Evaluation of the Effects of Intravenous and Percutaneous Low Level Laser Therapy in the Management of Shoulder Myofascial Pain Syndrome

Abstract

Introduction: Myofascial pain syndrome (MPS) treatment is challenging with a high recurrence rate and still lacks a clear treatment frame. Therefore research on new, more efficient and long lasting effect treatment modalities is necessary. This study looked at the effects of intravenous laser therapy (IVL) and percutaneous low level laser (PLLL) in the management of shoulder MPS. Methods: In this randomized controlled trial, 30 patients fulfilling inclusion criteria were randomly equally allocated to 3 groups, control, IVL and PLLL. Control group received 12 sessions of placebo low level laser, IVL group received 12 sessions of IVL therapy, and PLLL group received 12 sessions of PLLL therapy. All patients were trained for better body posture, body mechanics, gentle massage of trigger points, stretching exercises of affected muscle (trapezius), and received 10 mg of oral nortriptyline regimen every night for 3 months. Outcomes included pain severity, functional disability, and quality of life. Patients were assessed using Numeric Rating Scale (NRS), Pain Disability Index (PDI), and Short Form Health Survey (SF-12). Data collected were analyzed using analysis of variance (ANOVA), Mann-Whitney and t tests. Results: The mean of PDI and maximum pain intensity during day and night significantly reduced in both PLLL and IVL groups compared to control group. Although pain severity and PDI reduction was more pronounced in IVL group compared to PLLL group, the differences were not statistically significant. Also, quality of life statistically significantly improved in both IVL and PLLL groups compared to control group was more, and although higher in IVL group, the difference was not statistically significant when compared to PLLL group. No side effects were observed in the intervention groups. Conclusion: Intravenous laser and PLLL therapy had a positive effect on pain severity and PDI reduction, and quality of life in this study. Also no adverse event was recorded. Thus, intravenous lasers and PLLL therapy seem to be effective complementary modalities in managing patients with shoulder MPS.

The Effectiveness of the Polarized Low-Level Laser in the Treatment of Patients With Myofascial Trigger Points in the Trapezius Muscles

“…[15][16][17][18][19][20] Imani et al and Munguia et al concluded that almost 60% of the literature between 2000 to 2018 demonstrated that LLLT was useful in reducing pain and trigger point sensitivity, improving the quality of life. 21,22 Momenzadeh et al 23 reached the same result. 24 Several mechanisms of action have been proposed for pain reduction by LLLT.…”

“…The superior results of LLLT in reducing pain, in accordance with our VAS scores, agree with many reports that investigated the effect of laser light on reducing pain. 23,34,35 Uemoto et al 36 investigated the effect of laser therapy and needling on deactivating MTrPs. In this research, in 4 sessions of laser irradiation at wavelength=795 nm at power=80 mW and an exposure rate of 4 J/cm 2 , a significant pain reduction compared to a control group was observed.…”

“…4,5 The treatment modalities of trigger points are multiple and include pharmacotherapy (antidepressant, anticonvulsants, muscle relaxants, local anesthetics, etc) and non-pharmacological treatments (massage therapy, dry needling, stretching exercises, ultrasound, etc). [6][7][8] One of the debated treatment modalities, despite its common use, is low-level laser therapy (LLLT) [9][10][11][12][13][14] that is used in the treatment of many diseases. [15][16][17][18][19][20] Imani et al and Munguia et al concluded that almost 60% of the literature between 2000 to 2018 demonstrated that LLLT was useful in reducing pain and trigger point sensitivity, improving the quality of life.…”

The Adjuvant Therapy of Intravenous Laser Irradiation of Blood (ILIB) on Pain and Sleep Disturbance of Musculoskeletal Disorders

“…That is to say, if patients were to be given an increased dose of an analgesic drug, it may mask the effect of ILIB pain control, causing participants to be excluded. In addition, although there has been no report about obvious adverse events of ILIB treatment so far, patients with recent hemorrhage history, photosensitivity, infection status, or pregnancy were excluded to receive ILIB treatment, according to our routine clinical practice [ 6 , 16 ].…”

Histological and biochemical effects of preventive and therapeutic vascular photobiomodulation on rat muscle injury

“…Moreover, it is also difficult to predict the muscular area involved in the case of a preventive application of PBM. Thus, another type of PBM is the intravascular laser irradiation of blood (ILIB), which was developed more than 30 years age for the treatment of systemic diseases [28][29][30][31]. A modification of this technique to a transcutaneous, noninvasive application modality is denominated noninvasive laser irradiation of blood (NLIB), systemic photobiomodulation (SPBM) [31], or vascular photobiomodulation (VPBM) [32].…”