Skip to main content
SpringerLink
Log in

Efficacy of high-intensity laser therapy in the treatment of chronic neck pain: a randomized double-blind placebo-control trial

  • Original Article
  • Published:
Lasers in Medical Science Aims and scope Submit manuscript

Abstract

The aim of the study was to investigate the effect of high-intensity laser therapy (HILT) in treatment of patients with chronic neck pain (CNP) on cervical range of motion (ROM), pain, and functional activity. Sixty male patients participated in this study with mean (SD) age of 35.47 (4.18) years. Patients were randomly assigned into two groups and treated with HILT plus exercise (HILT + EX) and placebo laser plus exercise (PL + EX) in groups 1 and 2, respectively. The outcomes measured were cervical ROM, pain level by visual analog scale (VAS), and functional activity by neck disability index (NDI) score. Statistical analyses were performed to compare the differences between baseline and post-treatment. The level of statistical significance was set as p < 0.05. Cervical ROM significantly increased after 6 weeks of treatment in all groups. VAS and NDI results showed significant decrease post-treatment in both groups. HILT + EX effectively increased cervical ROM and decreased VAS and NDI scores after 6 weeks of treatment compared to PL + EX. HILT + EX is an effective physical therapy modality for patients with CNP compared to PL + EX therapy. The combination of HILT + EX effectively increased cervical ROM, functional activity, and reduced pain after 6 weeks of treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Picavet HS, Schouten JS (2003) Musculoskeletal pain in the Netherlands: prevalences, consequences and risk groups, the DMC(3)-study. Pain 102(1–2):167–78

    Article  CAS  PubMed  Google Scholar 

  2. Cote P, Cassidy JD, Carroll LJ, Kristman V (2004) The annual incidence and course of neck pain in the general population: a population-based cohort study. Pain 112(3):267–73

    Article  PubMed  Google Scholar 

  3. Wood TG, Colloca CJ, Matthews R (2001) A pilot randomized clinical trial on the relative effect of instrumental (MFMA) versus manual (HVLA) manipulation in the treatment of cervical spine dysfunction. J Manipulative Physiol Ther 24(4):260–71

    Article  CAS  PubMed  Google Scholar 

  4. Cherkin DC, Eisenberg D, Sherman KJ, Barlow W, Kaptchuk TJ, Street J et al (2001) Randomized trial comparing traditional Chinese medical acupuncture, therapeutic massage, and self-care education for chronic low back pain. Arch Intern Med 161(8):1081–8

    Article  CAS  PubMed  Google Scholar 

  5. Hoy DG, Protani M, De R, Buchbinder R (2010) The epidemiology of neck pain. Best Pract Res Clin Rheumatol 24(6):783–92

    Article  CAS  PubMed  Google Scholar 

  6. Hill J, Lewis M, Papageorgiou AC, Dziedzic K, Croft P (2004) Predicting persistent neck pain: a 1-year follow-up of a population cohort. Spine (Phila Pa 1976) 29(15):1648–54

    Article  Google Scholar 

  7. Hoving JL, Gross AR, Gasner D, Kay T, Kennedy C, Hondras MA et al (2001) A critical appraisal of review articles on the effectiveness of conservative treatment for neck pain. Spine (Phila Pa 1976) 26(2):196–205

    Article  CAS  Google Scholar 

  8. Webb R, Brammah T, Lunt M, Urwin M, Allison T, Symmons D (2003) Prevalence and predictors of intense, chronic, and disabling neck and back pain in the UK general population. Spine (Phila Pa 1976) 28(11):1195–202

    Google Scholar 

  9. Seo BK, Lee JH, Kim PK, Baek YH, Jo DJ, Lee S. Bee venom acupuncture, NSAIDs or combined treatment for chronic neck pain: study protocol for a randomized, assessor-blind trial. Trials. 15. England2014. p. 132.

  10. Bakar Y, Sertel M, Ozturk A, Yumin ET, Tatarli N, Ankarali H (2014) Short term effects of classic massage compared to connective tissue massage on pressure pain threshold and muscle relaxation response in women with chronic neck pain: a preliminary study. J Manipulative Physiol Ther 37(6):415–21

    Article  PubMed  Google Scholar 

  11. Akhter S, Khan M, Ali SS, Soomro RR (2014) Role of manual therapy with exercise regime versus exercise regime alone in the management of non-specific chronic neck pain. Pak J Pharm Sci 27(6 Suppl):2125–8

    PubMed  Google Scholar 

  12. Chow RT, Heller GZ, Barnsley L. The effect of 300 mW, 830 nm laser on chronic neck pain: a double-blind, randomized, placebo-controlled study. Pain. 124. Netherlands2006. p. 201–10.

