Pain attenuation with diode laser therapy: A retrospective study of the long-term lllt experience in the private clinic environment

Abstract

We report on a 130 month retrospective study of pain entities treated with 830 nm diode laser therapy carried out at the authors’ clinic. In 11,139 mostly chronic pain patients (M:F 1:1.5) presenting with a total of 19,275 symptoms, an overall efficacy rate of 82 ± 5.7% was achieved (mean ± standard error of deviation, range of efficacy, 67.8% ~ 88.9%). The results were recorded under five grades: excellent (total pain removal, no recurrence, >9 point improvement on 11 point visual analogue scale [VAS] score); good (very noticeable attenuation, little or no regression, > 7 point improvement on VAS); fair (some improvement, some recurrence, >5 point improvement on VAS); unchanged (little or no improvement, <4 point improvement on VAS); and poor (exacerbation of pain). The overall efficacy was achieved by adding the ‘excellent’ and ‘good’ scores, i.e. a minimum of > 7 VAS points, thereby possibly removing some of the ‘placebo effect’. The efficacy rate of 82% for low level laser therapy (LLLT) in chronic pain entities is consistent with previous reports from the authors and others. Only one patient in the entire study reported exacerbation of their symptoms. While recognizing that this is not a ‘scientific’ controlled study, the authors suggest that the stringent criteria used to calculate the overall efficacy, the large patient population and clearly delineated pain entities lend strong credence to the data. In any event, as general practitioners, the authors firmly believe that the placebo effect may well be a useful component of laser therapy, always provided it is an effect which can be maintained and improved on by the actual documented physiological effects attributed to laser therapy. LLLT using a diode laser at 60 mW, 830 nm, continuous wave, in the contact pressure technique as used in the study, is therefore considered as a safe, effective and side effect free adjunctive therapeutic modality for intractable chronic and other pain types. However, in addition to intense training and continuing education for the therapists, their clinical environment and motivation are also important components in achieving consistently excellent therapeutic results in LLLT for pain attenuation in the private clinic. © 1998, International Phototherapy Association. All rights reserved.