Treatment of neuropathic pain in leprosy patients with a physiotherapeutic protocol combined with photobiomodulation

Abstract

Purpose: Leprosy, when diagnosed late, often leads to persistent complications, including neuropathic pain due to Mycobacterium leprae infection. This study aimed to apply a physiotherapeutic protocol combined with photobiomodulation as a non-pharmacological resource to reduce neuropathic pain and maintain functional capacity in leprosy patients. Methods: A single-blind randomized clinical trial was conducted with 30 leprosy patients. Patients were randomly divided into two groups: physiotherapeutic protocol (PPG) and physiotherapeutic protocol combined with photobiomodulation (PPBMG). They were analyzed for pain scale (VAS), screening of activity limitation and safety awareness (SALSA), participation scale, and quality of life survey (SF-36). Results: In the SALSA, a reduction in the number of patients with very severe limitation was observed in the PPBMG (effect size, 0.24). In participation scale, there was an increase in the number of patients without restrictions in the PPBMG. Regarding VAS, there was improvement in both groups (PPG, P=0.0061; PPBMG, P=0.041), with no difference between them. In relation to neurological evaluation by nerve palpation, there was improvement in the ulnar nerve condition (P=0.0244) in the PPG group, and in the fibular nerve (P=0.0425) in the PPBMG group. In the functional assessment, PPBMG patients showed statistical differences with improvement in the median (P=0.0281) and tibial (P=0.0267) nerves. In the SF-36, there was an increase in the domains of physical limitations (PPG, P=0.0273; and PPBMG, P=0.0078) and pain (PPG, P=0.0156; and PPBMG, P=0.0020; effect size, 0.34). Conclusion: This study provides highly relevant evidence for the efficacy of PPBMG in treating neuropathic pain in leprosy patients.