Low-level Laser Therapy (LLLT) has been used to treat a variety of conditions for decades. LLLT, also known as cold laser therapy, involves a high-frequency laser that has a low energy output.
The technology used in this kind of therapy has been applied for many years in several forms. It has been used to reduce the appearance of wrinkles, blemishes on the skin, and for reducing pain. The energy output in laser devices can be adjusted for different treatments. This means that the laser can be adjusted to put out just enough energy to make a physiological change that is needed or desired however, it won&#;t emit enough energy to damage tissue.
These kinds of lasers are also known as cold lasers for cold laser therapy sessions. These are basically the same thing. The only difference is what kind of condition is being treated, the kind of laser equipment and the intensity of the laser being used.
Benefits of LLLT
When most people think of lasers, they associate them with dangerous weapons or devices meant to cause injury or harm. This kind of therapy has been used as a non-invasive form of surgery. In many cases, it&#;s carried out as a substitute to invasive surgical procedures.
Less Pain Medication
Since there is very minimal discomfort associated with the use of these kinds of lasers, there is often no need for doctors to prescribe pain medications. Pain medications can be dangerous, especially in those with a tendency towards addictive behaviour. The recent problems with pain medication addiction and deadly overdoses have caused more doctors to become wary of prescribing them when there is a healthier and safer alternative.
Less Risk of Infection
When a patient is treated for neck pain with LLLT, there is little room for a chance of an infection. Sometimes prolonged and unexplainable pain in the neck can be a symptom of a more serious condition than just sore muscles and spinal misalignment. When pain in the neck is treated with laser therapy, it will also increase blood circulation.
Reduces Inflammation and Pain
LLLT has the benefit of increasing the circulation in the treated area. This means that necessary nutrients are being brought into the treated area by way of the red blood cells and that harmful toxins are being transported away from the treated area.
One of the better reasons for choosing to go with this kind of therapy is its ability to treat neck pain that occurs for reasons that are as yet unspecified. It&#;s safe enough to reduce pain and inflammation in the neck without the fear of worsening or exacerbating the causes of pain and inflammation.
Seniors
When treating pain in seniors, laser treatment can be very beneficial. Seniors suffering from neck and joint pain due to arthritis have experienced substantial relief without the need for other therapies.
Since laser treatments are safe enough to be administered as often as is necessary, it&#;s well suited for elderly chronic pain sufferers. Chronic pain is classified as any pain that is persistent and lasts for weeks or years. Many of the elderly suffer from chronic pain in the neck, joints, and muscles that can be relieved with regular low-level laser treatments.
Low-Level Laser Treatments Healing Properties
Cellular regeneration and the healing of muscular tissue is supported and maintained by adenosine triphosphate or ATP. In short, ATP is a nucleotide that is responsible for containing or carrying energy in the cells. This is the energy that is so badly needed for the regeneration of cells and the healing of injuries, whether they are neck-related or otherwise.
When to See a Doctor for Neck Pain
Sometimes pain in the neck can be due to a minor issue. There are so many ways the neck muscles can be strained during a workday. This is true if your job involves physical labor or sitting at a desk all day. At times, clerical or administrative jobs that require sitting at a desk can lead to severe neck pain.
Other symptoms to look out for include, but are not limited to:
Neck injuries can be severe and get worse over time if they are not treated. It&#;s also critical for a doctor to examine the neck for spinal injury. If you have a hard time walking or urinating along with neck-related pain after an injury, that is a sure sign of a spinal injury.
For more information on how Low-Level Laser Therapy can help treat your neck pain, contact Focus Physiotherapy. Focus Physiotherapy has 6 convenient physiotherapy clinic locations in the Greater Toronto Area: Etobicoke, Mississauga, Brampton, Bolton, North York and York. Please click one of the locations below for contact information, directions and hours of operation. We look forward to speaking with you.
Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials
The review concluded that low-level laser therapy reduced pain immediately after treatment in acute neck pain, and up to 22 weeks after completion of treatment, in patients with chronic neck pain. Considering the variation in treatments, and the uncertainty regarding possible bias in the small trials included, the authors' conclusions should be interpreted with a degree of caution.
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To evaluate the effectiveness of low-level laser therapy for acute or chronic neck pain.
MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), Physiotherapy Evidence Database, BIOSIS Previews and AMED (Allied and Complementary Medicine) were searched, without language restriction, from inception to July . Search terms were reported. Experts were consulted, and reference lists of obtained reports and textbooks scanned, in order to identify further studies.
