Tieppo Francio Vinicius, Dima Robert S, Towery Chris, Davani Saeid
University of Science, Arts and Technology - USAT College of Medicine, Olveston, Montserrat, BWI.
Essential Integrative Health - Spine, Orthopaedics and Pain Management, Oklahoma City, OK, USA.
Anesth Pain Med. 2017 Oct 15;7(5):e14470. doi: 10.5812/aapm.14470. eCollection 2017 Oct.
Regenerative injection therapy and low level laser therapy are alternative remedies known for their success in the treatment and symptomatic management of chronic musculoskeletal conditions. In response to the growing demand for alternative therapies in the face of the opioid epidemic, the authors conduct a literature review to investigate the potential for prolotherapy and LLLT to be used adjunctively to manage chronic osteoarthritis (OA). OA is a degenerative chronic musculoskeletal condition on the rise in North America, and is frequently treated with opioid medications. The regenerative action of prolotherapy and pain-modulating effects of LLLT may make these two therapies well-suited to synergistically provide improved outcomes for osteoarthritis patients without the side effects associated with opioid use. A narrative descriptive review through multiple medical databases (Google Scholar, PubMed, and MedLine) is conducted, restricted by the use of medical subject headings. 71 articles were selected for reading in full, and 40 articles were selected for use in the study after reading in full. A review of the literature revealed good clinical results in the use of prolotherapy and LLLT separately to manage chronic musculoskeletal pain due to osteoarthritis and other chronic conditions. It is also recognized in the literature that prolotherapy works most effectively when used adjunctively with other treatments. Downsides to the use of prolotherapy include mild side effects of pain, stiffness and bruising and potential adverse events as a result of injection. This study is limited by the lack of clinical trials available involving both LLLT and prolotherapy injections used adjunctively, and by the low number of high impact literature concerning the treatment of (specifically) osteoarthritis by alternative methods. The authors suggest that practicing health care providers consider utilizing LLLT and prolotherapy together as a supplementary method in the management of chronic pain due to osteoarthritis, to minimize the long-term prescription of opioids and emphasize a less invasive treatment for this debilitating condition.
再生注射疗法和低强度激光疗法是已知在慢性肌肉骨骼疾病的治疗和症状管理方面取得成功的替代疗法。面对阿片类药物流行，替代疗法的需求不断增长，作者进行了一项文献综述，以研究注射增殖疗法和低强度激光疗法辅助治疗慢性骨关节炎（OA）的潜力。OA是一种在北美呈上升趋势的退行性慢性肌肉骨骼疾病，常用阿片类药物治疗。注射增殖疗法的再生作用和低强度激光疗法的疼痛调节作用可能使这两种疗法非常适合协同为骨关节炎患者提供更好的治疗效果，而无使用阿片类药物的相关副作用。通过多个医学数据库（谷歌学术、PubMed和MedLine）进行了叙述性描述性综述，受医学主题词使用的限制。选择了71篇文章进行全文阅读，阅读全文后选择了40篇文章用于该研究。文献综述显示，单独使用注射增殖疗法和低强度激光疗法治疗骨关节炎和其他慢性疾病引起的慢性肌肉骨骼疼痛取得了良好的临床效果。文献中还认识到，注射增殖疗法与其他治疗方法联合使用时效果最佳。注射增殖疗法的缺点包括疼痛、僵硬和瘀伤等轻微副作用以及注射导致的潜在不良事件。本研究受到限制，因为缺乏关于联合使用低强度激光疗法和注射增殖疗法的临床试验，以及关于（特别是）替代方法治疗骨关节炎的高影响力文献数量较少。作者建议，执业医疗保健提供者考虑将低强度激光疗法和注射增殖疗法联合使用，作为管理骨关节炎引起的慢性疼痛的补充方法，以尽量减少阿片类药物的长期处方，并强调针对这种使人衰弱的疾病采用侵入性较小的治疗方法。
