Management of Rheumatic Diseases Using Low Level Laser Therapy

Introduction

The body is protected by the immune system. For unknown reasons, the immune system attacks the body’s cells and tissues and causes inflammation that mainly affects the joints, bones, ligaments, tendons, and muscles and progresses to other organs as well. The individual experiences severe pain and discomfort, with episodes of "flare" (when symptoms become more painful and uncomfortable than usual) or "remission" (when no symptoms of the rheumatic disease are experienced). Certain factors, such as unhealthy lifestyle practices (smoking, eating unhealthy foods), genetics, and older age, could increase the risk of developing rheumatic diseases for some individuals.

What Are the Symptoms of Rheumatic Diseases?

Individuals with rheumatic diseases experience severe pain in the joints. The disease may be localized to one joint, to begin with, and progress with time, affecting more joints and organs. Inflammation caused by the attack of the immune system can cause stiffness in the joints and muscles, making day-to-day activities difficult. Some may experience fever, loss of appetite, and subsequent weight loss.

How to Treat Rheumatic Disease?

Rheumatic diseases does not have a permanent cure. However, treatment measures aim to improve the quality of life of the individual by managing the symptoms. Some of the ways to manage rheumatic diseases are as follows:

• Medications - Non-steroidal anti-inflammatory drugs (Ibuprofen), disease-modifying anti-rheumatic drugs (DMARDs- Methotrexate), and biologics (Abatacept) are some of the medications used to relieve pain and slow down the progression of rheumatoid diseases. The choice of medication varies among individuals depending on age, the type, the progression of rheumatic disease, and the presence of any underlying disease conditions which would contraindicate the use of a specific medicine.

• Therapy - Physical therapy such as regular exercises or intense exercises to improve strength and mobility of the joints is advised. Certain occupational therapies can provide comfort and ease the pain for individuals with the movements and activities advised by the therapists.

• Surgery - Although surgeries are invasive, it is indicated when medications and therapies are not beneficial and the involved joint or muscle is damaged to a point where repair (through fusion or removal) or replacement is needed.

• Low-Level Laser Therapy - Using low-level laser therapy may be used as a non-invasive approach for the treatment of rheumatic diseases.

What Is Low-Level Laser Therapy?

Low-level laser therapy uses a low-intensity laser, LED, or a combination of both to heal tissue and cell damage. Low-level laser therapy is non-invasive since it involves applying light to the affected area. Low-level laser therapy does not cure the disease condition but helps reduce the inflammation and pain related to the disease. Low-level laser therapy is used for various health conditions, such as:

• Musculoskeletal Pain - To reduce pain and swelling.

• Injury - To promote wound healing.

• Skin Conditions - To heal or for cosmetic purposes.

• Neurology - For example following a brain injury.

How Does Low-Level Laser Therapy Work?

Low-level laser therapy emits light on the affected area and stimulates healthy cells to proliferate and promote healing. The light was also shown to stimulate macrophages, which showed a reduction in antigen-antibody complexes and better stability of the joints. Unlike other forms of laser therapy, there is no heat produced in low-level laser therapy; hence, it is also termed cold therapy. The wavelength used for low-level laser therapy usually ranges from 670 nm to 950 nm.

What Are the Advantages of Low-Level Laser Therapy?

Some of the advantages of using low-level laser therapy at the affected site are as follows:

• No heat is produced at the site of treatment.

• No sound or vibration is heard or felt during treatment.

• Easy to use.

• Non-invasive, hence no bed rest is required after the treatment.

• Promotes healing faster than conventional methods hence less time consumed.

• Reduce the intensity of pain and swelling.

• Improve blood circulation.

• Improves nerve functions and tissue strength of muscles and bone.

• Can be used in conjunction with medications and other therapies.

• No side effects.

• Safer compared to conventional drug therapy which causes toxicity in individuals.

How Does Low-Level Laser Therapy Help Rheumatic Diseases?

Several studies have been conducted over the years to evaluate the effectiveness of low-level laser therapy in rheumatic diseases. With the advantages and minimally invasive nature of low-level laser therapy, rheumatic disease conditions showed marginal improvements for most individuals. Several studies showed the following changes and benefits of using low-level laser therapy with wavelengths ranging from 632 nm to 904 nm in rheumatic diseases:

• Reduced inflammation and pain by promoting cellular proliferation and healing.

• Stimulated rheumatoid synovial cells to increase protein synthesis which is responsible for a decrease in inflammation.

• The synovial membrane in synovial joints of individuals with rheumatic diseases tends to have increased permeability. Low-level laser therapy showed improvement and restoration of the disturbed permeability.

• Improved blood circulation in the affected area, thereby improving the stiffness of the affected joint and muscles.

The wavelength used and the duration of treatment varied in each study. The site for low laser application was also different. Hence, a definite protocol of the dosage, duration, and wavelength for respective joints and areas of the body needs to be set to use low-level laser therapy as a therapy of choice.

Furthermore, low-level laser therapy does not provide complete control of the disease condition and is considered beneficial when used along with medication or physical therapy.

What Are the Disadvantages of Low-Level Laser Therapy?

Although advantageous to a large extent, some of the disadvantages noted in multiple studies are as follows:

• The disease symptoms relapse after a few weeks or months.

• Multiple visits for laser therapy are needed for a noticeable positive effect.

• Laser therapy could be costly for some individuals.

• Laser therapy could cause eye damage if not used cautiously.

Are There Contraindications for Using Low-Level Laser Therapy?

Low-level laser therapy is relatively safe to use, but it is contraindicated in some instances.

• Low-level laser therapy should not be used in conditions where cancer is a possibility.

• Pregnant women should not use laser therapy as the possibility of any side effects on the fetus is unknown.

Conclusion

Rheumatoid disease is a debilitating disease condition. The progress of the disease conditions affects an individual’s life on a day-to-day basis. With the disease being incurable, the availability of a faster mode of symptomatic relief would be appreciated by those suffering. Once the protocol for using low-level laser therapy is accepted, its extensive use can provide comfort to millions.