Randomised controlled trials (RCTs) or quasi-RCTs of low-level laser therapy, for participants aged 16 or over with acute or chronic neck pain, were eligible for inclusion. The diagnostic labels allowed for neck pain were reported. Lasers had to be delivered to points with tenderness, local acupuncture points, or on a grid at predetermined points overlying the neck. Control groups had to receive placebo laser (an identical inactive laser, but with an active operating panel) or an active treatment control, such as exercise. Pain relief had to be reported as a primary outcome (both before and after therapy) either on a visual analogue scale, a numerical rating scale, or by patient-reported improvement. Functional measures of disability and adverse events were also assessed. Trials where specific pathological changes (e.g. rheumatoid arthritis) could be identified were excluded.
Most included trials were of chronic, non-specific neck pain, although two were of acute pain; a variety of sites on the neck were treated (laser was applied to an average of 11 points). The mean age of patients was 43 years, mean symptom duration was 90 months, and mean baseline pain was 57mm (on a 100mm scale). Of the patients with chronic pain, 79% were women. Trials used different wavelengths of light ranging from 632.6 to 904nm; even wider variation was evident for all the other laser-related parameters (such as average output, and frequency of treatment). Patients received an average of 10 treatments. Some trials allowed specific cointerventions (e.g. analgesics, acupuncture), some did not, and some failed to report any details on cointerventions. All but two trials used placebo as a comparator (the other trials used placebo and needling, and exercise).
Two reviewers independently selected studies for inclusion, with disagreements resolved by consensus or arbitration.
Trial quality was assessed using the Jadad scale, which examined reporting of randomisation, blinding, and description of drop-outs. Trials received a score between 0 and 5 points.
Data was extracted in order to calculate mean differences and relative risks (RR) with 95% confidence intervals (CI). When specific details were not reported, calculations were made from report details (when possible). Manufacturers or trial investigators were contacted if important parameter details were not reported.
Two reviewers independently extracted data, with disagreements resolved by consensus or arbitration.
Weighted mean differences, standardised mean differences (SMD), or relative risks were pooled in meta-analyses using a fixed-effect model, unless heterogeneity was significant, in which case a random-effects model was used. Statistical heterogeneity was assessed using the X2 test and I2 statistic. An expert in laser therapy assessed clinical (laser) heterogeneity. Sensitivity analyses were performed to examine the effect of trial quality (trials scoring 3 or more). Publication bias was assessed by graphical plot.
Sixteen RCTs (n=820 participants) were included in the review, with sample sizes ranging from 20 to 90 participants. Jadad scores ranged from 0 to 5, with all but two trials scoring 3 or more. All trials but one were double-blinded.
Pooled data from two RCTs of acute neck pain suggested that low-level laser therapy improved pain outcomes compared to placebo (RR 1.69, 95% CI 1.22 to 2.33; I2=89%). Results (of categorical data) for five trials of chronic pain suggested even greater benefit (RR 4.05, 95% CI 2.74 to 5.98; I2=7%). Eleven trials assessed pain intensity in patients with chronic pain and found a reduction of 19.9mm (95% CI 10 to 29.7; I2=91%) compared with placebo. The pain-relieving effect persisted for up to six months. A significant improvement in disability was also seen with low-level laser therapy (SMD 1.38, 95% CI 0.39 to 2.38; I2=93%; five RCTs).
A wavelength dose-response pattern was seen (further details were reported). Reported side-effects included tiredness, nausea, headache and increased pain, but were mostly mild and there was only one difference between the treatment groups: one trial reported a significant increase in tiredness in the laser group. Half the trials though did not report side-effect data. There was no evidence of publication bias.
Low-level laser therapy reduced pain immediately after treatment in acute neck pain, and for up to 22 weeks after completion of treatment, in patients with chronic neck pain.
Practice: The authors stated that when treating neck pain with low-level laser therapy, irradiation of known trigger points, tender points, and symptomatic zygapophyseal joints is advisable.
Research: The authors recommended the need for a multi-centre trial to test the optimal parameter values reported in their review, using both pain intensity and functional improvement as outcomes. The authors also recommended systematic reporting of side-effects in future studies.
None.
Chow RT, Johnson MI, Lopes-Martins RA, Bjordal JM. Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials. Lancet ; 374(): -. [PubMed: ]
http://www.thelancet.com/journals/lancet/article/PIIS-(09)-1/abstract
Guzman J. Neck pain and low-level laser: does it work and how? Lancet : doi:10./S-(09)-7.
Subject indexing assigned by NLM
Humans; Laser Therapy, Low-Level; Neck Pain /etiology /radiotherapy; Pain Measurement; Randomized Controlled Trials as Topic
This is a critical abstract of a systematic review that meets the criteria for inclusion on DARE. Each critical abstract contains a brief summary of the review methods, results and conclusions followed by a detailed critical assessment on the reliability of the review and the conclusions drawn.
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