  13. Braddom RLCL (2011) Physical medicine and rehabilitation. Saunders/Elsevier, Philadelphia

    Google Scholar 

  14. Ozdemir F, Birtane M, Kokino S (2001) The clinical efficacy of low-power laser therapy on pain and function in cervical osteoarthritis. Clin Rheumatol 20(3):181–4

    Article  CAS  PubMed  Google Scholar 

  15. Gur A, Karakoc M, Nas K, Cevik R, Sarac J, Demir E (2002) Efficacy of low power laser therapy in fibromyalgia: a single-blind, placebo-controlled trial. Lasers Med Sci 17(1):57–61

    Article  CAS  PubMed  Google Scholar 

  16. Peplow PV, Chung T, Baxter GD (2010) Application of low level laser technologies for pain relief and wound healing: overview of scientific bases. Phys Ther Rev 15(4):253–85

    Article  Google Scholar 

  17. Hagiwara S, Iwasaka H, Hasegawa A, Noguchi T (2008) Pre-Irradiation of blood by gallium aluminum arsenide (830 nm) low-level laser enhances peripheral endogenous opioid analgesia in rats. Anesth Analg 107(3):1058–63

    Article  CAS  PubMed  Google Scholar 

  18. Alayat MS, Atya AM, Ali MM, Shosha TM (2014) Long-term effect of high-intensity laser therapy in the treatment of patients with chronic low back pain: a randomized blinded placebo-controlled trial. Lasers Med Sci 29(3):1065–73

  19. Santamato A, Solfrizzi V, Panza F, Tondi G, Frisardi V, Leggin BG et al (2009) Short-term effects of high-intensity laser therapy versus ultrasound therapy in the treatment of people with subacromial impingement syndrome: a randomized clinical trial. Phys Ther 89(7):643–52

    Article  PubMed  Google Scholar 

  20. Kheshie AR, Alayat MS, Ali MM (2014) High-intensity versus low-level laser therapy in the treatment of patients with knee osteoarthritis: a randomized controlled trial. Lasers Med Sci 29(4):1371–6

  21. Dundar U, Evcik D, Samli F, Pusak H, Kavuncu V (2007) The effect of gallium arsenide aluminum laser therapy in the management of cervical myofascial pain syndrome: a double blind, placebo-controlled study. Clin Rheumatol 26(6):930–4

    Article  CAS  PubMed  Google Scholar 

  22. Tousignant M, Duclos E, Lafleche S, Mayer A, Tousignant-Laflamme Y, Brosseau L et al (2002) Validity study for the cervical range of motion device used for lateral flexion in patients with neck pain. Spine (Phila Pa 1976) 27(8):812–7

    Article  Google Scholar 

  23. Tousignant M, Smeesters C, Breton AM, Breton E, Corriveau H (2006) Criterion validity study of the cervical range of motion (CROM) device for rotational range of motion on healthy adults. J Orthop Sports Phys Ther 36(4):242–8

    Article  PubMed  Google Scholar 

  24. Wewers ME, Lowe NK (1990) A critical review of visual analogue scales in the measurement of clinical phenomena. Res Nurs Health 13(4):227–36

    Article  CAS  PubMed  Google Scholar 

  25. Shaheen AA, Omar MT, Vernon H (2013) Cross-cultural adaptation, reliability, and validity of the Arabic version of neck disability index in patients with neck pain. Spine (Phila Pa 1976) 38(10):E609–15

    Article  Google Scholar 

  26. Yao M, Sun YL, Cao ZY, Dun RL, Yang L, Zhang BM, et al. A Systematic Review of Cross-cultural Adaptation of the Neck Disability Index. Spine (Phila Pa 1976). 2015.

  27. Exelby L (1995) Mobilisations with Movement:A Personal View. PHYST Physiother 81(12):724–9

    Article  Google Scholar 

  28. Mulligan BR (2010) Manual therapy : NAGS, SNAGS, MWMS etc. Wellington, N.Z.: Plane View Services Ltd.

  29. Jull GA, Falla D, Vicenzino B, Hodges PW (2009) The effect of therapeutic exercise on activation of the deep cervical flexor muscles in people with chronic neck pain. Man Ther. 14. Scotland, p 696–701

  30. Bot SD, Bouter LM (2006) The efficacy of low level laser therapy for chronic neck pain. Pain. 124. Netherlands, p 5–6

  31. Chow RT, Johnson MI, Lopes-Martins RA, Bjordal JM (2009) Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials. Lancet 374(9705):1897–908

  32. Maeda T (1989) Morphological demonstration of low reactive laser therapeutic pain attenuation effect of the gallium aluminium arsenide diode laser. Laser Ther 1(1):23–6

    Article  Google Scholar 

  33. King CE, Clelland JA, Knowles CJ, Jackson JR (1990) Effect of helium-neon laser auriculotherapy on experimental pain threshold. Phys Ther 70(1):24–30

    CAS  PubMed  Google Scholar 

  34. Hsieh YL, Hong CZ, Chou LW, Yang SA, Yang CC (2015) Fluence-dependent effects of low-level laser therapy in myofascial trigger spots on modulation of biochemicals associated with pain in a rabbit model. Lasers Med Sci 30(1):209–16

