Effects of High - Intensity Laser in Treatment of Patients with Chronic Low Back Pain
DOI:
https://doi.org/10.3889/oamjms.2019.117Keywords:
Chronic low back pain, Therapy, High-intensity laser, Therapeutic ultrasoundAbstract
BACKGROUND: Chronic low back pain lasts longer than 12 weeks and is characterised by pain, muscle weakness, reduced functional ability and psychosocial burden.
AIM: To compare the effects of two physical modalities, high-intensity laser against ultrasound therapy in the treatment of patients with chronic low back pain.
MATERIAL AND METHODS: This was a prospective, monocentric, controlled clinical study comprising a group of 54 patients at the age between 25 and 65 years. Patients were divided into two groups: examined group of 27 patients (high-intensity laser and exercises) and a control group of 27 patients (ultrasound therapy and exercises). The results were evaluated by the Numeric Pain Rating Scale, Oswestry Disability Index and Schober’s test. Clinical findings were evaluated at the same time points for all patients, before treatment, at two weeks and three months following treatment. Statistical analyses were made to compare the differences between the results obtained on admission and the two consecutive control check-ups. Statistical significance was defined as a P value < 0.05.
RESULTS: The examined group showed statistically significantly better results than the control group after completion of the treatment (at two weeks) and at follow up after three months.
CONCLUSION: This study has shown that patient with chronic low back pain treated with a high-intensity laser has significantly reduced low back pain, reduced disability and improved range of motion. Its positive effect maintained for three months. It seems to be an effective, safe and useful physical modality in the treatment of a patient with chronic low back pain.
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Hart OR, Uden RM, McMullan JE, Ritchie MS, Williams TD, Smith BH. A study of National Health Service management of chronic osteoarthritis and low back pain. Prim Health Care Res Dev. 2014; 27:1–10.
Hayden JA, Dunn KM, van der Windt DA, Shaw WS. What is the prognosis of back pain? Best Pract Res Clin Rheumatol. 2010; 24(2):167-79. https://doi.org/10.1016/j.berh.2009.12.005 PMid:20227639
Urwin M, Symmons D, Allison T, Grammah T, Busby H, Roxby M et al. Estimating the burden of musculoskeletal disorders in the community: the comparative prevalence of symptoms at different anatomical sites, and the relation to social deprivation. Ann Rheum Dis. 1998; 57:649-55. https://doi.org/10.1136/ard.57.11.649 PMid:9924205 PMCid:PMC1752494
Chou. R, Shekelle. P. "Will this patient develop persistent disabling low back pain?" JAMA: the journal of the American Medical Association. 2010; 303(13):1295–302. https://doi.org/10.1001/jama.2010.344 PMid:20371789
Pillastrini P, Gardenghi I, Bonetti F et al. An updated overview of clinical guidelines for chronic low back pain management in primary care. Joint Bone Spine. 2012; 79(2):176-185. https://doi.org/10.1016/j.jbspin.2011.03.019 PMid:21565540
Hayashi K, Young-Chang PA, Ikemoto T, Nishihara M, et al. Predictive factors for the outcome of multidisciplinary treatments in chronic low back pain at the first multidisciplinary pain center of Japan. J Phys Ther Sci. 2015; 27(9):2901–2905. https://doi.org/10.1589/jpts.27.2901 PMid:26504321 PMCid:PMC4616122
Ui-Cheol J, Jae-Heon S, Cheol-Yong K, Gak H, Chan-Woo N. The effects of gluteus muscle strengthening exercise and lumbar stabilization exercise on lumbar muscle strength and balance in chronic low back pain patients. J Phys Ther Sci. 2015; 27(12):3813–3816. https://doi.org/10.1589/jpts.27.3813 PMid:26834359 PMCid:PMC4713798
Dilek D, Yeşim A, Kıvanç C, Tülay T, Ferhan C. Effects of Therapeutic Ultrasound on Pain, Disability, Walking Perfor-mance, Quality of Life, and Depression in Patients with Chronic Low Back Pain: A Randomized, Placebo Controlled Trial. Archives of Rheumatology. 2010; (2):082-087.
