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Low-level laser therapy to treat fibromyalgia

Abstract

Several clinical treatments have been proposed to manage symptoms of fibromyalgia. Low-level laser therapy (LLLT) may be a useful tool to treat this dysfunction. The aim of this study was to evaluate the effects of LLLT in patients with fibromyalgia. A placebo-controlled, randomized clinical trial was carried out with 20 patients divided randomly into either an LLLT group (n = 10) or a placebo group (n = 10). The LLLT group was treated with a GaAlAs laser (670 nm, 4 J/cm2 on 18 tender points) three times a week over 4 weeks. Before and after treatment, patients were evaluated with the Fibromyalgia Impact Questionnaire (FIQ), McGill Pain Questionnaire, and visual analog scale (VAS). Data from the FIQ and McGill questionnaire for the treated and control groups were analyzed by paired t tests, and Wilcoxon tests were used to analyze data from the VAS. After LLLT or sham treatment, the number of tender points was significantly reduced in both groups (LLLT, p < 0.0001; placebo, p = 0.0001). However, all other fibromyalgia symptoms showed significant improvements after LLLT compared to placebo (FIQ, p = 0.0003; McGill, p = 0.0078; and VAS, p = 0.0020). LLLT provided relief from fibromyalgia symptoms in patients and should be further investigated as a therapeutic tool for management in fibromyalgia.

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References

  1. 1.

    Wolfe F, Ross K, Anderson J, Russel IJ, Hebert L (1995) The prevalence and characteristics of fibromyalgia in the general population. Arthritis Rheum 38(1):19–28. doi:10.1002/art.1780380104

    PubMed  Article  CAS  Google Scholar 

  2. 2.

    Provenza JR, Pollak DF, Martinez JE, Paiva ES, Helfenstein M, Heymann R, Matos JMC, Souza EJR (2004) Fibromialgia. Rev Bras Reumatol 44(6):443–449. doi:10.1590/S0482-50042004000600008

    Article  Google Scholar 

  3. 3.

    Haun MVA, Ferraz MB, Pollack DF (1999) Validation of the American College of Rheumatology 1990 criteria for the classification of fibromyalgia in a Brazilian population. Rev Bras Reumatol 39(4):221–230. doi:10.1590/S0482-50042006000100006

    Google Scholar 

  4. 4.

    Fan PT, Blantom ME (1992) Clinical features and diagnosis of fibromyalgia. J Musculoskelet Med 9(4):24–42

    Google Scholar 

  5. 5.

    Häuser W, Thieme K, Turk DC (2010) Guidelines on the management of fibromyalgia syndrome—a systematic review. Eur J Pain 14(1):5–10. doi:10.1016/j.ejpain.2009.01.006

    PubMed  Article  Google Scholar 

  6. 6.

    Goldenberg DL, Burckhardt C, Crofford L (2004) Management of fibromyalgia syndrome. JAMA 292(19):2388–2395. doi:10.1001/jama.292.19.2388

    PubMed  Article  CAS  Google Scholar 

  7. 7.

    Gür A, Karakoc M, Nas K, Cevik R, Sarac AJ, Ataoglu S (2002) Effects of low power laser and low dose amitriptyline therapy on clinical symptoms and quality of life in fibromyalgia: a single-blind, placebo-controlled trial. Rheumatol Int 22(5):188–193. doi:10.1007/s00296-002-0221-z

    PubMed  Article  Google Scholar 

  8. 8.

    Vitorino DFM, Martins FLM, Souza AC, Galdino D, Prado GF (2004) Using SF-36 in clinical trials of fibromyalgia patients: determining minimal criterios for clinical improvement. Rev Neurociências 12(3):147–151

    Article  Google Scholar 

  9. 9.

    Souza LPM, Forgione MCR, Alves VLR (2000) The relaxation techniques in psychotherapy for patients with chronic pain: a proposal. Acta Fisiatr 7(2):56–60

    Google Scholar 

  10. 10.

    Gür A, Karakoç M, Nas K, Cevik R, Nas K, Sarac AJ, Demir E (2002) Efficacy of low power laser therapy in fibromyalgia: a single-blind, placebo-controlled trial. Lasers Med Sci 17(1):57–61. doi:10.1007/s101030200010

    PubMed  Article  Google Scholar 

  11. 11.

    Gür A (2006) Physical therapy modalities in management of fibromyalgia. Curr Pharm Des 12(1):29–35

    PubMed  Article  Google Scholar 

  12. 12.

    Longo L, Simunovic Z, Postiglione M, Postiglione M (1997) Laser therapy for fibromyositic rheumatisms. J Clin Laser Med Surg 15(5):217–220

    PubMed  CAS  Google Scholar 

  13. 13.

    Marques AP, Matsutani LA, Ferreira EAG, Mendonça LLF (2002) Physical therapy in the treatment of patients with fibromyalgia: a literature review. Rev Bras Reumatol 42(1):42–48

    Google Scholar 

  14. 14.

