 |
Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2023, vol. 29, issue3
Subject Area: Public Health
-
DOI: 10.5272/jimab.2023293.5079
Published online: 08 September 2023
Original article
J of IMAB. 2023 Jul-Sep;29(3):5079-5084
EFFECTS OF MLS-LASER ON NEUROPATHIC PAIN IN DIABETIC SENSОMOTOR NEUROPATHY
Lili Yosifova1
, Evgenia Vladeva1, Mira Siderova2,
1) Department of Physiotherapy, Rehabilitation and Thalassotherapy, Faculty of Public Health, Medical University – Varna, Bulgaria.
2) Second Department of Internal Medicine, Medical University – Varna, Bulgaria.
ABSTRACT:
About 20-50 % of patients with diabetes and about 60 % of those with diabetic neuropathy develop neuropathic pain, which is characterized by tingling, burning, sharp, shooting, or stabbing sensations, and even electric shock-like sensations. Painful diabetic neuropathy can significantly affect the quality of life of patients with diabetes, the ability to perform daily activities and negatively affect mood. According to the 2021 consensus of an international panel of experts regarding the treatment of painful distal symmetric polyneuropathy, non-pharmacological forms of treatment should also be considered due to unsatisfactory pharmacotherapy. A number of studies have demonstrated the role of photobiomodulation as a non-pharmacological method of treating painful diabetic neuropathy.
The purpose of this placebo-controlled, longitudinal study was to investigate the effect of high-energy MLS-laser therapy on neuropathic pain.
Material and methods: A total of 69 cases of patients with type 2 diabetes and painful diabetic neuropathy of the lower extremities were followed, divided into two groups: an experimental - 41 patients received high-energy laser radiation and a control (placebo) group - 28 patients, with a "mock" laser treatment. For objectification of pain, the Bulgarian version of the short form of the McGill pain questionnaire, version SF-MPQ-2, which includes the visual analog scale (VAS), was used. Comparisons between groups were performed with parametric or non parametric tests depending on the distribution of the variables, the number of the compared groups and the study pre test – post test design.
Results: The pain index, reported by the McGill questionnaire, in the experimental group, decreased by - 63.2 % at the end of the nine-day treatment and by - 56.1 % at the 90th day after the start of treatment compared to the value before therapy. In the control group, there was a minimal change at the end of treatment (day 21), which did not persist until the end of the observation period (day 90).
Conclusions: MLS laser therapy significantly increases the pain threshold and should be considered a safe, non-pharmacological adjunct to standard therapy in patients with painful diabetic peripheral neuropathy.
Keywords: MLS-laser, neuropathic pain, McGill Pain Questionnaire, diabetic neuropathy,
- Download FULL TEXT /PDF 694 KB/
Please cite this article as: Yosifova L, Vladeva E, Siderova M. Effects of MLS-laser on neuropathic pain in diabetic sensîmotor neuropathy. J of IMAB. 2023 Jul-Sep;29(3):5079-5084. [Crossref - 10.5272/jimab.2023293.5079]
Correspondence to: Lili Yosifova, MD, PhD, Department of Physiotherapy, Rehabilitation and Thalassotherapy, Faculty of Public Health, Medical University - Varna; 55, Marin Drinov Str., 9002 Varna, Bulgaria; E-mail: lili.yosifova77@gmail.com
REFERENCES:
1. Rosenberger DC, Blechschmidt V, Timmerman H, Wolff A, Treede RD. Challenges of neuropathic pain: focus on diabetic neuropathy. J Neural Transm (Vienna). 2020 Apr;127(4):589-624. [PubMed ]
2. Schreiber AK, Nones CF, Reis RC, Chichorro JG, Cunha JM. Diabetic neuropathic pain: Physiopathology and treatment. World J Diabetes. 2015 Apr 15;6(3):432-44. [PubMed]
3. Arora S, Pomposelli F, LoGerfo FW, Veves A. Cutaneous microcirculation in the neuropathic diabetic foot improves significantly but not completely after successful lower extremity revascularization. J Vasc Surg. 2002 Mar;35(3):501-5. [PubMed]
4. Sorensen L, Molyneaux L, Yue DK. The relationship among pain, sensory loss, and small nerve fibers in diabetes. Diabetes Care. 2006 Apr;29(4):883-7. [PubMed]
5. Gore M, Brandenburg NA, Dukes E, Hoffman DL, Tai KS, Stacey B. Pain severity in diabetic peripheral neuropathy is associated with patient functioning, symptom levels of anxiety and depression, and sleep. J Pain Symptom Manage. 2005 Oct;30(4):374-85. [PubMed]
6. Ziegler D, Tesfaye S, Spallone V, Gurieva I, Al Kaabi J, Mankovsky B, et al. Screening, diagnosis and management of diabetic sensorimotor polyneuropathy in clinical practice: International expert consensus recommendations. Diabetes Res Clin Pract. 2022 Apr;186:109063. [PubMed]
7. Georgiev G. [Morphological basis of laser therapy.] Elestra, Sofia. 2018. 118-120 p. [in Bulgarian]
8. Carmeliet P. Blood vessels and nerves: common signals, pathways and diseases. Nat Rev Genet. 2003 Sep;4(9):710-20. [PubMed]
9. Dworkin RH, Turk DC, Revicki DA, Harding G, Coyne KS, Peirce-Sander S, et al. Development and initial validation of an expanded and revised version of the Short-form McGill Pain Questionnaire (SF-MPQ-2). Pain. 2009 Jul:144(1-2):35-42. [PubMed]
10. Cg SK, Maiya AG, Hande HM, Vidyasagar S, Rao K, Rajagopal KV. Efficacy of low level laser therapy on painful diabetic peripheral neuropathy. Laser Ther. 2015 Oct 2;24(3):195-200. [PubMed]
11. Chatterjee P, Srivastava AK, Kumar DA, Chakrawarty A, Khan MA, Ambashtha AK, et al. Effect of deep tissue laser therapy treatment on peripheral neuropathic pain in older adults with type 2 diabetes: a pilot randomized clinical trial. BMC Geriatr. 2019 Aug 12;19(1):218. [PubMed]
12. Micheli L, Di Cesare Mannelli L, Lucarini E, Cialdai F, Vignali L, Ghelardini C, et al. Photobiomodulation therapy by NIR laser in persistent pain: an analytical study in the rat. Lasers Med Sci. 2017 Nov;32(8):1835-1846. [PubMed]
13. Yamany АА, Sayed HM. Effect of low level laser therapy on neurovascular function of diabetic peripheral neuropathy. J Adv Res. 2012 Jan;3(1):21-28. [Internet]
Received: 22 February 2023
Published online: 08 September 2023