Abstract
Periostitis in the lower leg caused by overexercise is a universal problem in athletes and runners. The purpose of this study was to observe the functional improvement of the lower limbs upon rehabilitation low-level laser therapy (LLLT). All medical data were gathered from enrolled adults with sports-related lower leg pain. A total of 54 patients underwent triple-phase bone scans using skeletal nuclear scintigraphy, which confirmed periostitis in their lower limbs. The patients were then randomly divided into two groups: one group received laser therapy (N = 29) and the other group (N = 25) received an equivalent placebo treatment (a drug or physical therapy). Treatment protocol commenced with rehabilitation intervention and LLLT was performed three times daily for 5 days at a dosage of 1.4 J/cm2. A Likert-type pain scale was used to evaluate the severity of pain. Balance function, including postural stability testing (PST) and limits of stability (LOS), was also performed to evaluate the function outcome. Patients experienced a significant improvement in pain by day 2 or day 5 after starting LLLT, but here was no significant difference in pain scale between the measurements before (baseline) and after LLLT. Comparing the PST, the group differences of dynamic vs. static testings ranged from −18.54 to −50.22 (compared 12, 8, 4, 3, 2, 1 to 0, all p < 0.0001), and the PST after LLLT were 3.73 units (p = 0.0258) lower than those of before LLLT. Comparing the LOS, the group differences of dynamic vs. static testing were similar to those in PST, and the relationship between LOS and groups only varied with the direction control during dynamic testing in direction at backward/right vs. right (p < 0.0001). LLLT had a positive effect on proprioception in patients with lower limb periostitis. Larger, better controlled studies are needed to determine what specific effects LLLT has on the function of proprioception.
Similar content being viewed by others
References
Gotliv AA (1959) Periostites due to over-strain in military personnel. Voen Med Zh 10:68–69
Ivanova LA (1970) Diagnosis and expertise in “march periostitis”. Voen Med Zh 12:30–32
Staff PH, Nilsson S (1980) Tendoperiostitis in the lateral femoral condyle in long-distance runners. Br J Sports Med 14:38–40
Renstrom P, Johnson RJ (1985) Overuse injuries in sports. A review. Sports Med 2:316–333
Kelm J, Ahlhelm F, Pitsch W, Kirn-Jünemann U, Engel C, Kohn D, Regitz T (2003) Sports injuries, sports damages and diseases of world class athletes practicing modern pentathlon. Sportverletz Sportschaden 17:32–38
Reshef N, Guelich DR (2012) Medial tibial stress syndrome. Clin Sport Med 31:273–290
Bates P (1985) Shin splints—a literature review. Br J Sports Med 19:132–137
Batt ME (1995) Shin splints—a review of terminology. Clin J Sport Med 5:53–57
D'Ambrosia RD, Zelis RF, Chuinard RG, Wilmore J (1977) Interstitial pressure measurements in the anterior and posterior compartments in athletes with shin splints. Am J Sports Med 5:127–131
Gerow G, Matthews B, Jahn W, Gerow R (1993) Compartment syndrome and shin splints of the lower leg. J Manipulative Physiol Ther 16:245–252
Cetinus E, Uzel M, Bilgiç E, Karaoguz A, Herdem M (2004) Exercise induced compartment syndrome in a professional footballer. Br J Sports Med 38:227–229
Tweed JL, Avil SJ, Campbell JA, Barnes MR (2008) Etiologic factors in the development of medial tibial stress syndrome: a review of the literature. J Am Podiatr Med Assoc 98:107–111
Nguyen JT, Peterson JS, Biswal S, Beaulieu CF, Fredericson M (2008) Stress-related injuries around the lesser trochanter in long-distance runners. AJR Am J Roentgenol 190:1616–1620
Seitz JP, Unguez CE, Corbus HF, Wooten WW (1995) SPECT of the cervical spine in the evaluation of neck pain after trauma. Clin Nucl Med 20:667–673
Milgrom C, Giladi M, Stein M, Kashtan H, Margulies J, Chisin R, Steinberg R, Swissa A, Aharonson Z (1986) Medial tibial pain. A prospective study of its cause among military recruits. Clin Orthop Relat Res 213:167–171
Mattila KT, Komu ME, Dahlstrom S, Koskinen SK, Heikkila J (1999) Medial tibial pain: a dynamic contrast-enhanced MRI study. Magn Reson Imaging 17:947–954
Allen MJ, O'Dwyer FG, Barnes MR, Belton IP, Finlay DB (1995) The value of 99Tcm-MDP bone scans in young patients with exercise-induced lower leg pain. Nucl Med Commun 16:88–91
