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Using low-level laser therapy for treating osteoarthritis and rheumatoid

Low-Level Laser Therapy

Low-Level Laser is a new therapy which is non-intrusive, extremely safe and employs the use of light instead of drugs or surgical procedures. It is called LLLT because it delivers a low level of optimized energy density to the tissues. LLLT employ the use of coherent lasers of mid to low power or it employs the use of non-coherent LEDs ranging from 1mW to 500mW. It is most frequently used to reduce inflammation, pain, wound healing, repair of nerves and induce tissue regeneration. Lightly used in LLLT is red with a wavelength of 600 to 700nm and spectral range of 1 to 40nm reaching an average density of power between 0.001 to 5.0 W/cm2. It is directed to the affected area for a variable duration ranging from seconds to minutes. It could be applied daily or 3-4 days per week for a period of 8 to 10 week, totally depending upon chronicity LLLT works as biomodulator through effective photochemical and photophysical mechanisms like that of photosynthesis where the light absorbed is capable of activating a cascade of functional and molecular changes.

What is Rheumatoid Arthritis?

Rheumatoid arthritis (RA) is a long-term autoimmune disorder primarily affecting joints. It causes inflammation of joints and synovial membrane resulting in warm, swollen, painful joints along with stiffness of joints limiting joint movements.  Apart from the inflammation of joints, it could also attack other organs of the body inducing lungs, heart and low RBCs.when there is multiple joint involvements its called polyarthritis. Most commonly involved joints are small joints of hands, feet, and cervical spin but large joints like shoulder and knee can also be affected. Synovitis can lead to tethering of tissue with loss of movement and erosion of the joint surface causing deformity and loss of function. RA typically manifests with signs of inflammation, with the affected joints being swollen, warm, painful and stiff, particularly early in the morning on waking or following prolonged inactivity. Increased stiffness early in the morning is often a prominent feature of the disease and typically lasts for more than an hour. The disease could lead to inefficiency and impairment of joints if not taken care of properly. Also, this disease has rapid progression which could be slowed down through appropriate medical care Persons having RA are more likely to suffer from substantial comorbidities which could possibly result from defects of the musculoskeletal system. These comorbidities could lead to a decline in physical function and quality of life and an enhanced risk of long term complications. RA could affect any person without any discrimination of ethnic group. Recent stats show that it affects 40 out of each 100,000 individuals worldwide with women being more affected than men. Overall, the risk of RA in men and women is 1.7% and 3.6% respectively. RA is a combo of environmental and genetic factors. Environmental factors in association with genetic factors could elevate clinical manifestations.

Low-Level Laser Therapy in Rheumatoid Arthritis

Patients of RA experience severe pain. LLLT has been proved as an efficient pain reliever. It is recommended for the relief of pain for most of the diseases. Similarly, LLLT is referred for short term treatment of RA for the relief of pain especially for the stiffness that patients experience in the morning. But LLLT is in an early stage of its evolution. Until now, no side effects are experienced in patients who have used LLLT for the relief of pain caused by RA. Physicians and clinicians are regularly updating more and more information on this behalf There are also several on-going clinical trials to optimize a standard protocol for the use of LLLT. Physicians are trying to optimize several different factors essential for the optimization of LLLT including wavelength, duration of exposure of LLLT, the efficacy of long-term and short-term exposure and dosage applicable for a particular site of pain. There are several studies which have shown that the use of LLLT can significantly improve mononuclear inflammatory cells, extrude protein, medullary hemorrhage, hyperemia, necrosis, distribution of fibrocartilage and osteoblast at both, early as well as late, stage of progression of RA

What is Osteoarthritis?

Osteoarthritis is inflammation of joints that results from degeneration of cartilage.  Osteoarthritis can be caused by aging, heredity, trauma or disease. It is characterized by extreme joint pain, tenderness, stiffness, crepitus, restriction of movement and inflammation. In the early stages of osteoarthritis, pain is related to the activities of the body but at later stages, it turns out to be a constant factor of disease. All this happen due to the degeneration of cartilage between the joints resulting in stiffness, restriction in movement of joints and extreme pain It is also known to damage menisci, muscles and ligaments. Small fragments of bone as well as of cartilage might float into the spaces between the joints leading to discomfort and pain. Additional pain may also be caused by osteophytes. Most frequently, osteoarthritis affects the joints of knees, hands, spine, feet, hip and shoulder joints. Around the world, almost 18 % of women and 9.6% of men have some degree of OA which are above the age of 60 Obesity, any previous joint injury, and increase in age are considered as risk factors of primary OA. While secondary OA could develop due to any kind of metabolic, chemical or physical injury to the joint like congenital or developmental malformations of bone.

Low-Level Laser Therapy in Osteoarthritis

LLLT is a new and emerging technology with promising results in the field of pain. Reviewing its present effects on other diseases it should have promising outcomes in the OA too. In the case of OA, the effectiveness of LLLT depend upon the ways in which the therapy is applied along with the other elements of LLLT. Its effectiveness heavily relies on the precision and accuracy of the method of application, the device being used and physician. Physicians, researchers, and clinicians should constantly update their device and methods of application of LLLT The wavelength of the laser, duration of treatment, dosage and position of nerves and joints are the most important factors which should be considered while using LLLT on patients of OA.

In OA, pain mostly occurs in joints (also involving skin, ligaments, and muscles) while it is the CNS which is responsible for all the cognitive processes involving long strokes of pain. All of this is happening through a sensory input to CNS and LLLT is capable of modifying that input, possibly resulting in advancement in the area of pain and less perception of pain in that area. In medical science, it is well known that a painful stimulus on one side of the body has a contralateral effect Therefore, LLLT could be utilized on joints and on nerves in order to induce a larger reduction in pain through sensory input to CNS.

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