Results from the recent Lancet review of
Low level laser Therapy for chronic neck
pain.
The Lancet report declares that neck pain
is approaching epidemic proportions with 10
– 24% of the population affected. Health
economic reports from
USA
and
European Union
state that
musculoskeletal injury and disease costs
€240 Billion / €194 Billion annually. The
paper also reports that pharmacological
therapies for neck pain are widely used but
have “not shown any conclusive evidence of
benefit” The
BMJ
agrees “There isn’t any specific
research that shows drugs help neck pain”.
There is now more evidence for the use of
laser for neck pain than any other medical
procedure. The Lancet report says “(Relief
using) Laser for neck pain lasted for up to
22 weeks.Trials of LLLT for knee
osteoarthritis tendinopathies and low back
pain reported similar results”. “This
contrasts with drug therapies where the
effect ends rapidly when treatment is
discontinued.”
BRIEF SUMMARY OF LASER STUDIES
REVIEWED FOR THE LANCET:
- 16 RCT's of acceptable
methodological quality
- Mean duration of symptoms 7.5 years
+/-36.9months
- Mean baseline of pain intensity
56.9mm +/-7.5mm
RESULTS:
- Reduce pain intensity
- Reduced disability
- Reduces recurrence of acute neck
pain
- Mean Pain intensity reduction over
placebo 20mm (95%CI: 17.1 to 29.8 @
10-22 weeks)
COMMENT:
This establishes LLLT as an evidence
based treatment for neck pain. It is at
least equivalent to and probably better than
other accepted medical treatments for neck
pain
WHAT IS LLLT AND HOW DOES IT WORK ON NECK
PAIN:
A gentle beam of laser light can
stimulate cells to repair tissues, reduce
inflammation and inhibit pain fibres to
reduce pain. The application of specific
wavelengths of red or near infrared laser or
LED light on acute injuries and degenerative
conditions relieves pain and improves
healing. There are two main mechanisms:
- At low doses it acts on
mitochondrial proteins to reduce
oxidative stress and increase production
of ATP
- At high doses it inhibits fast
axonal flow in C and A delta fibres
causing a temporary neural blockade,
reducing central sensitisation.
HOW SOON DOES IT START TO WORK:
Patients typically experience improvement
(reduction in pain / greater range of
movement) immediately after the first
treatment.
HOW MANY TREATMENTS DOES IT TAKE:
It can take as much as a dozen sessions
but sometimes as few as three.
HOW OFTEN SHOULD PATIENTS COME FOR
TREATMENT:
Twice a week for the first two weeks then
once a week for a further two weeks.
HOW LONG DO THE BENEFITS LAST:
In most cases, once an acute episode is
over, patients are unlikely to need further
treatment. For a few people, the benefit may
only be temporary - they may need long term
maintenance every 6 - 8 weeks.
ADVANTAGES OVER DRUG THERAPIES
The evidence for LLLT is much stronger
than for drug therapies. There are no
analgesics or anti-inflammatories licensed
for the treatment of neck pain. LLLT also
has the advantage of having no side effects,
unlike many drug therapies.