Festen JJ, Kuipers FC, Schaars AH (1985) Multifocal recurrent periostitis responsive to colchicine. Scand J Rheumatol 14:8–14
Lirani-Galvão AP, Lazaretti-Castro M (2010) Physical approach for prevention and treatment of osteoporosis. Arq Bras Endocrinol Metabol 54:171–178
Vescovi P, Nammour S (2010) Bisphosphonate-Related Osteonecrosis of the Jaw (BRONJ) therapy. A critical review. Minerva Stomatol 59(181–203):204–213
Brosseau L, Robinson V, Wells G, Debie R, Gam A, Harman K, Morin M, Shea B, Tugwell P (2007) WITHDRAWN: low level laser therapy (classes III) for treating osteoarthritis. Cochrane Database Syst Rev 1:CD002046
Shomina SA, Bogatov VV, Chervinets VM (2005) [Clinical–microbiological evaluation of the efficacy of combined use of chitosan, low intensity laser radiation and photosensitizer in treatment of patients with acute suppurative maxillofacial periostitis]. Stomatologiia (Mosk) 84:23–26
Ahn BC, Kim HJ, Lee SW, Yoo J, Choi JK, Lee J (2009) New quantitative method for bone tracer uptake of temporomandibular joint using Tc-99 m MDP skull SPECT. Ann Nucl Med 23:651–656
Ferrante M, Petrini M, Trentini P, Perfetti G, Spoto G (2013) Effect of low-level laser therapy after extraction of impacted lower third molars. Lasers Med Sci 28:845–849
Khullar SM, Brodin P, Barkvoll P, Haanaes HR (1996) Preliminary study of low-level laser for treatment of long-standing sensory aberrations in the inferior alveolar nerve. J Oral Maxillofac Surg 54:2–8
Khullar SM, Emami B, Westermark A, Haanaes HR (1996) Effect of low-level laser treatment on neurosensory deficits subsequent to sagittal split ramus osteotomy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 82:132–138
Forrester DM, Kirkpatrick J (1976) Periostitis and pseudoperiostitis. Radiology 118:597–601
Ninomiya T, Hosoya A, Nakamura H, Sano K, Nishisaka T, Ozawa H (2007) Increase of bone volume by a nanosecond pulsed laser irradiation is caused by a decreased osteoclast number and an activated osteoblasts. Bone 40:140–148
Fukuoka H, Daigo Y, Enoki N, Taniguchi K, Sato H (2011) Influence of carbon dioxide laser irradiation on the healing process of extraction sockets. Acta Odontol Scand 69:33–40
Kawasaki K, Shimizu N (2000) Effects of low-energy laser irradiation on bone remodeling during experimental tooth movement in rats. Lasers Surg Med 26:282–291
Sun X, Zhu X, Xu C, Ye N, Zhu H (2001) Effects of low energy laser on tooth movement and remodeling of alveolar bone in rabbits. Hua Xi Kou Qiang Yi Xue Za Zhi 19:290–293
Garavello-Freitas I, Baranauskas V, Joazeiro PP, Padovani CR, Dal Pai-Silva M, da Cruz-Höfling MA (2003) Low-power laser irradiation improves histomorphometrical parameters and bone matrix organization during tibia wound healing in rats. J Photochem Photobiol B 70:81–89
Nicola RA, Jorgetti V, Rigau J, Pacheco MT, dos Reis LM, Zângaro RA (2003) Effect of low-power GaAlAs laser (660 nm) on bone structure and cell activity: an experimental animal study. Lasers Med Sci 18:89–94
Renno AC, de Moura FM, dos Santos NS, Tirico RP, Bossini PS, Parizotto NA (2006) Effects of 830-nm laser, used in two doses, on biomechanical properties of osteopenic rat femora. Photomed Laser Surg 24:202–206
Renno AC, de Moura FM, dos Santos NS, Tirico RP, Bossini PS, Parizotto NA (2006) Effects of 830-nm laser light on preventing bone loss after ovariectomy. Photomed Laser Surg 24:642–645
Xu M, Deng T, Mo F, Deng B, Lam W, Deng P, Zhang X, Liu S (2009) Low-intensity pulsed laser irradiation affects RANKL and OPG mRNA expression in rat calvarial cells. Photomed Laser Surg 27:309–315
Habib FA, Gama SK, Ramalho LM, Cangussú MC, Santos Neto FP, Lacerda JA, Araújo TM, Pinheiro AL (2010) Laser-induced alveolar bone changes during orthodontic movement: a histological study on rodents. Photomed Laser Surg 28:823–830
Pires-Oliveira DA, Oliveira RF, Amadei SU, Pacheco-Soares C, Rocha RF (2010) Laser 904 nm action on bone repair in rats with osteoporosis. Osteoporos Int 21:2109–2114
Bahcall J, Howard P, Miserendino L, Walia H (1992) Preliminary investigation of the histological effects of laser endodontic treatment on the periradicular tissues in dogs. J Endod 18:47–51
Barushka O, Yaakobi T, Oron U (1995) Effect of low-energy laser (He-Ne) irradiation on the process of bone repair in the rat tibia. Bone 16:47–55