    Article  PubMed  Google Scholar 

  35. Chow R, Armati P, Laakso EL, Bjordal JM, Baxter GD (2011) Inhibitory effects of laser irradiation on peripheral mammalian nerves and relevance to analgesic effects: a systematic review. Photomed Laser Surg 29(6):365–81

    Article  PubMed  Google Scholar 

  36. Moriyama Y, Nguyen J, Akens M, Moriyama EH, Lilge L (2009) In vivo effects of low level laser therapy on inducible nitric oxide synthase. Lasers Surg Med 41(3):227–31

    Article  PubMed  Google Scholar 

  37. Tam G (1999) Low power laser therapy and analgesic action. J Clin Laser Med Surg 17(1):29–33

    CAS  PubMed  Google Scholar 

  38. Stadler I, Lanzafame RJ, Oskoui P, Zhang RY, Coleman J, Whittaker M (2004) Alteration of skin temperature during low-level laser irradiation at 830 nm in a mouse model. Photomed Laser Surg 22(3):227–31

    Article  PubMed  Google Scholar 

  39. Gross AR, Dziengo S, Boers O, Goldsmith CH, Graham N, Lilge L, et al. (2013) Low Level Laser Therapy (LLLT) for Neck Pain: A Systematic Review and Meta-Regression. Open Orthop J 7:396–419

  40. Zati A, Valent A (2008) Laser therapy in medicine. Torino, Italy, Edizioni Minerva Medica, p 20–30

    Google Scholar 

  41. Dundar U, Turkmen U, Toktas H, Ulasli AM, Solak O (2015) Effectiveness of high-intensity laser therapy and splinting in lateral epicondylitis; a prospective, randomized, controlled study. Lasers Med Sci 30(3):1097–107

    Article  PubMed  Google Scholar 

  42. Alayat MS, Elsodany AM, El Fiky AA (2014) Efficacy of high and low level laser therapy in the treatment of Bell's palsy: a randomized double blind placebo-controlled trial. Lasers Med Sci 29(1):335–42

    Article  PubMed  Google Scholar 

  43. Dundar U, Turkmen U, Toktas H, Solak O, Ulasli AM (2015) Effect of high-intensity laser therapy in the management of myofascial pain syndrome of the trapezius: a double-blind, placebo-controlled study. Lasers Med Sci 30(1):325–32

    Article  PubMed  Google Scholar 

  44. Sarig-Bahat H (2003) Evidence for exercise therapy in mechanical neck disorders. Man Ther 8(1):10–20

    Article  CAS  PubMed  Google Scholar 

  45. Bronfort G, Evans R, Nelson B, Aker PD, Goldsmith CH, Vernon H (2001) A randomized clinical trial of exercise and spinal manipulation for patients with chronic neck pain. Spine (Phila Pa 1976) 26(7):788–97, discussion 98–9

    Article  CAS  Google Scholar 

  46. Falla D, O'Leary S, Farina D, Jull G (2012) The change in deep cervical flexor activity after training is associated with the degree of pain reduction in patients with chronic neck pain. Clin J Pain 28(7):628–34

    Article  PubMed  Google Scholar 

  47. Schomacher J, Falla D (2013) Function and structure of the deep cervical extensor muscles in patients with neck pain. Man Ther 18(5):360–6

    Article  PubMed  Google Scholar 

  48. Schomacher J, Petzke F, Falla D (2012) Localised resistance selectively activates the semispinalis cervicis muscle in patients with neck pain. Man Ther 17(6):544–8

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors would like to thank Institute of Scientific Research and Revival of Islamic Heritage at Umm Al-Qura University (project # 43309002) for the financial support. The authors express their appreciation to all subjects who participated in this study with all content and cooperation, and give special thanks to their colleagues at the Department of Physical Therapy, Faculty of Applied Medical Science, Umm AL-Qura University, Saudi Arabia.

Author information

Authors and Affiliations

  1. Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm Al-Qura University, Mecca, Saudi Arabia

    Mohamed Salaheldien Mohamed Alayat, Ashraf Abdelaal Mohamed & Omar Farouk Helal

  2. Department of Rehabilitation science, Faculty of Applied Medical Sciences, Tibah University, Medina, Saudi Arabia

    Osama Ahmed Khaled

Authors
  1. Mohamed Salaheldien Mohamed Alayat
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ashraf Abdelaal Mohamed
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Omar Farouk Helal
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Osama Ahmed Khaled
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mohamed Salaheldien Mohamed Alayat.

Ethics declarations

Conflicts of interest

None.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Alayat, M.S.M., Mohamed, A.A., Helal, O.F. et al. Efficacy of high-intensity laser therapy in the treatment of chronic neck pain: a randomized double-blind placebo-control trial. Lasers Med Sci 31, 687–694 (2016). https://doi.org/10.1007/s10103-016-1910-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10103-016-1910-2

Keywords

Search

Navigation