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Ohkuni I.,Toho University | Ushigome N.,Toho University | Harada T.,Toho University | Ohshiro T.,Japan Medical Laser Laboratory | And 4 more authors.
Laser Therapy | Year: 2011

Background and Aims: Sacroiliac joint pain not associated with a major etiological factor is a common problem seen in the orthopedic clinical setting, but diagnosis is difficult because of the anatomical area and thus it is sometimes difficult to effect a complete cure. Low level laser therapy (LLLT) has been well-reported as having efficacy in difficult pain types, so the following preliminary study was designed to assess the efficacy of LLLT for sacroiliac pain. Materials and Methods: Nine patients participated, 4 males and 5 females, average age of 50.4 yrs, who attended the outpatient department with sacroiliac pain. The usual major disorders were ruled out. Pain was assessed subjectively pre-and post-LLLT on a visual analog scale, and trunk range of motion was examined with the flexion test to obtain the pre- and post-treatment finger to floor distance (FFD). The LLLT system used was an 830 nm CW diode laser, 1000 mW, 30 sec/point (20 J/cm 2) applied on the bilateral tender points twice/week for 5 weeks. Baseline and final assessment values (after the final treatment session) were compared with the Wilcoxon signed rank test (nonparametric score). Results: All patients completed the study. Eight of the 9 patients showed significant pain improvement and 6 demonstrated significantly increased trunk mobility (P <0.05 for both). Conclusions: LLLT was effective for sacroiliac pain, and this may be due to improvement of the blood circulation of the strong ligaments which support the sacroiliac joint, activation of the descending inhibitory pathway, and the additional removal of irregularities of the sacroiliac joint articular surfaces. Further larger-scale studies are warranted. © 2011 JMLL, Tokyo, Japan.


Nakamura T.,Toho University | Ebihara S.,Toho University | Ohkuni I.,Toho University | Izukura H.,Toho University | And 7 more authors.
Laser Therapy | Year: 2014

Background and Aims: Chronic knee joint pain is one of the most frequent complaints which is seen in the outpatient clinic in our medical institute. In previous studies we have reported the benefits of low level laser therapy (LLLT) for chronic pain in the shoulder joints, elbow, hand, finger and the lower back. The present study is a report on the effects of LLLT for chronic knee joint pain.Material and Methods:Over the past 5 years, 35 subjects visited the outpatient clinic with complaints of chronic knee joint pain caused by the knee osteoarthritis-induced degenerative meniscal tear. They received low level laser therapy. A 1000 mW semi-conductor laser device was used to deliver 20.1 J/cm2 per point in continuous wave at 830nm, and four points were irradiated per session (1 treatment) twice a week for 4 weeks.Results: A visual analogue scale (VAS) was used to determine the effects of LLLT for the chronic pain and after the end of the treatment regimen a significant improvement was observed (p <0.001). After treatment, no significant differences were observed in the knee joint range of motion. Discussions with the patients revealed that it was important for them to learn how to avoid postures that would cause them knee pain in everyday life in order to have continuous benefits from the treatment.Conclusion: The present study demonstrated that 830 nm LLLT was an effective form of treatment for chronic knee pain caused by knee osteoarthritis. Patients were advised to undertake training involving gentle flexion and extension of the knee. © 2014 JMLL, Tokyo, Japan.


Shiroto C.,Shiroto Clinic | Ohshiro T.,Keio University | Ohshiro T.,Japan Medical Laser Laboratory
Laser Therapy | Year: 2014

The assessment of the efficacy of low level laser therapy (LLLT) for pain attenuation varies among institutions, all having their own method of assessment with no common standards. At the author’s institution in the beginning, the patients were asked how they assessed their pain relief immediately after the treatment. They were to choose from excellent, good, fair, no change and poor. The overall efficacy rate was calculated by the numbers of patients scoring excellent and good, expressed as a percentage of the total number of patients.However, a large number of institutions have utilized the Visual Analogue Scale (VAS) or the Pain Relief Score (PRS) for the assessment of treatment; but even then, the evaluation could not be considered uniform. Therefore, the standardization of the efficacy rate was continuously discussed among the practitioners of LLLT, dating back to the 9thannual meeting of the Japan Laser Therapy Association (JaLTA) in 1997. It took four years (including the 1997 meeting) until finally an agreement was reached and a new standard of efficacy was presented at the 12thJaLTA meeting in 2000, based on the PRS.The new standard defined excellent as pain reduction in any treatment session from 10 to 0 or 1, good as reduction from 10 to 2∼5, fair as reduction from 10 to 6∼8, no change as a reduction from 10 to 9∼10 and poor was defined as exacerbation of pain from 10 to 11 or greater. Efficacy rate was calculated by the number of patients scoring excellent and good expressed as a percentage of the total number of patients. For the purpose of reference, the VAS was to be used for patients receiving the treatment for the first time. © 2014 JMLL, Tokyo, Japan.


