Laser therapy: A randomized, controlled trial of the effects of low-intensity Nd:YAG laser irradiation on musculoskeletal back pain

      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      Objective: To assess the effectiveness of low-intensity laser therapy in the treatment of musculoskeletal low back pain.
      Design: A double-masked, placebo-controlled, randomized clinical trial.
      Setting: A physical medicine and rehabilitation clinic.
      Participants: Sixty-three ambulatory men and women between the ages of 18 and 70yrs with symptomatic nonradiating low back pain of more than 30 days' duration and normal neurologic examination results.
      Intervention: Subjects were bloc randomized into two groups with a computer-generated schedule. All underwent irradiation for 90 seconds at eight symmetric points along the lumbosacral spine three times a week for 4 weeks by a masked therapist. The sole difference between the groups was that the probes of a 1.06μm neodymium: yttrium-aluminum-garnet laser emitted 542mW/cm 2 for the treated subjects and were inactive for the control subjects.
      Main Outcome Measures: Subject's perception of benefit, level of function as assessed by the Oswestry Disability Questionnaire, and lumbar mobility.
      Results: The treated group had a time-dependent improvement in two of the three outcome measures: perception of benefit and level of function. These results were most marked at the midpoint evaluation ( p < .005, p < .01) and end of treatment ( p < .017, p < .001) but tended to lessen at the 1-month follow-up ( p < .10, p < .004). Lumbar mobility did not differ between the groups at any time. All tests were two-sample t tests with unequal variances.
      Conclusions: Treatment with low-intensity 1.06μm laser irradiation produced a moderate reduction in pain and improvement in function in patients with musculoskeletal low back pain. Benefits, however, were limited and decreased with time. Further research is warranted.
      To read this article in full you will need to make a payment

      References

        • Licht S
        Therapeutic electricity and ultraviolet radiation.
        2nd ed. Elizabeth Licht, New Haven (CT)1967
        • Basford JR
        Physical agents in rehabilitation medicine: principles and practice.
        in: Delisa JA Rehabilitation medicine: principles and practice. 2nd ed. Lippincott, Philadelphia1993: 404-424
        • Basford JR
        Low intensity laser therapy: still not an established clinical tool.
        Lasers Surg Med. 1995; 16: 331-342
        • Mester E
        • Spiry T
        • Szende Tota JG
        Effect of laser rays on wound healing.
        Am J Surg. 1971; 122: 532-535
        • Mester E
        • Mester AF
        • Mester A
        The biomedical effects of laser application.
        Lasers Surg Med. 1985; 5: 31-39
        • Mester E
        • Toth N
        • Mester A
        The biostimulative effect of laser beam.
        Laser Basic Biomed Res. 1982; 22: 4-7
        • Vizi ES
        • Mester E
        • Tizza S
        • Mester A
        Acetylcholine releasing effect of laser irradiation on Auerbach's plexus in guinea pig ileum.
        J Neural Transm Park Dis Dement Sect. 1977; 40: 305-308
        • Karu TI
        Molecular mechanism of the therapeutic effect of low-intensity laser radiation.
        Lasers Life Sci. 1988; 2: 53-74
        • Karu TI
        • Ryabykh TP
        • Fedoseyeva GE
        • Puchkova NI
        Helium-neon laser-induced respiratory burst of phagocytic cells.
        Lasers Surg Med. 1989; 9: 585-588
        • Karu TI
        • Pyatibrat LV
        • Kalendo GS
        • Esenaliev RO
        Effects of monochromatic low-intensity light and laser irradiation on adhesion of HeLa cells in vitro.
        Lasers Surg Med. 1996; 18: 171-177
        • Gerschman JA
        • Ruben J
        • Gebart-Eaglemont J
        Low level laser therapy for dentinal tooth hypersensitivity.
        Aust Dent J. 1994; 39: 353-357
        • Khullar SM
        • Emami B
        • Westermark A
        • Haanaes HR
        Effect of low-level laser treatment on neurosurgery deficits subsequent to sagittal split ramus osteotomy.
        Oral Surg Oral Med Oral Pathol. 1996; 82: 132-138
        • Baxter GD
        Therapeutic lasers: theory and practice.
        Churchill Livingstone, Edinburgh1994
        • Heussler JK
        • Hinchey G
        • Margiotta E
        • Quinn R
        • Butler P
        • Martin J
        • et al.
        A double blind randomized trial of low power laser treatment in rheumatoid arthritis.
        Ann Rheum Dis. 1993; 52: 703-706
        • Krasheninnikoff M
        • Ellitsgaard N
        • Rogvi-Hansen B
        • Zeuthen A
        • Harden K
        • Larsen R
        • et al.
        No effect of low power laser in lateral epincondylitis.
        Scand J Rheumatol. 1994; 23: 260-263
        • Vecchio P
        • Cave M
        • King V
        • Adebajo AO
        • Smith M
        • Hazleman BL
        • et al.
        A double-blind study of the effectiveness of low level laser treatment of rotator cuff tendinitis.
        Br J Rheumatol. 1993; 32: 740-742
        • Grzesiak-Janas G
        Exposure of eyes to laser radiation during dental surgery.
        Int J Occup Med Environ Health. 1996; 9: 163-166
        • Logan ID
        • McKenna PG
        • Barnett YA
        An investigation of the cytotoxic and mutagenic potential of low intensity laser irradiation in Friend erythroleukaemia cells.
        Mutat Res. 1995; 347: 67-71
        • Fairbank JCT
        • Couper J
        • Davies JB
        • O'Brien JP
        The Oswestry low back pain disability questionnaire.
        Physiotherapy. 1980; 66: 271-273
        • Beurskens AJHM
        • devet HCW
        • Koke AJA
        Responsiveness of functional status in low back pain: a comparison of different instruments.
        Pain. 1996; 65: 71-76
        • Magee DJ
        Lumbar spine in orthopedic physical assessment.
        2nd ed. Saunders, Philadelphia1992
        • Williams Jr, JW
        • Holleman Jr, DR
        • Simel DL
        Measuring shoulder function with the shoulder pain and disability index.
        J Rheumatol. 1995; 22: 727-732
        • Babul N
        • Darke AC
        • Johnson DH
        • Charron-Vinvent K
        Using memory for pain in analgesic research.
        Ann Pharmacother. 1993; 22: 9-12
        • Fries JF
        • Ramey DR
        “Arthritis specific” global health analog scales assess “generic” health related quality-of-life in patients with rheumatoid arthritis.
        J Rheumatol. 1997; 24: 1697-1702
        • SAS Institute Inc
        SAS users guide: basics.
        5th ed. SAS Institute, Cary (NC)1985
        • Hastie TJ
        • Tibshirani RJ
        Generalized additive models.
        1st ed. Chapman and Hall, New York1990