High level laser therapy for the treatment of lower back pain: clinical efficacy and comparison of different wavelengths.

High energy laser therapy (HELT) could be a new alternative treatment for lower back pain (LBP), which is a significant public health problem. Nevertheless, differences between the various light waves of HELT have not yet been fully researched. Sixty-six patients with lower back pain were treated using a high energy laser therapy. They were randomized into three different protocols which differed according to wave length (650 nm, 810 nm and TRIAX, which is simultaneous emission of 810 nm, 980 nm e 1064 nm). The other parameters remained constant (5 W and 50 J/cm2 for ten daily sessions). The visual analogue scale (VAS), the Roland Scale, and the Oswestry Score were measured before treatment (T0), and at end of the treatment session (T1) and 1 month (T1), 2 months (T2) and 4 months of follow-up (T4). In each group we verified a statistically significant improvement over time and that there was a relationship between the time and treatment (p less than 0.01). At T1 for all wavelengths we found a statistically significant improvement of three scores (p less than 0.01), which was maintained up to T4. The group treated with 810 nm HELT, showed a better remission of pain on the VAS scale, and disability on the Oswestry Scale at T4 (p=0.01). Comparing T0-T1 the variation in the Roland Score was significant in the patients treated with 810 nm (p less than 0.01). All the wavelengths analyzed proved to be efficacious for LBP. The greater efficacy of 810 nm in promoting nerve regeneration and in modulating the nociception transmission could explain the better outcomes.