The Effects of Photobiomodulation Therapy on Post-Surgical Pain

Abstract

Introduction: One of the major complains after surgery is pain. Recent advances in the prevention and reduction of postoperative pain have provided several modalities. One of them is the use of laser irradiation on the surgical area. Objectives: To evaluate the effects of low level laser therapy (LLLT) on pain and side effects after surgery. Methods: In this research, databases such as: PubMed, Science Direct, Google Scholar, Springer and Cochrane were used and the words of laser therapy, photobiomodulation, therapeutic laser, low level laser therapy, surgery and pain were searched. Articles, including systematic reviews, original articles, case series, and clinical intervention studies related to these words, were studied. The language of all articles was English and consists of papers from 2009 until 2017. Results: A total of 370 papers were studied and 10 articles that met inclusion criteria were selected for this review. Few of these articles were followed up. Surgery included a wide range of surgeries including mastectomy, breast augment post-fracture, episiotomy, tonsillectomy and hernia. The methodological quality score on the PEDro scale was between 5 and 11. 8 trials reported positive effects and 2 trials reported negative effects. In order to study clinical effect size of laser therapy after surgery, only 4 papers met entry criteria and the mean effect sizes were 0.13 to 2.77. Accordingly, the best treatment protocol included a red laser dose of 4 J/cm2 for the post-operative pain of tonsillectomy, which was irradiated through the infra mandibular angle on the tonsils. Conclusion: LLLT may be an appropriate modality for reducing pain after surgery, nevertheless the effect size of this modality is variable. Therefore, further research based on proper protocols for these patients and follow-up of therapeutic course should be designed and implemented.

The Beneficial Effects of High-Intensity Laser Therapy and Co-Interventions on Musculoskeletal Pain Management: A Systematic Review

“…The full text of 34 remaining articles was screened and 15 articles were excluded [1][2][3]6,7,9,10,[23][24][25][26][27][28][29][30] because: the PEDro score of three studies was 6 2,3,28 . Six articles didn't report pain by VAS; it was not possible to estimate ES in two studies 1,6,7,9,10,23,24,27 ; two studies 29,30 were case reports; and two studies did not have at least one another group for comparison. 25,26 Finally, 19 studies (HILT: 11, +other interventions: 8) were included for qualitative and quantitative assessment.…”

“…1,4,5 Low-power laser (light) therapy (power ≤ 500 mW) can be used to decrease acute and chronic pain, induce recovery of damaged nerves, enhance peripheral circulation and metabolism, and reduce joint inflammation. 2,5,6 The effects of low-power laser therapy are photochemical not thermal. In a recent review, Cotler et al concluded that low-power laser therapy is a new cost-effective therapy for musculoskeletal pain, which improves the quality of life and reduces financial strains.…”

“…5 High-intensity laser therapy (HILT) has been used more recently in the therapeutic protocols of physiotherapy. 1,2,6 The main difference between HILT and low-power laser therapy, is that the more powerful beams (power >500 mW) are irradiated to penetrate deeper, bringing a desired high amount of multi-directional energy to deep tissues in a short time. 2,[6][7][8][9][10] Also, application techniques, the time of treatment and the cost of the device are different between these two generations of the laser therapy.…”

“…1,2,6 The main difference between HILT and low-power laser therapy, is that the more powerful beams (power >500 mW) are irradiated to penetrate deeper, bringing a desired high amount of multi-directional energy to deep tissues in a short time. 2,[6][7][8][9][10] Also, application techniques, the time of treatment and the cost of the device are different between these two generations of the laser therapy. [11][12][13] A recent systematic review indicated that HILT is effective in reducing musculoskeletal pain.…”

Photobiomodulation with cluster does not present superior results to placebo in young people with chronic non-specific lumbar pain

“…Conservative treatment is usually the initial choice, in which physiotherapeutic modalities are included, among them, joint mobilization and manipulation [8,9], fascial manipulation [10], electrotherapy [11], therapeutic ultrasound [12] and photobiomodulation (PBM) [13]. PBM with the low-level laser therapy (LLLT) associated with a light emitting diode (LED) (Cluster) [8] with therapeutic purposes, such as increased RNA, DNA and ATP synthesis, fibroblast cell proliferation rate and collagen synthesis, increased vascularization and variations in nerve conduction [15][16][17]. In isolation, LLLT has been shown to be effective, both in clinical and experimental studies in several conditions helping to control pain, reduce the inflammatory process and speed-up tissue repair [18][19][20][21], but not without controversial outcomes [22].…”