A Photomechanic Effect of High-Intensity Laser of Class 4 1064nm on the Pain Transfer Via Free Nerve Endings: a Multi-Centric, Randomized, Placebo-Controlled Study


Authors: M. Procházka 1;  P. Davídek 2;  K. Kazalakova 3;  O. Prouza 4
Authors‘ workplace: Rehabilitačníoddělení Jarov, Praha 1;  Katedra základů kinantropologie a humanitních věd, Fakulta tělesné kultury a sportu Univerzita Karlova v Praze 2;  Katedra fyzikální medicíny a rehabilitace, Pirogov univerzitní nemocnice, Sofie, Bulharsko 3;  Katedra anatomie a biomechaniky, Fakulta tělesné kultury a sportu, Univerzita Karlova v Praze 4
Published in: Rehabil. fyz. Lék., 24, 2017, No. 1, pp. 11-18.
Category: Original Papers

Overview

Introduction:
Chronic pain is a globally widespread problem, which could become an epidemic. Chronic pain is the cause of working incapacity for people in productive age and the therapy cot millions of crowns annually. It is therefore necessary to understand mechanism of effects of chronic pain and the search for noninvasive, effective and safe solution of the problem. Laser therapy is one way for the solution, which fulfils these criteria. The study is aimed at demonstration of an analgesic effect of high-intensity laser (HIL) energy as a consequence of photo-mechanic effect in human tissue.

Method:
A multi-centric, randomized placebo-controlled study is performed for the purpose of evaluating the relief from pain, caused by the photomechanic effect of high intensity laser energy on free nerve endings. Fifty six patients were enrolled in the study (27 man and 29 women) at the age of 42 to 64 years, who suffered from chronic back pain causing difficulties in common daily activities. The patients were randomly distributed into an experimental and control group. The experimental group treated with high-intensity laser (BTL-6000 High Intensity Laser 12W, BTL Company Ltd.). Each patient underwent nine treatments in the course of three weeks ‘three treatments per week). The pain intensity was evaluated in a 10point Visual analog scale (VAS) (Supplement 1). A questionnaire celled PFAG (Patient Functional Assessment Questionnaire) was used for the evaluation of functional dysfunction in common daily activities (ADL). It contains 2 items evaluated on the 0 to 6 scale (Supplement 2). The data were obtained for the period before, after three weeks of treatment and after subsequent 30 days.

Results:
In the experimental group there was a 69% decrease in pain perception (from strong to medium) and in 69% there was an improvement of functional dysfunction in ADL (from moderate to low or no problems). In contrast, ni the control group we observed 38% decrease in pain perception (from strong to medium strong pain intensity) and 34% improvement in the ADL area (from mild to low problems). The results obtained after the 30 days time lapse show a 52% decrease in pain perception (from strong to low) and 53% decrease in functional dysfunction ADL (form moderate to low or no problems) in the experimental group or a 6% pain decrease (from strong to mild) and 6% improvement in ADL (from mild problems to low or mild) in the control group.

Conclusion:
Results of the study demonstrated a pain relief and the effect of high–intensity laser of 12 W-power in the pulse regimen. The difference in the decrease of pain intensity between the control and experimental group reached the level of probability p <0.05 (p = 3.01E-10. The results support the theory of mechanic inhibition of free nerve endings. The results in the area of functional dysfunction in ADL measured by the questionnaire (PFAG) demonstrated a decreased of limiting factors in ADL in the experimental group. The evaluation of data obtained in the experimental group after the 30-day time-lapse from the treatment indicated a lasting effect in both parameters: in the pain relief and in improved ability to perform ADL. These results also demonstrate the effect of HIL on a decrease of pain and decrease of limiting factors in ADL. The HIL treatment is therefore an easy solution of these problems.

Keywords:
high intensity laser, pain, chronic backpain, analgesic effect, pain relief, well-being


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Labels
Physiotherapist, university degree Rehabilitation Sports medicine
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