Effect of high-intensity laser therapy in the management of myofascial pain syndrome of the trapezius: a double-blind, placebo-controlled study

Abstract

Myofascial pain syndrome (MPS) of the trapezius muscle is one of the main causes of neck pain. In this randomized, double-blind study, we evaluated the effects of high-intensity laser therapy (HILT) in female patients with chronic MPS of the trapezius muscle. The patients were assigned to two groups. The HILT group was treated with HILT and exercise, and the sham therapy group was treated with placebo HILT and exercise. The patients were assessed for pain, cervical active range of motion, disability, and quality of life. Evaluations were performed before treatment (week 0) and after treatment (weeks 4 and 12). Both groups showed significant improvement in all parameters at weeks 4 and 12. However, in a comparison of the percentage changes in the parameters at weeks 4 and 12 relative to pretreatment values, the HILT group showed greater improvement in pain scores, the neck disability index, and several subparts of the short-form 36 health survey (SF-36) (physical functioning, role limitations due to physical functioning, bodily pain, general health perceptions, social functioning, and role limitations due to emotional problems) than did the sham therapy group. We conclude that HILT is an effective therapeutic method in the treatment of patients with chronic MPS of the trapezius muscle.

The Beneficial Effects of High-Intensity Laser Therapy and Co-Interventions on Musculoskeletal Pain Management: A Systematic Review

“…25,26 Finally, 19 studies (HILT: 11, +other interventions: 8) were included for qualitative and quantitative assessment. [11][12][13][15][16][17]19,[31][32][33][34][35][36][37][38][39][40][41][42] The characteristics of all studies in two groups are listed in Table 1.…”

“…In the first group of classification (HILT and exercise) 4 studies 14,32,34,35 were about spinal pain which were matched to another group. [16][17][18]20 The average of the effect size differences was higher in the first group (1/08) for spinal pain patients.…”

“…32 Conversely, the studies which did not supporting a positive effect of HILT (low differences in ES) most commonly did not specify the amount of introduced energy or the simultaneous consumption of non-steroid anti-inflammatory drugs, so it was not possible to make a judgment on whether the energy parameters may have contributed to a suboptimal outcome. 34,36,41 The consumption of non-steroid anti-inflammatory drugs may be a confounding factor in evaluating the effects of laser therapy, as identified in some studies 13,41 Some studies did not mention the effects of disease chronicity, despite the fact that this is a major factor in determining the amount of energy density and power output which is needed in the treatment protocol by laser therapy. 13,18,[32][33][34]36,38,41,42 It seems that adding thermal and non-thermal agents to HILT may enhance the effects of laser therapy.…”

“…34,36,41 The consumption of non-steroid anti-inflammatory drugs may be a confounding factor in evaluating the effects of laser therapy, as identified in some studies 13,41 Some studies did not mention the effects of disease chronicity, despite the fact that this is a major factor in determining the amount of energy density and power output which is needed in the treatment protocol by laser therapy. 13,18,[32][33][34]36,38,41,42 It seems that adding thermal and non-thermal agents to HILT may enhance the effects of laser therapy. 16,[38][39][40]42 The Management of acute and chronic pain is based on different mechanisms and it seems that we should apply more irradiance of laser therapy in chronic pain conditions.…”

Update of Extracorporeal Shockwave Therapy in Myofascial Pain Syndrome

“…Extracorporeal shockwave therapy (ESWT). [9][10][11][12][13][14] And High Intensity Laser (HTL) 15 also play a role as desensitization. Kinesio Taping (KT) 16 and Fascial manipulation 17 are increasing evidences support.…”