12.08.10

Cold Laser (LLLT) & Elbow Pain

Posted in Uncategorized at 9:25 PM by Dr. Greathouse

From BMC Musculoskeletal Disorders
A Systematic Review With Procedural Assessments and Meta-analysis of
Low Level Laser Therapy in Lateral Elbow Tendinopathy (Tennis Elbow)

Posted 08/22/2008
Jan M. Bjordal, PT-MSc, PhD; Rodrigo A.B. Lopes-Martins, MPharm, PhD;
Jon Joensen, PT, MSc; Christian Couppe, PT, MSc; Anne E. Ljunggren,
PhD; Apostolos Stergioulas, PT, PhD; Mark I. Johnson, BSc, PhD, PGCHE

Conclusion
The available material suggests that LLLT is safe and effective, and
that LLLT acts in a dose-dependent manner by biological mechanisms,
which modulate both tendon inflammation and tendon repair processes.
With the recent discovery that long-term prognosis is significantly
worse for corticosteroid injections than placebo in LET, LLLT
irradiation with 904 nm wavelength aimed at the tendon insertion at
the lateral elbow is emerging as a safe and effective alternative to
corticosteroid injections and NSAIDs (non-steroidal anti-inflammatory
drugs).

LLLT also seems to work well when added to exercise and
stretching regimens. There is a need for future trials to compare
adjunctive pain treatments such as LLLT with commonly used
pharmacological agents.

The positive results for combining LLLT of 904 nm wavelength with an
exercise regimen, are encouraging. We would have thought that exercise
therapy could have erased possible positive effects of LLLT, but the
results showed an added value in terms of a more rapid recovery when
LLLT was used in conjunction with an exercise regimen. This may
indicate that exercise therapy can be more effective when inflammation
is kept under control. Adding LLLT to regimens with eccentric and
stretching exercises reduced recovery time by 4 and 8 weeks in two
trials.

Commentary
My clinical results with laser are good. They’re not perfect but a
relatively high percentage of the time it’s very effective; for acute
as well as chronic musculoskeletal problems. It seems the results are
more dramatic in chronic conditions. This I believe is because the
chronic low-grade inflammation is a stubborn condition that has simply
not responded to other forms of care, therefore, a positive response
seems more impressive if you’ve been suffering for a long time.
Laser is emerging as a safe and effective alternative to
corticosteroid injections and NSAIDs.

We get  good results with plantar fasciitis, carpal tunnel syndrome, ulnar neuritis, shoulder tendonitis, simple non-surgical knee pain conditions, bursitis, tendonitis, even with back and neck problems that fail to respond to mechanical forms of care.

See my website at greathousechiropractic.com

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