Saad A, El Yamany M, Abbas O, Yehia M (2010) Possible role of low level laser therapy on bone turnover in ovariectomized rats. Endocr Regul 44:155–163
Altan BA, Sokucu O, Ozkut MM, Inan S (2012) Metrical and histological investigation of the effects of low-level laser therapy on orthodontic tooth movement. Lasers Med Sci 27:131–140
Marquezan M, Bolognese AM, Araújo MT (2010) Effects of two low-intensity laser therapy protocols on experimental tooth movement. Photomed Laser Surg 28:757–762
Biguetti CC, Filho EJ, de Andrade HL, Caviquioli G, Moreschi E, Comparin E, Matsumoto MA (2012) Effect of low-level laser therapy on intramembranous and endochondral autogenous bone grafts healing. Microsc Res Tech 75:1237–1244
Bouvet-Gerbettaz S, Merigo E, Rocca JP, Carle GF, Rochet N (2009) Effects of low-level laser therapy on proliferation and differentiation of murine bone marrow cells into osteoblasts and osteoclasts. Lasers Surg Med 41:291–297
Stein A, Benayahu D, Maltz L, Oron U (2005) Low-level laser irradiation promotes proliferation and differentiation of human osteoblasts in vitro. Photomed Laser Surg 23:161–166
Renno AC, McDonnell PA, Crovace MC, Zanotto ED, Laakso L (2010) Effect of 830 nm laser phototherapy on osteoblasts grown in vitro on Biosilicate scaffolds. Photomed Laser Surg 28:131–133
Kubota K, Wakabayashi K, Matsuoka T (2003) Proteome analysis of secreted proteins during osteoclast differentiation using two different methods: two-dimensional electrophoresis and isotope-coded affinity tags analysis with two-dimensional chromatography. Proteomics 3:616–626
Aihara N, Yamaguchi M, Kasai K (2006) Low-energy irradiation stimulates formation of osteoclast-like cells via RANK expression in vitro. Lasers Med Sci 21:24–33
Fujita S, Yamaguchi M, Utsunomiya T, Yamamoto H, Kasai K (2008) Low-energy laser stimulates tooth movement velocity via expression of RANK and RANKL. Orthod Craniofac Res 11:143–155
Shimizu N, Mayahara K, Kiyosaki T, Yamaguchi A, Ozawa Y, Abiko Y (2007) Low-intensity laser irradiation stimulates bone nodule formation via insulin-like growth factor-I expression in rat calvarial cells. Lasers Surg Med 39:551–559
Yamaguchi M, Hayashi M, Fujita S, Yoshida T, Utsunomiya T, Yamamoto H, Kasai K (2010) Low-energy laser irradiation facilitates the velocity of tooth movement and the expressions of matrix metalloproteinase-9, cathepsin K, and alpha(v) beta(3) integrin in rats. Eur J Orthod 32:131–139
Lee JH, Heo SJ, Koak JY, Kim SK, Lee SJ, Lee SH (2008) Cellular responses on anodized titanium discs after laser irradiation. Lasers Surg Med 40:738–742
Kim IS, Cho TH, Kim K, Weber FE, Hwang SJ (2010) High power-pulsed Nd:YAG laser as a new stimulus to induce BMP-2 expression in MC3T3-E1 osteoblasts. Lasers Surg Med 42:510–518
Hirata S, Kitamura C, Fukushima H, Nakamichi I, Abiko Y, Terashita M, Jimi E (2010) Low-level laser irradiation enhances BMP-induced osteoblast differentiation by stimulating the BMP/Smad signaling pathway. J Cell Biochem 111:1445–1452
Fujimoto K, Kiyosaki T, Mitsui N, Mayahara K, Omasa S, Suzuki N, Shimizu N (2010) Low-intensity laser irradiation stimulates mineralization via increased BMPs in MC3T3-E1 cells. Lasers Surg Med 42:519–526
Chellini F, Sassoli C, Nosi D, Deledda C, Tonelli P, Zecchi-Orlandini S, Formigli L, Giannelli M (2010) Low pulse energy Nd:YAG laser irradiation exerts a biostimulative effect on different cells of the oral microenvironment: “an in vitro study”. Lasers Surg Med 42:527–539
Hudson DE, Hudson DO, Wininger JM, Richardson BD (2013) Penetration of laser light at 808 and 980 nm in bovine tissue samples. Photomed Laser Surg 31:163–168
Montes-Molina R, Martínez-Rodríguez ME, Rodríguez AB, Martínez-Ruiz F, Prieto-Baquero A (2012) Interferential light therapy in the treatment of shoulder tendinopathies: a randomized controlled pilot study. Clin Rehabil 26:1114–1122
Acknowledgments
This research project was supported by Scientific Research Grant No. C-11-010 (2011) and No. MAB-102-56 (2013) provided by the Ministry of National Defense-Medical Affairs Bureau, Taiwan.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Chang, CC., Ku, CH., Hsu, WC. et al. Five-day, low-level laser therapy for sports-related lower extremity periostitis in adult men: a randomized, controlled trial. Lasers Med Sci 29, 1485–1494 (2014). https://doi.org/10.1007/s10103-014-1554-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10103-014-1554-z