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.
ArneEckerdal and and Lehmann Bastian
Department of Oral and Maxillofacial Surgery and Oral Medicine, Odense University Hospital, Denmark
Abstract: 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.
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 Oshiro
Abstract: Post herpetic. Neuralgia can be 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 both pain intensity and distribution following a course of low-level laser therapy.
Efficacy of low reactive-level laser therapy for pain attenuation of postherpetic neuralgia.
Osamu Kemmotsu, Kenichi Sato,Hitoshi Furumido, Koji Harada, Chizuko Takigawa, Shigeo Kaseno, Sho Yokota, Yukari Hanaoka and Takeyasu Yamamura
Department of Anaesthesiology, Hokkaido University School of Medicine, N-15. W-7, Kita-ku. Sapporo 060, Japan.
Abstract: The efficacy of low reactive-level laser therapy (LLLT) for pain attenuation in patients with postherpetic neuralgia (PHN) was evaluated in 63 patients (25 males, 38 females with an average age of 69 years) managed at our pain clinic over the past four years. A double blind assessment of LLLT was also performed in 12 PHN patients. The LLLT system is a gallium aluminium arsenide (GaAlAs) diode laser (830 nm, 60 mW continuous wave). Pain scores (PS) were obtained using a linear analog scale (O to 10) before and after LLLT, The immediate effect after the initial LLLT was very good (PS: 0-3) in 26, and good (PS: 7-4) in 30 patients. The long-term effect at the end of LLLT (the average number of treatments 36 ± 12) resulted in no pain (PS: 0) in 12 patients and slight pain (PS: 1-4) in 46 patients, No complications attributable to LLLT occurred. Although a placebo effect was observed, decreases in pain scores and increases of the body surface temperature by LLLT were significantly greater than those that occurred with the placebo treatment. Our results indicate that LLLT is a useful modality for pain attenuation in PHN patients and because LLLT is a noninvasive, painless and safe method of therapy, it is well acceptable by patients.
Low Reactive Level Laser Therapy in the Treatment of Post Herpetic Neuralgia
Katsumi Sasaki, Toshio Ohshiro, Takafumi Ohshiro, and Yuki Taniguchi
Laser Therapy. 2010, Vol. 19, No. 2, p.101-105.
Abstract: Post herpetic neuralgia (PHN) can be an extremely painful condition which in many cases proves resistant to all the accepted forms of treatment. It is frequently most severe in the elderly and may persist for years with no predictable course. Since 1980, we have been applying low reactive level laser therapy (LLLT) for patients with PHN. We report herein on the results of a retrospective study concerning those patients in whom LLLT has been applied for pain attenuation of PHN. One hundred and twenty-three patients (73 male, 50 female, mean age: 66.11yr) have received LLLT for various entities of PHN over the past 29 years. In these cases the affected tissue area(s) was as follows: thorax and back (48 cases); head and neck (41 cases); abdomen and lumbar (17 cases); upper limb (9 cases); and lower limb (8 cases). The overall total improvement rate was 60.16%. Patient whose treatment was given within six month of onset obtained the highest improvement rate (mean, 76.34%). LLLT was effective for PHN in the acute and chronic phase, but LLLT was particularly effective for the acute phase patients whose onset before treatment was 6 months or less. The results demonstrate a significant reduction in PHN pain intensity, hypersensitivity and other complaints.