By: Dr Alex Robber
Ultra-laser fibromyalgia therapy decreases pain by 75 percent when applied to the hands
A new device that combines low-intensity laser light and therapeutic ultrasound
A new device incorporating low intensity laser light and clinical ultrasound significantly reduces pain experienced by fibromyalgia patients. A scientific study has shown that application to the palms has greater analgesic and anti-inflammatory effects, rather than tender points on different parts of the body. Patients often sleep better as a result of pain reduction and are able to perform daily tasks with less discomfort.
The overall quality of life is also improving. In an article published in the Journal of Novel Physiotherapies, researchers at the Center for Optics and Photonics Research (CEPOF), one of the Science, Innovation and Distribution Centers (RIDCs) funded by the São Paulo Research Foundation–FAPESP, identify the concurrent application of low-intensity laser light and therapeutic ultrasound to the palms of patient’s hands for three minutes The therapy consisted of ten hours, twice a week.
Mechanism of action
“The study discusses two innovations: the unit, and the procedure for treatment. Through concurrently emitting laser light and ultrasound, we have helped to normalize the pain threshold for the patient. Application to the palms varies from the emphasis on tender points found almost everywhere in fibromyalgia care today, “said Antônio Eduardo de Aquino Junior, a researcher at the São Carlos Physics Institute (IFSC-USP) at the University of São Paulo in Brazil, and co-author of the study. The application of low-intensity laser is used for its anti-inflammatory and analgesic properties and to increase the production of energy in cells, whereas therapeutic ultrasound is well known for pain relieving.
A team from the Brazilian Research Center for Optics and Photonics has created a prototype that allows for the simultaneous use of ultrasonic emission and light energy, or ultrasound plus laser, a method they call ultra-laser.
A total of 48 women of 40-65 years of age with fibromyalgia were divided into six groups of eight patients, each receiving either the combination ultra-laser technique, only laser, or only ultrasound, applied to the palms of the hands or to a tender point in the trapezoidal muscle (back).
Tender points are tenderness regions around joints commonly used for diagnosing fibromyalgia. Researchers decided to test the palms of the hands in the hands of fibromyalgia patients based on the recorded high number of sensory nerve fibers near blood vessels.
Point to be noted
Therefore, we changed emphasis to check the technique’s direct action on these sensory cells in the hands rather than just so-called pain trigger points, such as the trapezius, which is usually very painful in patients with fibromyalgia, “said Juliana da Silva Amaral Bruno, a physical therapist and the study’s first author, in a press release.
The concept of testing the results of the new device applied to the palms of the hands emerged from a scientific literature review. “Previous studies found that fibromyalgia patients had larger numbers of neuroreceptors in their hands near to blood vessels. In this area some patients even had red dots.
We have therefore shifted emphasis to check the technique’s direct action on these sensory cells in the hands rather than just so-called pain trigger points, such as the trapezius, which is usually very painful in patients with fibromyalgia,” said Juliana da Silva Amaral Bruno, a physical therapist and the study’s first author. The study showed that all pain points within the patient’s body are influenced by application to the hands.
Previously, the same group of centers sponsored by FAPESP had published an article in the Journal of Novel Physiotherapies detailing a case study on applying the tool to pain points. Although the findings of this first study were satisfactory, it has proved impossible to reduce global pain.
As measured by the Fibromyalgia Impact Questionnaire (FIQ) of functional status and the Visual Analog Scale (VAS) for Pain, they found that application to the hands was substantially more effective than to the trapezius muscle regardless of the technique used.
The combined therapy was spread over 10 twice-weekly sessions over three minutes. Through simultaneously emitting laser light and ultrasound, we have managed to normalize the pain threshold for the patient, “said Antônio Eduardo de Aquino Junior, the senior author of the study. Targeting the trapezius muscle with ultra-laser resulted in a significant laser increase in both FIQ and VASP ratings, and a gain of 57.72 percent (FIQ) and 63.31 percent (VASP) over ultrasound, albeit not statistically different.
Targeting the palms with ultra-laser resulted in a major laser increase in both FIQ and VASP, and an ultrasound gain of 46.6 percent (FIQ) and a statistically significant (VASP).
Combined application of ultrasound and laser to pain points
“The combined application of ultrasound and laser to pain points such as the trapezoid was highly effective but failed to attain the other major disorder-affected innervations,” Bruno said. “Application to the palms of the hands has had a global impact, improving the quality of life of the patient and removing their pain.”
The team indicated that the systemic benefits obtained by applying ultra-laser to the hands are derived from normalizing blood flow, metabolism and body temperature.
Application of the palm’s treatment
“The application of palm treatment in contrast to conventional procedures shows a modern and effective treatment choice for fibromyalgia, not relying on chemical treatment and minimizing patient exposure to pain,” the researchers wrote in the report.
Of note, a previous case study from the same team had previously shown that this combination of ultrasound and laser to the palms allowed pain reduction as well as an improvement in FIQ score in a fibromyalgia 61-year-old woman.
The new device will appear on the market in early 2019, according to Aquino. Osteoarthritis, knees, hands and feet are currently being tested, “and the findings have been fascinating,” he said.
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Could Hands be a New Treatment to Fibromyalgia? A Pilot Study by Juliana Silva Amaral Bruno and Others via Journal of Novel Physiotherapies.