Long-term effect of pulsed high-intensity laser therapy in the treatment of post-mastectomy pain syndrome: a double blind, placebo-control, randomized study

Ebid, Anwar Abdelgayed; Elsodany, Ahmed Mohamed

doi:10.1007/s10103-015-1780-z

Cited by 24 publications

(19 citation statements)

References 40 publications

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“…No evidence of differences in pain relief were found in a trial of cutaneous magnetic stimulation for 24 h compared with sham treatment after spinal surgery in 17 patients. Four weeks of laser therapy compared with placebo laser therapy was found to reduce mastectomy pain at 12 weeks in a trial of 61 participants. An unblinded trial that included ten patients, which was at risk of bias, found that 2 weeks of sensory discrimination training led to a reduction in phantom limb pain at 3 months compared with comprehensive psychophysiological assessment.…”

Section: Resultsmentioning

confidence: 95%

Systematic review of management of chronic pain after surgery

Wylde

Dennis

Beswick

et al. 2017

British Journal of Surgery

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BackgroundPain present for at least 3 months after a surgical procedure is considered chronic postsurgical pain (CPSP) and affects 10–50 per cent of patients. Interventions for CPSP may focus on the underlying condition that indicated surgery, the aetiology of new‐onset pain or be multifactorial in recognition of the diverse causes of this pain. The aim of this systematic review was to identify RCTs of interventions for the management of CPSP, and synthesize data across treatment type to estimate their effectiveness and safety.Methods MEDLINE, Embase, PsycINFO, CINAHL and the Cochrane Library were searched from inception to March 2016. Trials of pain interventions received by patients at 3 months or more after surgery were included. Risk of bias was assessed using the Cochrane risk‐of‐bias tool.ResultsSome 66 trials with data from 3149 participants were included. Most trials included patients with chronic pain after spinal surgery (25 trials) or phantom limb pain (21 trials). Interventions were predominantly pharmacological, including antiepileptics, capsaicin, epidural steroid injections, local anaesthetic, neurotoxins, N‐methyl‐d‐aspartate receptor antagonists and opioids. Other interventions included acupuncture, exercise, postamputation limb liner, spinal cord stimulation, further surgery, laser therapy, magnetic stimulation, mindfulness‐based stress reduction, mirror therapy and sensory discrimination training. Opportunities for meta‐analysis were limited by heterogeneity. For all interventions, there was insufficient evidence to draw conclusions on effectiveness.ConclusionThere is a need for more evidence about interventions for CPSP. High‐quality trials of multimodal interventions matched to pain characteristics are needed to provide robust evidence to guide management of CPSP.

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Section: Resultsmentioning

confidence: 95%

Systematic review of management of chronic pain after surgery

Wylde

Dennis

Beswick

et al. 2017

British Journal of Surgery

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“…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.…”

Section: Resultsmentioning

confidence: 99%

“…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.…”

Section: Discussionmentioning

confidence: 99%

“…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. 50,51 The treatment area of the scanner lasers is a major contributor to laser efficacy, indicated by some studies.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2020

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Introduction: High-intensity laser therapy (HILT) has been used more recently in the therapeutic protocols of pain managements. Adding therapeutic interventions to laser therapy is usual in clinical practice. This study aimed to evaluate the efficacy of HILT and beneficial effects of adding cointerventions to HILT in musculoskeletal pain management. Methods: The following databases were searched up to August 2018: Medline, PubMed, EMBASE, Cochrane, Google Scholar, Springer and ISI. The keywords of pain, HILT, high power laser therapy, laser therapy, photobiomodulation, physical therapy and rehabilitation were searched. The quality of the articles was assessed using the PEDro scale. The primary measure was pain severity expected to be reported in all studies. Effect size was calculated as standardized mean differences divided by the standard deviation of either the treatment or other group. Results: Initially 52 potential studies were found. Eighteen of these studies were excluded based on title and abstract. The full text of 34 remaining articles was screened and 15 of the studies were excluded. All included studies had high quality (PEDro ≥7). Approximately, 94% of included articles (n=18) revealed positive effects of HILT on pain. The effect sizes for HILT and placebo/comparator groups were 0.9-9.11 and 0.21-11.22 respectively. Also, the differences of effect size between two groups were between 0.03 to 5.85. Conclusion: It is early to determine that HILT may be an effective non-invasive agent in the management of musculoskeletal pain, as few studies have shown its clinical efficacy. Adding related co-interventions to HILT may enhance the beneficial effects of laser therapy. The variability of the study methods and outcomes suggests that further long-term follow-up, randomized controlled clinical trials with appropriate methodological design are needed regarding the effectiveness of HILT on pain.

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“…However, in patients with breast cancer and unilateral lymphedema, LLLT failed to significantly improve their quality of life, pain scores, grip strength, or limb volume 91 . In contrast, long-term beneficial effects have been reported with pulsed HILT in the treatment of post-mastectomy pain syndrome 92 . A recent literature review 93 suggested that LLLT might be a promising option for the management of cancer treatment-related side effects (for example, oral mucositis, radiodermatitis, lymphedema, and chemotherapy-induced peripheral neuropathic pain).…”

Section: Laser Therapymentioning

confidence: 95%

Use of electroanalgesia and laser therapies as alternatives to opioids for acute and chronic pain management

White

Elvir-Lazo

Galeas³

et al. 2017

F1000Res

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The use of opioid analgesics for postoperative pain management has contributed to the global opioid epidemic. It was recently reported that prescription opioid analgesic use often continued after major joint replacement surgery even though patients were no longer experiencing joint pain. The use of epidural local analgesia for perioperative pain management was not found to be protective against persistent opioid use in a large cohort of opioid-naïve patients undergoing abdominal surgery. In a retrospective study involving over 390,000 outpatients more than 66 years of age who underwent minor ambulatory surgery procedures, patients receiving a prescription opioid analgesic within 7 days of discharge were 44% more likely to continue using opioids 1 year after surgery. In a review of 11 million patients undergoing elective surgery from 2002 to 2011, both opioid overdoses and opioid dependence were found to be increasing over time. Opioid-dependent surgical patients were more likely to experience postoperative pulmonary complications, require longer hospital stays, and increase costs to the health-care system. The Centers for Disease Control and Prevention emphasized the importance of finding alternatives to opioid medication for treating pain. In the new clinical practice guidelines for back pain, the authors endorsed the use of non-pharmacologic therapies. However, one of the more widely used non-pharmacologic treatments for chronic pain (namely radiofrequency ablation therapy) was recently reported to have no clinical benefit. Therefore, this clinical commentary will review evidence in the peer-reviewed literature supporting the use of electroanalgesia and laser therapies for treating acute pain, cervical (neck) pain, low back pain, persistent post-surgical pain after spine surgery (“failed back syndrome”), major joint replacements, and abdominal surgery as well as other common chronic pain syndromes (for example, myofascial pain, peripheral neuropathic pain, fibromyalgia, degenerative joint disease/osteoarthritis, and migraine headaches).

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Long-term effect of pulsed high-intensity laser therapy in the treatment of post-mastectomy pain syndrome: a double blind, placebo-control, randomized study

Cited by 24 publications

References 40 publications

Systematic review of management of chronic pain after surgery

Systematic review of management of chronic pain after surgery

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

Use of electroanalgesia and laser therapies as alternatives to opioids for acute and chronic pain management

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