Photobiomodulation for modulation of neuropathic pain and improvement of scar tissue

Abstract

Background This case-report explores the effects of photobiomodulation therapy (PBMT) on the healing of scar tissue. The patient was a 32-year old female two years post cholecystectomy resulting in a 15 cm linear scar that was causing severe pain. Methods Treatment was initiated using the BIOFLEX® therapist device which consists of LED arrays and laser probes of a specific wavelength, power and frequency applied directly on the skin overlying the scar. The frequency and duration of treatment was every other day for six weeks in a clinic setting, followed by three times a week for two months at home. Then the patient continued to use the BIOFLEX® therapist home device on an as-needed basis. Findings The final result of this patient's treatment was significant flattening and decreased redness of her scar. Her self-reported pain decreased to a 6/10. At the one year follow up, the patient reported that she stopped taking her opioids, antidepressant and sleeping pills and that her pain decreased to a 4/10. At the last review her pain score was 1/10; and she had returned to work and took Tylenol (acetaminophen) occasionally for breakthrough pain. Conclusions We attribute the patient's improvement in scar appearance and pain symptoms to PBMT. Since pain is often associated with depressed mood and sleep disturbances, it cannot be determined whether PBMT was the direct or indirect cause of this patient's improved mood. For future studies, we propose the use of control subjects with similar scars treated with sham treatment compared to those who will receive the PBMT and observed for the same duration of time and compare the overall results. Lay Summary Dermatological applications, especially wound healing; are accepted indications for photobiomodulation therapy (PBMT). The expansion into other clinical applications, particularly neurological ones show potential benefit. We present a case of a patient with a hypertrophic scar associated with severe neuropathic pain and concurrent depression, all of which improved directly or indirectly with PBMT. Although the original focus of treatment was dermatological the improvement in pain plus the discontinuation of therapy (opioids, antidepressants and benzodiazepines) were considered to be due to the PBMT.

CO2 Laser for Esthetic Healing of Injuries and Surgical Wounds with Small Parenchymal Defects in Oral Soft Tissues

“…As a result, the downregulation of TGF-b1 by PBMT affects the reduction and inhibition of profibrotic gene synthesis and collagen synthesis. These are likely to indicate the suppression of wound tissue scarring [42,43]. On the other hand, TGF-b1 is a potent regulator of inflammatory responses and is usually upregulated in the early phase of wound healing.…”

Photobiomodulation of Neurogenesis through the Enhancement of Stem Cell and Neural Progenitor Differentiation in the Central and Peripheral Nervous Systems

“…Photobiomodulation (PBM), also known as low-level light therapy, is a non-invasive technique that uses lasers or light-emitting diodes (LEDs) with low-level light in the visible and near-infrared (NIR) spectra to regulate biological processes [17,18]. PBM research is being conducted worldwide and has already been shown to be effective in clinical applications, such as tissue repair or pain relief, and in various medical applications including sports medicine [19][20][21][22][23][24][25]. PBM is thought to enhance cellular metabolism and other processes, eventually leading to increased cell proliferation and differentiation [26].…”