Comparison of the effects of low-level laser and pulsed and continuous ultrasound on pain and physical disability in chronic non-specific low back pain: a randomized controlled clinical trial

Abstract

Objective: To compare the short-term effects of pulsed laser and pulsed and continuous ultrasound on pain and functional disability in women with chronic non-specific low back pain. Methods: The sample was composed of 100 volunteers randomly allocated into four groups: The Pulsed Laser Group (n = 26) was treated with 3 J/cm 2 ; the Pulsed Ultrasound Group (n = 24; 3 MHz) was treated with 1 W/cm 2 ; the Continuous Ultrasound Group (n = 26; 1 MHz) was treated with 1 W/cm 2 ; and a Control Group (n = 24), where the patients were still waiting for treatment. Before and after 10 sessions of treatment, the intensity of pain was assessed using the visual analogue scale (VAS), the quality of pain was evaluated using the McGill pain questionnaire and functional disability was investigated using the Roland-Morris questionnaire. Results: The three treated groups exhibited a decrease in pain (p < 0.001); the Pulsed Laser Group showed the greater relative gain (91.2%), Meanwhile, the Control Group exhibited a worsening of − 5.8%. The three treated groups demonstrated improvement in the quality of pain (McGill) in the total, sensory and affective dimensions (p < 0.005; p < 0.002; p < 0.013, respectively). All treated groups showed a decrease in functional disability (p < 0.001), but the Pulsed Ultrasound Group showed the highest relative gain (83.3%). Conclusions: The three modalities have significant effects to decreasing low back pain and improving functional disability in women with non-specific chronic low back pain, but the pulsed low-level laser had the best results on pain while the pulsed ultrasound had the best results on improve the functional disability.

Photobiomodulation with cluster does not present superior results to placebo in young people with chronic non-specific lumbar pain

“…Contrary to the results observed in the current research, in a study comparing the effect of LLLT (904nm, 0.04W, applied in six points totalling 18J, during 10 therapies over four weeks) with therapeutic ultrasound and also using the McGill and Roland-Morris questionnaires, the authors observed that the LLLT showed a reduction in pain intensity and quality, besides functional improvement [12]. Tantawy et al [27] also observed advantages of LLLT (808nm, 17.05 J/cm 2 , 30 J) associated with exercises, with two sessions per week for eight weeks, compared with therapeutic ultrasound, in the reduction of pain, improvement in functional performance and reduction of disability in individuals with chronic non-specific lumbar pain.…”

“…Conservative treatment is usually the initial choice, in which physiotherapeutic modalities are included, among them, joint mobilization and manipulation [8,9], fascial manipulation [10], electrotherapy [11], therapeutic ultrasound [12] and photobiomodulation (PBM) [13]. PBM with the low-level laser therapy (LLLT) associated with a light emitting diode (LED) (Cluster) [8] with therapeutic purposes, such as increased RNA, DNA and ATP synthesis, fibroblast cell proliferation rate and collagen synthesis, increased vascularization and variations in nerve conduction [15][16][17].…”

Effects of low-intensity pulsed ultrasound on pain and functional disability in patients with early-stage lumbar spondylolysis: A randomized controlled trial

“…A similar study by Rubira et al compared the effects of LLLT and LIPUS on chronic non-specific low back pain and demonstrated a reduction in pain (p < 0.001), with the LLLT (low-level lased therapy) group showing the greater relative increase (91.2 percent). Meanwhile, the RPT group showed a -5.8% worsening of functional disability (p < 0.001), but the LIPUS group showed the greatest relative improvement (p < 0.001) (83.3 percent) [15]. Different researches have also been conducted on other body regions to know its effects.…”

Low-Intensity Continuous Ultrasound Therapies—A Systematic Review of Current State-of-the-Art and Future Perspectives

“…Importantly, there are only a few head-to-head studies of LICUS and LIPUS; thus, there is a need for studies directly comparing LICUS and LIPUS by only altering the duty cycle and keeping all other US parameters constant to conclusively determine which is better for a given indication [ 108 , 167 ]. LIPUS biological effects are highly dependent on mechanotransductive pathways, while LICUS can activate both thermal and mechanotransductive pathways, so there are likely preferential applications for each modality.…”