    Schochat T, Raspe H (2003) Elements of fibromyalgia in an open population. Rheumatology 42(7):829–835. doi:10.1093/rheumatology/keg199

    PubMed  Article  CAS  Google Scholar 

  15. 15.

    Sprott H (2003) What can rehabilitation interventions achieve in patients with primary fibromyalgia? Curr Opin Rheumatol 15(2):145–150

    PubMed  Article  Google Scholar 

  16. 16.

    Thorsen H, Gam AN, Jensen H, Højmark L, Wahlstrøm L (1991) Low energy laser treatment-effect in localized fibromyalgia in the neck and shoulder regions. Ugeskr Laeger 153(25):1801–1804

    PubMed  CAS  Google Scholar 

  17. 17.

    Ricci NA, Dias CN, Driusso P (2010) The use of electrothermal and phototherapeutic methods for the treatment of fibromyalgia syndrome: a systematic review. Rev Bras Fisioter 14(1):1–9. doi:10.1590/S1413-35552010000100002

    PubMed  Article  Google Scholar 

  18. 18.

    Matsutani LA, Marques AP, Ferreira EA, Assumpção A, Lage LV, Casarotto RA, Pereira CAB (2007) Effectiveness of muscle stretching exercises with and without laser therapy at tender points for patients with fibromyalgia. Clin Exp Rheumatol 25(3):410–415

    PubMed  CAS  Google Scholar 

  19. 19.

    Armagan O, Tascioglu F, Ekim A, Oner C (2006) Long-term efficacy of low level laser therapy in women with fibromyalgia: a placebo-controlled study. J Back Musculoskelet Rehabil 19:135–140

    Google Scholar 

  20. 20.

    Laakso EL (1994) Plasma ACTH and B-endorphin levels in response to low level laser therapy (LLLT) for myofascial trigger points. Laser Therapy 6:133–142. doi:10.5978/islsm.94-OR-07

    Article  Google Scholar 

  21. 21.

    Allen RJ (2006) Physical agents used in the management of chronic pain by physical therapists. Phys Med Rehabil Clin N Am 17:315–345

    PubMed  Article  Google Scholar 

  22. 22.

    Panton L, Simonavice E, Williams K, Mojock C, Kim JS, Kingsley JD, McMillan V, Mathis R (2012) Effects of Class IV laser therapy on fibromyalgia impact and function in women with fibromyalgia. J Altern Complement Med. doi:10.1089/acm.2011.0398

    PubMed  Google Scholar 

  23. 23.

    de Carvalho PT, Leal-Junior EC, Alves AC, Rambo CS, Sampaio LM, Oliveira CS, Albertini R, de Oliveira LV (2012) Effect of low-level laser therapy on pain, quality of life and sleep in patients with fibromyalgia: study protocol for a double-blinded randomized controlled trial. Trials 13:221. doi:10.1186/1745-6215-13-221

    Article  PubMed Central  Google Scholar 

  24. 24.

    Fernández García R, Suárez Holgado JD, Formieles Ortiz I, Zurita Ortega F, Valverde Cepeda M, Fernández Sánchez M (2011) Using a laser based program in patients diagnosed with fibromyalgia. Reumatol Clin 7(2):94–97. doi:10.1016/j.reuma.2010.01.007

    PubMed  Article  Google Scholar 

  25. 25.

    Crofford LJ, Clauw DJ (2002) Fibromyalgia: where are we a decade after the American College of Rheumatology classification criteria were developed? Arthritis Rheum 46(5):1136–1138. doi:10.1002/art.10217

    PubMed  Article  Google Scholar 

  26. 26.

    Wolfe F, Smythe HA, Yunus MB, Bennet RM, Bombardier C, Goldenberg DL, Tugwell P, Campbell SM, Abeles M, Clark P et al (1990) The American College of Rheumatology 1990 criteria for the classification of fibromyalgia: report of the multicentre criteria committee. Arthritis Rheum 33(2):160–172

    PubMed  Article  CAS  Google Scholar 

  27. 27.

    Esper MAL, Nicolau RA, Arisawa EA (2011) The effect of two phototherapy protocols on pain control in orthodontic procedure—a preliminary clinical study. Lasers Med Sci 26(5):657–663. doi:10.1007/s10103-011-0938-6

    PubMed  Article  Google Scholar 

  28. 28.

    Burckhardt CS, Clark SR, Bennett RM (1991) The Fibromyalgia Impact Questionnaire: development and validation. J Rheumatol 18(5):728–733

    PubMed  CAS  Google Scholar 

  29. 29.

    Marques AP, Santos AMB, Assumpção A, Matsutani LA, Lage LV, Pereira CAB (2006) Validation of the Brazilian version of the Fibromyalgia Impact Questionnaire (FIQ). Rev Bras Reumatol 46(1):24–31. doi:10.1590/S0482-50042006000100006

    Article  Google Scholar 

  30. 30.

    Teixeira MJ, Pimenta CAM (1996) Questionário de dor McGill: proposta de adaptação para a língua portuguesa. Rev Esc Enf USP 30(3):473–483

    Google Scholar 

  31. 31.

