment of Rheumatoid Arthritis, Cervical Spine Osteoarthritis, including LLLT Research on Pain Relief for other Inflammatory Conditions and Injuries.

Cold or Low level laser therapy,

A review on research published by The Lancet shows that Low Level Laser Therapy (LLLT) also so known as Cold Laser Therapy has been tested in over 200 clinical trials (RCTs) and published in the world’s top medical journals including a review by The Lancet, a clinical study in the journal PAIN and is acknowledged by the World Health Organisation Bone and Joint Task Force, and published in the journal Spine. There are 26 research papers on low level laser therapy, for Musculoskeletal pain and syndromes, both chronic and acute, Rheumatoid Arthritis, Cervical Spine Osteoarthritis, lateral and medial epicondylitis,(Tennis, Golfers Elbow).Achilles Tendonitis, Carpal Tunnel, TMJ, Tendonitis, Bursitis, soft tissue injuries, fractures, neck, shoulder, back, lower back pain, disc injuries, hip, joints knee, ankle injuries, conditions and disorders, and research on low level laser therapy are included on this page.

Cold or Low Level Laser Therapy (LLLT) Clinical application of GaAIAs 830 NM diode laser in treatment of Rheumatoid Arthritis. Department of Orthopaedic Surgery, Osaka City University Medical School, Japan

The authors have been involved in the treatment of rheumatoid arthritis (RA), in particular chronic poly-arthritis and the associated pain complaints. The biggest problem facing such patients is joint contracture, leading to bony ankylosis. This in turn severely restricts the range of motion (ROM) of the RA-affected joints, thereby seriously restricting the patient’s quality of life (QOL). The authors have determined that in these cases, daily rehabilitation practice is necessary to maintain the patient’s QOL at a reasonable level.

The greatest problem in the rehabilitation practice is the severe pain associated with RA-affected joints, which inhibits restoration of mobility and improved ROM. LLLT or low reactive level laser therapy has been recognized in the literature as having been effective in pain removal and attenuation. The authors accordingly designed a clinical trial to assess the effectiveness of LLLT in RA related pain (subjective self-assessment) and ROM improvement (objective documented data).

From July 1988 to June 1990, 170 patients with a total of 411 affected joints were treated using a GaAlAs diode laser system (830 nm, 60 mW C/W). Patients mean age was 61 years, with a ratio of males: females of 1: 5.25 (16%: 84%). Effectiveness was graded under three categories: excellent (remarkable improvement), good (clearly apparent improvement), and unchanged (little or no improvement).

For pain attenuation, scores were: excellent – 59.6%; good – 30.4%; unchanged – 10%.

For ROM improvement the scores were: excellent – 12.6%; good – 43.7%; unchanged – 43.7%. This gave a total effective rating for pain attenuation of 90%, and for ROM improvement of 56.3%.

Low Level Laser Therapy for Osteoarthritis and Rheumatoid Arthritis: A Metaanalysis

ABSTRACT.Osteoarthritis (OA) and rheumatoid arthritis (RA) affect a large proportion of the population. Low level laser therapy (LLLT) was introduced as an alternative non-invasive treatment for RA and OA about 10 years ago, but its effectiveness is still controversial. We assessed the effectiveness of LLLT in the treatment of RA and OA.

Objective.

Methods.A systematic review was conducted, following an a priori protocol, according to the methods recommended by the Cochrane Collaboration. Trials were identified by a literature search of Medline, Embase, and the Cochrane Controlled Trials Register. Only randomized controlled trials of LLLT for the treatment of patients with a clinical diagnosis of RA or OA were eligible. Thirteen trials were included, with 212 patients randomized to laser and 174 patients to placebo laser, and 68 patients received active laser on one hand and placebo on the opposite hand. Treatment duration ranged from 4 to 10 weeks. Follow-up was reported by only 2 trials for up to 3 months.

Results. In patients with RA, relative to a separate control group, LLLT reduced pain by 70% relative to placebo and reduced morning stiffness by 27.5 min (95% CI –52.0 to –2.9), and increased tip to palm flexibility by 1.3 cm (95% CI –1.7 to –0.8). Other outcomes such as functional assessment, range of motion, and local swelling were not different between groups. There were no significant differences between subgroups based on LLLT dosage, wavelength, site of application, or treatment length. In RA, relative to a control group using the opposite hand, there was no difference between control and treatment hand, but all hands were improved in terms of pain relief and disease activity. For OA, a total of 197 patients were randomized. Pain was assessed by 3 trials. The pooled estimate (random effects) showed no effect on pain (standardized mean difference –0.2, 95% CI –1.0 to +0.6), but there was statistically significant heterogeneity (p > 0.05). Other outcomes of joint tenderness, joint mobility, and strength were not significant.

Conclusion.LLLT should be considered for Pain relief and morning stiffness in RA, particularly since it has few side effects. For OA, the results are conflicting in different studies and may depend on the method of application and other features of the LLLT. Clinicians and researchers should consistently report the characteristics of the LLLT device and the application techniques. New trials on LLLT should make use of standardized, validated outcomes. Despite some positive findings, this metaanalysis lacked data on how effectiveness of LLLT is affected by 4 factors: wavelength, treatment duration of LLLT, dosage, and site of application over nerves instead of joints. There is a need to investigate the effects of these factors on effectiveness of LLLT for RA and OA in randomized controlled clinical trials. (J Rheumatol 2000;27:1961–9)

LUCIE BROSSEAU, VIVIAN WELCH, GEORGE WELLS, PETER TUGWELL, ROBERT de BIE, ARNE GAM, KATHERINE HARMAN, BEVERLEY SHEA, and MICHELLE MORIN

Key Indexing Terms:Leaders of International laser organizations met during the third Congress of the World Association for Laser Therapy held in Athens, Greece, to explore ways of advancing research, education and practice world-wide. Photo was taken immediately after the special session in May, 2000.

From "Arthritic Pain Relief, The Lancet Review for (LLLT)"

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Laser Therapy for Arthritis, From The Lancet Review for (LLLT)