Department of Anesthesiology, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, CA, USA.
The White Mountain Institute, The Sea Ranch, Box 548, Gualala, CA, USA.
Rheumatol Int. 2018 Mar;38(3):517-523. doi: 10.1007/s00296-017-3856-5. Epub 2017 Oct 28.
Fibromyalgia is a chronic musculoskeletal condition characterized by widespread pain in the body and is associated with tender points at the shoulder, back and hip regions. A wide variety of pharmacologic drugs and dietary supplements have been used with limited success in treating the musculoskeletal pain. Early clinical studies with low level laser therapy (LLLT) alone or in combination with drugs commonly used to treat fibromyalgia suggested that LLLT may be effective in reducing musculoskeletal pain and stiffness, as well as the number of tender locations. However, a sham-controlled study reported that LLLT was not significantly better than the sham treatment and kinesiotape. Preliminary studies with high-intensity laser therapy (HILT) suggest that it may be more effective than LLLT for treating chronic pain syndromes. Therefore, we evaluated low (1 W), intermediate (42 W) and high level (75 W) HILT in a woman with long-standing fibromyalgia syndrome which was resistant to both standard pharmacotherapy and treatment in an interdisciplinary pain management program. The patient received a series of treatments with a HILT device (Phoenix Thera-lase) at a wavelength of 1275 nm administered at both the paraspinous region and tender points in the shoulder and hip regions. Although the 1 W treatment produced minimal symptom relief, both the 42 and the 75 W treatments produced a dramatic reduction in her overall pain, improved quality of sleep, and increased her level of physical activity for 4-10 days after these treatment sessions. This case illustrates the potential beneficial effects of using higher power levels of HILT for patients with fibromyalgia syndrome who have failed to respond to conventional interdisciplinary treatment regimens.
纤维肌痛症是一种慢性肌肉骨骼疾病，其特征为全身广泛疼痛，并伴有肩部、背部和臀部的痛点。多种药物和膳食补充剂已被用于治疗肌肉骨骼疼痛，但疗效有限。早期的临床研究表明，低水平激光疗法（LLLT）单独或与常用于治疗纤维肌痛症的药物联合使用，可能对减轻肌肉骨骼疼痛和僵硬以及痛点数量有效。然而，一项假对照研究报告称，LLLT 并不比假治疗和运动贴布更有效。高强度激光疗法（HILT）的初步研究表明，它可能比 LLLT 更有效地治疗慢性疼痛综合征。因此，我们在一位患有长期纤维肌痛综合征的女性中评估了低（1 W）、中（42 W）和高（75 W）水平的 HILT，该女性对标准药物治疗和跨学科疼痛管理计划中的治疗均有抗性。患者接受了一系列使用 HILT 设备（Phoenix Thera-lase）的治疗，波长为 1275nm，在脊柱旁区域和肩部及臀部的痛点处进行治疗。虽然 1 W 的治疗仅产生了最小的症状缓解，但 42 W 和 75 W 的治疗均显著减轻了她的整体疼痛，改善了睡眠质量，并在治疗后 4-10 天内提高了她的身体活动水平。这个病例说明了对于那些对传统跨学科治疗方案无反应的纤维肌痛综合征患者，使用更高功率水平的 HILT 可能会产生有益的效果。
