Effect of electromagnetic therapy versus low-level laser therapy on diabetic patients with trigeminal neuralgia: a randomized control trial

Abstract

BACKGROUND Trigeminal neuralgia (TN) is defined as intense, abrupt, often unilateral, stabbing, short, repeated episodes of pain in one or more distributional branches of the trigeminal nerve. AIM To see how electromagnetic therapy (EMT) compared to low-level laser therapy (LLLT) affect TN in diabetes patients. DESIGN This is a randomized controlled trial. SETTING Physical therapy and Neurology Outpatients Clinics at Faculty of Physical Therapy. POPULATION One hundred and forty diabetic patients with TN were evaluated for eligibility. As a result, 126 diabetic patients with TN were included in this trial. They were randomly divided into three equal-sized groups using random allocation software. Due to travel to another country, two patients did not complete the treatment protocol, and four opted out of the post-therapy evaluation. So, 120 volunteer diabetic patients with TN of both sexes were diagnosed for the participation in this study by a neurologist (N.=40 in each group). METHODS For two months, participants in the control group A received the medication only (oral hypoglycemic drugs, Analgesics, vitamin B12), participants in the study group B received the medications as in group A in addition to LLLT, and participants in the study group C received medication as in group A in addition to electromagnetic therapy (EMT). The primary outcome was the amplitude of compound muscle action potentials of temporalis and masseter muscles by using NEXUS 10 (Mind media). The secondary outcome was pain intensity by using the Visual Analog Scale (VAS). RESULTS According to the results of this study, there is a statistically significant difference in visual analog scale scores and the amplitude of compound muscle action potentials of the temporalis and masseter muscles among groups in favor of group B. CONCLUSIONS After treatment, all groups improved significantly, with the laser group outperforming the electromagnetic group by a large margin. For irradiation, LLLT was more effective than EMT in reducing diabetic patients’ trigeminal pain, and increasing masseter and temporalis muscles compound action potential amplitude in diabetic patients with TN. CLINICAL REHABILITATION IMPACT LLLT was more effective than EMT at reducing diabetic patient’s trigeminal pain, and increasing masseter and temporalis muscles compound action potential amplitude in diabetic patients with TN patients after two months of interventions.

Peripheral magnetic stimulation for chronic peripheral neuropathic pain: A systematic review and meta‐analysis

“…After reviewing and resolving any conflicts in screening, a total of 23 studies fulfilled the eligibility criteria and were included in the review. Of the included studies, 15 were randomized controlled trials, 14,21–34 5 were case series, 35–37 2 were case reports, 38,39 and 1 was a non‐randomized trial 40 …”

“…For the 15 randomized controlled trials, risk of bias assessments is provided in Table S2. Seven of the included studies had at least one domain deemed to be at high risk of bias 21–24,27,30,33 . The domain most often reported to be at high risk of bias was blinding of participants, which occurred in trials that did not utilize a sham or placebo device, thereby resulting in an open trial for participants.…”

“…Studies were published across several countries (according to location of primary author) including Azerbaijan ( n = 1), 37 Canada ( n = 2), 35,38 Egypt ( n = 4), 21,29,31,32 Germany ( n = 1), 22 India ( n = 1), 30 Italy ( n = 2), 39,41 Japan ( n = 1), 42 Poland ( n = 2), 26,27 Romania ( n = 1), 23 Russia ( n = 1), 40 Thailand ( n = 1), 33 Turkey ( n = 1), 28 and United States ( n = 5) 14,24,25,34,36 …”

“…The type of neuropathic condition, study design, treatment groups, trial size, intervention characteristics, and duration of interventions are reported in Table 1. PMS was evaluated across several neuropathic pain disorders: carpal tunnel syndrome ( n = 3), 24,27,33 chemotherapy‐induced polyneuropathy ( n = 1), 22 complex regional pain syndrome ( n = 3), 28,35,39 diabetic peripheral neuropathy ( n = 5), 25,26,30,34,37 glossopharyngeal neuralgia ( n = 1), 38 lumbar radiculopathy ( n = 2), 23,32 orofacial pain ( n = 1), 41 phantom limb pain ( n = 1), 14 post‐herpetic neuralgia ( n = 1), 29 post‐traumatic neuroma/nerve entrapment ( n = 1), 36 pudendal neuralgia ( n = 1), 42 traumatic brachial plexopathy ( n = 1), 31 and trigeminal neuropathy ( n = 2) 21,40 . Nine studies compared PMS to a sham device, while the other studies compared a number of different controls (physiotherapy, 23 physiotherapy and vitamins, 33 transcutaneous electrical nerve stimulation, 29 laser therapy 21,27 ), or no additional treatment above the standard of care 30,40 …”

“…Included studies used varying types of PMS devices including round coils, 21,28,42 figure‐of‐eight coils, 31,35,36,38 racetrack coils, 23,33 diamagnetic pumps, 39 wearable devices, 24,41 and magnetic mattresses 26,27 . The range of magnetic field intensities ranged from 0.1 to 1500 mT, with variable frequencies ranging from 1 Hz to 1 MHz (median 20 Hz [IQR 70 Hz]).…”