Okuni I.,Toho University | Ushigome N.,Toho University | Harada T.,Toho University | Ohshiro T.,Japan Medical Laser Laboratory | And 2 more authors.
Laser Therapy | Year: 2012

Background and Aims: In previous studies, we successfully applied Low Level Laser Therapy (LLLT) in patients with non-specific chronic pain of the shoulder joint and lower back. The purpose of the present study was to assess the effectiveness of LLLT for chronic joint pain of the elbow, wrist, and fingers. Subjects and Methods: Nine male and 15 female patients with chronic joint pain of the elbow, wrist, or fingers, who were treated at the rehabilitation outpatient clinic at our hospital from April, 2007 to March, 2009 were enrolled in the study. We used a 1000 mW semiconductor laser device. Each tender point and three points around it were irradiated with laser energy. Each point was irradiated twice for 20 s per treatment, giving a total of three minutes for all 4 points. Patients visited the clinic twice a week, and were evaluated after four weeks of treatment. Pain was evaluated with a Visual Analogue Scale (VAS). Statistical analysis of the VAS scores after laser irradiation was performed with Wilcoxon,s signed rank sum test, using SPSS Ver.17. Results: All VAS scores were totaled and statistically analyzed. The average VAS score before irradiation was 59.2±12.9, and 33.1±12.2 after the irradiation, showing a significant improvement in VAS score (p<0.001) after treatment. The treatment effect lasted for about one and a half days in the case of wrist pain, epicondylitis lateralis (tennis elbow), and carpal tunnel syndrome. In other pain entities, it lasted for about three to fifteen hours. No change in the range of motion (ROM) was seen in any of the 24 subjects. Conclusion: We concluded that LLLT at the wavelength and parameters used in the present study was effective for chronic pain of the elbow, wrist, and fingers. © 2012 JMLL, Tokyo, Japan.


Ohshiro T.,Japan Medical Laser Laboratory
Laser Therapy | Year: 2012

Background and Aims: The 830 nm GaAlAs diode laser has played an extremely active role in low level laser therapy (LLLT) since the early 1980's. Recently, the author modified his original proximal priority laser technique (PPLT), and the current article set out to explain the improved approach and show scientific evidence for its efficacy. Laser Therapy System: The laser therapy system used was based on the GaAlAs diode (OhLase- 3D1, JMLL, Japan), delivering 60 mW in continuous wave at a wavelength of 830 nm in the near infrared with a power density at the tip of the probe head of approximately 1.2 W/cm2. Proximal Priority Laser Technique: Under the author's PPLT concept, the brain is the control center for the body so every other part of the body is distal to the head. The main blood supply to the head is through the carotid arteries, and the deep penetration of the 830 nm beam applied to the side of the neck can involve and photoactivate the external and internal carotids, increasing the blood supply to the brain and creating a systemic parasympathetic system-mediated wholebody effect. The author has added gentle neck-stretching, trunk-stretching and his distal tissue softening approaches concomitant with the irradiation which enhance treatment efficacy. Results: Real-time fine-plate thermography has revealed whole-body warming as a result of the PPLT, with applications including chronic pain attenuation, female infertility and functional training of paraplegic cerebral palsy patients. The warming effect had a latency from hours to days, increasing in intensity and latency with subsequent PPLT sessions. Both Doppler flowmetry and SPECT have shown increased cerebral and systemic blood flow following PPLT. Conclusions: PPLT is easy to deliver and offers tangible results in a large range of conditions, enhancing the efficacy of diode laser LLLT. ©2012 JMLL, Tokyo, Japan.

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