Ozdemir F, Birtane M, Kokino S. The clinical efficacy of low-power laser therapy on pain and function in cervical osteoarthritis. Clin Rheumatol. 2001; 20(3):181–4. https://doi.org/10.1007/s100670170061 PMid:11434469
Gur A, Karakoc M, Nas K, Cevik R, Sarac J, Demir E. Efficacy of low power laser therapy in fibromyalgia: a single-blind, placebo-controlled trial. Lasers Med Sci. 2002; 17(1):57–61. https://doi.org/10.1007/s10103-002-8267-4 PMid:11845369
Hagiwara S, Iwasaka H, Hasegawa A, Noguchi T. Pre-Irradiation of blood by gallium aluminum arsenide (830 nm) low-level laser enhances peripheral endogenous opioid analgesia in rats. Anesth Analg. 2008; 107(3):1058–63. https://doi.org/10.1213/ane.0b013e31817ee43e PMid:18713929
Santamato A, Solfrizzi V, Panza F, Tondi G, Frisardi V et al. Short-term Effects of High-Intensity Laser Therapy Versus Ultrasound Therapy in the Treatment of People With Subacromial Impingement Syndrome: A Randomized Clinical Trial. Phys Ther. 2009; 89(7):643-52. https://doi.org/10.2522/ptj.20080139 PMid:19482902
Jensen MP, Turner JA, Romano JM, Fisher LD. Comparative reliability and validity of chronic pain intensity measures. Pain. 1999; 83(2):157-162. https://doi.org/10.1016/S0304-3959(99)00101-3
MacDermid JC, Arumugam V, Vincent JI, Payne KL, So AK. Reliability of three landmarking methods for dual inclinometry measurements of lumbar flexion and extension. BMC Musculoskelet Disord. 2015; 20; 16:121.
Roland M, Fairbank J. The Roland–Morris Disability Questionnaire and the Oswestry Disability Questionnaire. SPINE. 2000; 25(24):3115–24. https://doi.org/10.1097/00007632-200012150-00006 PMid:11124727
Gur A, Karakoc M, Cevik R, Nas K, Sarac AJ, Karakoc M. Efficacy of low power laser therapy and exercise on pain and functions in chronic low back pain. Lasers Surg Med. 2003; 32(3):233–8. https://doi.org/10.1002/lsm.10134 PMid:12605431
Viliani T, Ricci E, Mangone G, Graziani C, Pasquetti P. Effects of Hilterapia vs. Viscosupplementation in knee osteoarthritis patients: a randomized controlled clinical trial. Energy for Health. International journal of information and scientific culture. 2009; (3):14–17.
Saggini R, Bellomo RG, Cancelli F. Hilterapia and chronic ankle pain syndromes. Abstract from Energy for Health; International journal of information and scientific culture. 2009; 3(3):22–25:38.
Maeda T. Morphological demonstration of low reactive laser therapeutic pain attenuation effect of the gallium aluminium arsenide diode laser. Laser Ther. 1989; 1(1):23–6. https://doi.org/10.5978/islsm.89-OR-02
Hsieh YL, Hong CZ, Chou LW, Yang SA, Yang CC. Fluence-dependent effects of low-level laser therapy in myofascial trigger spots on modulation of biochemicals associated with pain in a rabbit model. Lasers Med Sci. 2015; 30(1):209–16. https://doi.org/10.1007/s10103-014-1654-9 PMid:25190639
Hagiwara S, Iwasaka H, Hasegawa A, Noguchi T. PreIrradiation of blood by gallium aluminum arsenide (830 nm) lowlevel laser enhances peripheral endogenous opioid analgesia in rats. Anesth Analg. 2008; 107(3):1058–63. https://doi.org/10.1213/ane.0b013e31817ee43e PMid:18713929
Zati A, Valent A. Physical therapy: new technologies in rehabilitation medicine (translated to English). Edizioni Minerva Medica. 2006:162–185.
