Treatment of drug-resistant fibromyalgia symptoms using high-intensity laser therapy: a case-based review
- 702 Downloads
Fibromyalgia is a chronic musculoskeletal condition characterized by widespread pain in the body and is associated with tender points at the shoulder, back and hip regions. A wide variety of pharmacologic drugs and dietary supplements have been used with limited success in treating the musculoskeletal pain. Early clinical studies with low level laser therapy (LLLT) alone or in combination with drugs commonly used to treat fibromyalgia suggested that LLLT may be effective in reducing musculoskeletal pain and stiffness, as well as the number of tender locations. However, a sham-controlled study reported that LLLT was not significantly better than the sham treatment and kinesiotape. Preliminary studies with high-intensity laser therapy (HILT) suggest that it may be more effective than LLLT for treating chronic pain syndromes. Therefore, we evaluated low (1 W), intermediate (42 W) and high level (75 W) HILT in a woman with long-standing fibromyalgia syndrome which was resistant to both standard pharmacotherapy and treatment in an interdisciplinary pain management program. The patient received a series of treatments with a HILT device (Phoenix Thera-lase) at a wavelength of 1275 nm administered at both the paraspinous region and tender points in the shoulder and hip regions. Although the 1 W treatment produced minimal symptom relief, both the 42 and the 75 W treatments produced a dramatic reduction in her overall pain, improved quality of sleep, and increased her level of physical activity for 4–10 days after these treatment sessions. This case illustrates the potential beneficial effects of using higher power levels of HILT for patients with fibromyalgia syndrome who have failed to respond to conventional interdisciplinary treatment regimens.
KeywordsFibromyalgia Chronic pain High-intensity laser therapy (HILT)
None. This research did not receive any Grant funding agencies in the public, commercial, or not-for-profit sectors. Dr. White’s academic work is supported in part by a stipend from Cedars Sinai Medical Center and the White Mountain Institute (a private not-for-profit foundation). The high-intensity laser device used for these treatments was provided by Phoenix Thera-lase Systems, LLC, Dallas, TX.
Compliance with ethical standards
Conflict of interest
Dr. White is a non-paid Consultant to Phoenix Thera-lase and Mr. Hernandez is a paid employee of Phoenix Thera-lase Systems, LLC. Dr. Zafereo has received a study Grant from Phoenix Thera-lase. Dr. Elvir-Lazo has nothing to disclose.
- 1.Arnold LM, Clauw DJ (2017) Challenges of implementing fibromyalgia treatment guidelines in current clinical practice. Postgrad Med 19:1–6Google Scholar
- 2.Macfarlane GJ, Kronisch C, Dean LE, Atzeni F, Häuser W, Fluß E, Choy E, Kosek E, Amris K, Branco J, Dincer F, Leino-Arjas P, Longley K, McCarthy GM, Makri S, Perrot S, Sarzi-Puttini P, Taylor A, Jones GT (2017) EULAR revised recommendations for the management of fibromyalgia. Ann Rheum Dis 76:318–328CrossRefPubMedGoogle Scholar
- 5.Theadom A, Cropley M, Smith HE, Feigin VL, McPherson K (2015) Mind and body therapy for fibromyalgia. Cochrane Database Syst Rev 7(4):CD001980Google Scholar
- 6.Page MJ, McKenzie JE, Kirkham J, Dwan K, Kramer S, Green S, Forbes A (2014) Bias due to selective inclusion and reporting of outcomes and analyses in systematic reviews of randomised trials of healthcare interventions. Cochrane Database Syst Rev 5(10):MR000035Google Scholar
- 7.Page MJ, Green S, Mrocki MA, Surace SJ, Deitch J, McBain B, Lyttle N, Buchbinder R (2016) Electrotherapy modalities for rotator cuff disease. Cochrane Database Syst Rev 10(6):CD012225Google Scholar
- 11.Winkelmann A, Bork H, Brückle W, Dexl C, Heldmann P, Henningsen P, Krumbein L, Pullwitt V, Schiltenwolf M (2017) Physiotherapy, occupational therapy and physical therapy in fibromyalgia syndrome: updated guidelines 2017 and overview of systematic review articles. Schmerz 31:255–265CrossRefPubMedGoogle Scholar
- 31.Rhee YH, Moon JH, Choi SH, Ahn JC (2016) Low-level laser therapy promoted aggressive proliferation and angiogenesis through decreasing of transforming growth factor-β1 and increasing of Akt/Hypoxia inducible factor-1α in anaplastic thyroid cancer. Photomed Laser Surg 34:229–235CrossRefPubMedGoogle Scholar
- 35.White PF, Elvir-Lazo L, Cao X, Hernandez H (2017) Effect of high-intensity laser treatments on chronic pain related to osteoarthritis in former professional athletes: a case series. J Mol Biomark Diagn 8:343–346Google Scholar
- 40.White PF, Elvir-Lazo OL, Galeas L, Cao X (2017) Use of electroanalgesia and laser therapies as alternatives to opioids for acute and chronic pain management. Fac Rev 94:577–585Google Scholar