    Piva JAAC, Abreu EMC, SILVA VS, Nicolau RA (2011) Effect of low-level laser therapy on the initial stages of tissue repair: basic principles. An Bras Dermatol 86(5):947–954. doi:10.1590/S0365-05962011000500013

    PubMed  Article  Google Scholar 

  32. 32.

    Lins RDAU, Dantas EM, Lucena KCR, Catão MHCV, Granville-Garcia AF, Carvalho Neto LG (2010) Biostimulation effects of low-power laser in the repair process. An Bras Dermatol 85(6):849–855. doi:10.1590/S0365-05962010000600011

    PubMed  Article  Google Scholar 

  33. 33.

    Ortiz MC, Carrinho PM, Santos AAS, Gonçalves RC, Parizzoto NA (2001) Laser de baixa intensidade: princípios e generalidades – parte 1. Fisioter Bras 2(4):221–240

    Google Scholar 

  34. 34.

    Kelencz CA, Muñoz IS, Amorim CF, Nicolau RA (2010) Effect of low-power gallium-aluminum-arsenium noncoherent light (640 nm) on muscle activity: a clinical study. Photomed Laser Surg 28(5):647–652. doi:10.1089/pho.2008.2467

    PubMed  Article  CAS  Google Scholar 

  35. 35.

    Schimitt I, Raiser AG, Graça DL, Castagna CD, Gehver C, Maiorka P (1993) The effects of laser therapy AsGa on canine tendon healing. Braz J Vet Res Anim Sci 30(2):145–149

    Google Scholar 

  36. 36.

    Souza TO, Mesquita DA, Ferrari RA, Dos Santos PD, Jr CL, Bussadori SK, Fernandes KP, Martins MD (2011) Phototherapy with low-level laser affects the remodeling of types I and III collagen in skeletal muscle repair. Lasers Med Sci 26(6):803–814. doi:10.1007/s10103-011-0951-9

    PubMed  Article  Google Scholar 

  37. 37.

    Tatarunas AC, Matera JMD, Dagli MLZ (1998) Clinical and anatomopathological study of cutaneous healing in domestic cat: use of low-power GAAS laser (904 nm). Acta Cir Bras 13(2). doi: 10.1590/S0102-86501998000200004

  38. 38.

    Mester E, Mester AF, Mester A (1985) The biomedical effects of laser application. Lasers Surg Med 5(1):31–39. doi:10.1002/lsm.1900050105

    PubMed  Article  CAS  Google Scholar 

  39. 39.

    Gronemann ST, Ribel-Madsen S, Bartels EM, Danneskiold-Samsøe B, Bliddal H (2004) Collagen and muscle pathology in fibromyalgia. Rheumatology 43(1):27–31. doi:10.1093/rheumatology/keg452

    PubMed  Article  CAS  Google Scholar 

  40. 40.

    Warhol MJ, Siegel AJ, Evans WJ, Silverman LM (1985) Skeletal muscle injury and repair in marathon runners after competition. American J Pathol 118(2):331–339

    CAS  Google Scholar 

  41. 41.

    Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Katz RS, Mease P, Russell AS, Russell IJ, Winfield JB, Yunus MB (2010) The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res 62(5):600–610. doi:10.1002/acr.20140

    Article  Google Scholar 

  42. 42.

    Fitzcharles MA, Boulos P (2003) Inaccuracy in the diagnosis of fibromyalgia syndrome: analysis of referrals. Rheumatology 42(2):263–267. doi:10.1093/rheumatology/keg075

    PubMed  Article  Google Scholar 

  43. 43.

    Marques AP, Rhoden L, Siqueira JO, João SMA (2001) Pain evaluation of patients with fibromyalgia, osteoarthritis, and low back pain. Rev Hosp Clin 56(1):5–10. doi:10.1590/S0041-87812001000100002

    Article  CAS  Google Scholar 

  44. 44.

    Dourado E, Fernandes TCA, Meireles JSS, Monteiro IS (2004) Dor e efeito placebo. Rev Cir Traumatol Buco-maxilo-fac 4(3):197–203

    Google Scholar 

  45. 45.

    Caballero-Uribe CV, Abuchaibe I (1997) Treatment of tender points in patients with fibromyalgia syndrome (FMS) with therapeutic infrared laser ray. Arthritis Rheum 40:S44

    Google Scholar 

  46. 46.

    Fulop AM, Dhimmer S, Deluca JR, Johanson DD, Lenz RV, Patel KB, Douris PC, Enwemeka CS (2010) A meta-analysis of the efficacy of laser phototherapy on pain relief. Clin J Pain 26(8):729–736. doi:10.1097/AJP.0b013e3181f09713

    PubMed  Google Scholar 

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Ruaro, J.A., Fréz, A.R., Ruaro, M.B. et al. Low-level laser therapy to treat fibromyalgia. Lasers Med Sci 29, 1815–1819 (2014). https://doi.org/10.1007/s10103-014-1566-8

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Keywords

  • Fibromyalgia
  • Low-level laser therapy
  • Physical therapy modalities