Alayat MS, Atya AM, Ali MM, et al. Long-term effect of high-intensity laser therapy in the treatment of patients with chronic low back pain: a randomized blinded placebo-controlled trial. Lasers Med Sci. 2014; 29:1065–1073. https://doi.org/10.1007/s10103-013-1472-5 PMid:24178907
Angelova A, Ilieva EM. Effectiveness of High Intensity Laser Therapy for Reduction of Pain in Knee Osteoarthritis. Pain Res Manag. 2016; 2016:9163618. https://doi.org/10.1155/2016/9163618 PMid:28096711 PMCid:PMC5206453
Gook-Joo K, Jioun C, Sangyong L, Chunbae J, Kwansub L. The effects of high intensity laser therapy on pain and function in patients with knee osteoarthritis. J Phys Ther Sci. 2016; 28(11):3197–3199. https://doi.org/10.1589/jpts.28.3197 PMid:27942148 PMCid:PMC5140828
Kheshie AR, Alayat MS, Ali MM. High-intensity versus low-level laser therapy in the treatment of patients with knee osteoarthritis: a randomized controlled trial. Lasers Med Sci. 2014; 29:1371–1376. https://doi.org/10.1007/s10103-014-1529-0 PMid:24487957
Gür A, Karakoc M, Nas K, Cevik R, Sarac J, Ataoglu S. Efects of low power laser and low dose amitriptyline therapy on clinical symptoms and quality of life in fbromyalgia: a singleblind, placebo-controlled trial. Rheumatol Int. 2002; 22:188–193. https://doi.org/10.1007/s00296-002-0221-z PMid:12215864
Pires-Oliveira DA, Oliveira RF, Amadei SU, et al. Laser 904 nm action on bone repair in rats with osteoporosis. Osteoporos Int. 2010; 21:2109–2114. https://doi.org/10.1007/s00198-010-1183-8 PMid:20204601
Hou JF, Zhang H, Yuan X, et al. In vitro effects of low-level laser irradiation for bone marrow mesenchymal stem cells: proliferation, growth factors secretion and myogenic differentiation. Lasers Surg Med. 2008; 40:726–733. https://doi.org/10.1002/lsm.20709 PMid:19065562
Salaheldien M, Alayat M, Abdel-Kafy E, Elsoudany AM, Helal O, Alshehri M. Efficacy of high intensity laser therapy in the treatment of male with osteopenia or osteoporosis: a randomized placebo-controlled trial. J. Phys. Ther. Sci. 2017; 29:1675–1679.
https://doi.org/10.1589/jpts.29.1675
PMid:28932011 PMCid:PMC5599844
Fiore P, Panza F, Cassatella G, Russo A, Frisardi V et al. Short-term effects of high-intensity laser therapy versus ultrasound therapy in the treatment of low back pain: a randomized controlled trial. Eur J Phys Rehabil Med. 2011; 47(3):367–73.
PMid:21654616
Koes BW, Van Tulder M, et al. An updated overview of clinical guidelines for the management of non-specific low back pain in primary care. European Spine Journal. 2010; 19(12):2075–2094.
https://doi.org/10.1007/s00586-010-1502-y
PMid:20602122 PMCid:PMC2997201
Ebadi S, Ansari N, Naghdi S, Jalaei S, Sadat M et al. The effect of continuous ultrasound on chronic non-specific low back pain: a single blind placebo-controlled randomized trial. BMC Musculoskeletal Disorders. 2012; 13:192. https://doi.org/10.1186/1471-2474-13-192 PMid:23031570 PMCid:PMC3537701
Durmus D, Durmaz Y, Canturk F. Effects of therapeutic ultrasound and electrical stimulation program on pain, trunk muscle strength, disability, walking performance, quality of life, and depression in patients with low back pain: a randomized-controlled trial. Rheumatology International. 2010; 30(7):901–910. https://doi.org/10.1007/s00296-009-1072-7 PMid:19644691
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Copyright (c) 2019 Marija Gocevska, Erieta Nikolikj-Dimitrova, Cvetanka Gjerakaroska-Savevska
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