Simunovic Z
Laser Center, Locarno, Switzerland.
J Clin Laser Med Surg. 1996 Aug;14(4):163-7. doi: 10.1089/clm.1996.14.163.
Among the various methods of application techniques in low level laser therapy (LLLT) (HeNe 632.8 nm visible red or infrared 820-830 nm continuous wave and 904 nm pulsed emission) there are very promising "trigger points" (TPs), i.e., myofascial zones of particular sensibility and of highest projection of focal pain points, due to ischemic conditions. The effect of LLLT and the results obtained after clinical treatment of more than 200 patients (headaches and facial pain, skeletomuscular ailments, myogenic neck pain, shoulder and arm pain, epicondylitis humery, tenosynovitis, low back and radicular pain, Achilles tendinitis) to whom the "trigger points" were applied were better than we had ever expected. According to clinical parameters, it has been observed that the rigidity decreases, the mobility is restored (functional recovery), and the spontaneous or induced pain decreases or even disappears, by movement, too. LLLT improves local microcirculation and it can also improve oxygen supply to hypoxic cells in the TP areas and at the same time it can remove the collected waste products. The normalization of the microcirculation, obtained due to laser applications, interrupts the "circulus vitiosus" of the origin of the pain and its development (Melzak: muscular tension > pain > increased tension > increased pain, etc.). Results measured according to VAS/VRS/PTM: in acute pain, diminished more than 70%; in chronic pain more than 60%. Clinical effectiveness (success or failure) depends on the correctly applied energy dose--over/underdosage produces opposite, negative effects on cellular metabolism. We did not observe any negative effects on the human body and the use of analgesic drugs could be reduced or completely excluded. LLLT suggests that the laser beam can be used as monotherapy or as a supplementary treatment to other therapeutic procedures for pain treatment.
在低强度激光疗法(LLLT)的各种应用技术方法中(氦氖632.8纳米可见红光或820 - 830纳米连续波红外光以及904纳米脉冲发射),存在非常有前景的“触发点”(TPs),即由于缺血状况而具有特殊敏感性且是局部痛点最高投射的肌筋膜区域。对200多名应用了“触发点”的患者(头痛和面部疼痛、骨骼肌肉疾病、肌源性颈部疼痛、肩部和手臂疼痛、肱骨外上髁炎、腱鞘炎、下背部和神经根性疼痛、跟腱炎)进行临床治疗后,LLLT的效果及所获结果比我们预期的还要好。根据临床参数观察到,僵硬程度降低,活动能力得以恢复(功能恢复),并且无论是自发疼痛还是诱发疼痛,通过活动也会减轻甚至消失。LLLT可改善局部微循环,还能改善触发点区域缺氧细胞的氧气供应,同时能清除积聚的代谢废物。激光照射使微循环恢复正常,从而中断了疼痛产生及其发展的“恶性循环”(梅尔扎克:肌肉紧张>疼痛>紧张加剧>疼痛加剧等)。根据视觉模拟评分法/语言评定量表/疼痛阈值测量结果:急性疼痛减轻超过70%;慢性疼痛减轻超过60%。临床疗效(成功或失败)取决于能量剂量的正确应用——剂量过大/过小都会对细胞代谢产生相反的负面影响。我们未观察到对人体有任何负面影响,并且可以减少或完全不用止痛药物。LLLT表明激光束可作为单一疗法或作为其他疼痛治疗方法的辅助治疗手段。