Low-level laser therapy (LLLT) is believed to have an analgesic effect and a biomodulatory effect on microcirculation. This study was designed to examine the pain relieving effect of LLLT and possible alterations in the microcirculation measured by thermography in patients with knee osteoarthritis (KOA). Patients with mild or moderate KOA were randomly divided into groups to receive LLLT or placebo LLLT. The treatments were delivered twice a week for a period of 4 weeks with a diode laser (wavelength 830 nm, continuous wave, power 50 mW) in contact with the skin and a dose of 6 J/point. The placebo control group was treated with an ineffective probe (0.5 mW power) that looked the same. An evaluation by thermography (comparative bilateral thermography with AGA infrared camera) was performed before the treatment, then once a week during the therapy cycle and then two weeks and two months after the completion of the sessions; joint flexion, circumference and pressure sensitivity were measured; the visual analog scale was also recorded. In the group treated with active LLLT, a significant improvement in pain was found (before the treatment: 5.75; 2 months after treatment: 1.18); circumference (before the treatment: 40.45; after the treatment: 39.86); pressure sensitivity (before the treatment: 2.33; after the treatment: 0.77); flexion (before the treatment: 105.83; after the treatment: 122.94). In the placebo group, changes in joint flexion and pain were not significant. Thermographic measurements showed an increase in temperature of at least 0.58 °C and therefore an improvement in circulation compared to the initial values. In the placebo group, these changes did not occur. Our results show that LLLT reduces pain in KOA and improves microcirculation in the irradiated area.

Chronic pain in the foot and ankle joints is one of the most frequent ailments found in our medical institution. Benefits of low level laser therapy (LLLT) for chronic pain in the elbow, hand, fingers and lower back have been reported in previous studies. This study has examined the effects of LLLT on chronic pain of foot and ankle joints. In this study, 17 subjects with chronic foot or ankle pain (of various nature) received LLLT therapy (1000 mW, 20J/cm², 830 nm, continuous emission). Each subject received two treatments per week for 4 weeks. A visual analog scale (VAS) was used to report the effects of LLLT therapy on chronic pain and, at the end of the treatment cycle, a significant improvement in symptoms was noted. All but 2 patients showed improvement in symptoms: excellent (2) and good (13). After the treatment, however, no significant differences were observed in the range of motion of the ankle joint. Through interviews with patients, the importance of a good posture while walking and how not to overload the ankle joint was also addressed. The present study demonstrated that LLLT was an effective form of treatment for chronic pain in the foot and ankle joints, in combination with postural education during all daily activities.

Temporo-mandibular disorder is a generic term used to group all the clinical signs and symptoms involving the chewing muscles, the temporomandibular joint (TMJ) and associated structures. Since temporomandibular disorder is multifactorial, there are several therapeutic methods to eliminate signs and symptoms. LLLT (Low level laser therapy) is commonly used for pain reduction and acceleration of healing processes. The purpose of this study was to evaluate the efficacy of LLLT at 980 nm on patients with temporomandibular disorders. 48 subjects with temporomandibular disorders (which were not degenerative) were randomly divided into two groups. In the study group, patients underwent LLLT (980 nm, 80 Hz, 6 J) on three points of the temporomandibular joint for one minute. In the placebo group, the laser device was positioned and set with the same parameters but with no emission. The re-evaluation of pain and temporomandibular click was made after 2 days, after 4 days, after 6 and after 12 months. The intensity of pain after 4 days in the study group was significantly lower than the placebo group (2.4 ± 1.36 VS 4.4 ± 1.84). The reduction in temporomandibular click was 23.1% in the placebo group and 76.3% in the study group. The results were statistically significant for both pain and clicking up to 2 years of follow-up with no relapses. LLLT at 980 nm is therefore effective in the management of temporomandibular disorder in terms of reducing pain and clicking in patients with non-degenerative TMJ disorders.

Bariatric interventions are effective techniques for weight loss in case of obesity: it is still an invasive procedure and post-surgical complications can occur. LLLT (Low level laser therapy) is increasingly used for its effectiveness in controlling the inflammatory response, accelerating tissue repair and reducing pain. The goal of this study was to investigate the effects of photobiomodulation after bariatric surgery and understand the mechanisms of action of the laser on the inflammatory process, wound healing and pain. 85 gastric bypass patients were divided into two groups and underwent LLLT therapy on 10 different points of the surgical scar. The study group (43 patients) received active laser therapy while the placebo group (42 patients) was treated in the same way, but with the device turned off. The device used for the therapy (which was used above the abdominal wound, about 1 cm from its perimeter) was a diode laser, with a wavelength of 808 nm, used in continuous emission mode, fluence 10J / cm², power 100 mW, time 20 seconds per point, spot area 0.20 cm². Biochemical analyzes and digital images were used to document and evaluate the inflammatory response as well as the healing process of the surgical wound. Patients in the group that actually received laser therapy had a reduction in the temperature of the wound area as the percentage of erythrocyte sedimentation rate (ESR) compared to the placebo group, proving that there was better control of inflammatory processes, repair processes and analgesic ones. Therefore, LLLT allows to reduce biochemical markers and wound temperature and this indicates a good ability to control inflammatory processes. In addition, edema and pain decreased after the therapy and the healing of the surgical wound improved.

A diode laser system was used to treat 17 patients with nail disorders: nine patients with chronic paronychia and eight patients with ingrown toenails (onychocryptosis). Stage I ingrown toenails (according to Zaias N classification) or subcutaneous ingrown toenails (according to Baran R & Dawber RPR classification) was treated with LLLT. The laser system emitted a continuous wave beam of 150 mW at 830 nm in the near infrared on a small round spot of about 1 cm in diameter, delivering an incident dose of about 45 J/cm2 per spot. The laser beam was applied to six points on the fingers of patients with chronic paronychia and to fifteen points on the fingers of patients with ingrown toenails for fifteen seconds per point. The effect was evaluated and reported by the patients themselves based on clinical findings on a scale from zero to ten.

Scores based on the results obtained:
0-2 Excellent
3-5 Good
6-7 Sufficient
8-10 Poor

For paronychia, 3 subjects reported scores that were excellent, 5 good and 1 sufficient. For the ingrown toenail, 5 subjects reported scores that were excellent, 2 good and 1 sufficient. Therefore, 88% of patients proved satisfied with the treatment at the end of the cycle of sessions. After about 5±4 sessions of LLLT (2 to 14 days) the symptoms improved satisfactorily in most cases. For this reason, LLLT can be a valid tool for the treatment of patients with ingrown toenails in the initial stages, especially for its non-invasiveness, for the absence of pain, because it is well tolerated and for the absence of side effects.

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