ORIGINAL PAPER
Photobiomodulation in the treatment of chronic non-specific neck pain. Randomized clinical trial
 
More details
Hide details
1
Western Paraná State University, Unioeste, Cascavel, Brazil
 
 
Submission date: 2020-08-24
 
 
Acceptance date: 2020-12-15
 
 
Publication date: 2023-01-05
 
 
Physiother Quart. 2023;31(1):19-22
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Neck pain is defined as the presence of musculoskeletal pain in the posterior region of the neck, above the shoulders, or in the upper dorsal area. Physiotherapy aims to minimize pain, recover mobility, and strengthen muscles. For this, it uses several techniques, such as photobiomodulation, which can be achieved by light emitting diode (LED) therapy and low level laser therapy (LLLT). The objective of this study was to analyse the effect of the association of LED and LLLT in the treatment of chronic non-specific neck pain.

Methods:
A quantitative, experimental, randomized study was performed. The sample was composed of 28 individuals, divided into a control group and an intervention group. Pre- and post-treatment visual analogue scale, Leeds Assessment of Neuropathic Symptoms and Signs, and the McGill Pain Questionnaire were used. Both groups were submitted to 6 sessions during 2 weeks, with a cluster apparatus, composed of an arrangement of 3 LEDs (590 nm, 1500 mW) and an LLLT (830 nm, 150 mW); the control group received placebo laser intervention. The application was punctual (1 minute per region), at the point of greatest pain, in the trapezius, scalene, and sternocleidomastoid muscles.

Results:
In both cases, the pain reduction was significant (p < 0.05) for the 3 assessment instruments; however, the effect sizes for the visual analogue scale and the McGill Pain Questionnaire were higher in the intervention group.

Conclusions:
The cluster used was effective in reducing pain in individuals with chronic non-specific neck pain.

 
REFERENCES (32)
1.
Childs JD, Cleland JA, Elliott JM, Teyhen DS, Wainner RS, Whitman JM, et al. Neck pain: clinical practice guidelines linked to the International Classification of Functioning, Disability, and Health from the Orthopaedic Section of the American Physical Therapy Association. J Orthop Sports Phys Ther. 2008;38(9):1–34; doi: 10.2519/jospt.2008.0303.
 
2.
Aimi MA, Raupp EG, Schmit EFD, Vieira A, Candotti CT. Correlation between cervical morphology, pain, functionality, and ROM in individuals with cervicalgia. Coluna/Columna. 2019;18(2):101–105; doi: 10.1590/S1808-185120191802188667.
 
3.
Ahmad AM, Kamel KM, Mohammed RG. Effect of forward head posture on diaphragmatic excursion in subjects with non-specific chronic neck pain. A case-control study. Physiother Quart. 2020;28(3):9–13; doi: 10.5114/pq.2020.95769.
 
4.
Popescu A, Lee H. Neck pain and lower back pain. Med Clin North Am. 2020;104(2):279–292; doi: 10.1016/j.mcna.2019.11.003.
 
5.
Pellicciari L, Bonetti F, Di Foggia D, Monesi M, Vercelli S. Patient-reported outcome measures for non-specific neck pain validated in the Italian-language: a systematic review. Arch Physiother. 2016;6(1):9; doi: 10.1186/s40945-016-0024-2.
 
6.
Maissan F, Pool J, de Raaij E, Mollema J, Ostelo R, Wittink H. The clinical reasoning process in randomized clinical trials with patients with non-specific neck pain is incomplete: a systematic review. Musculoskelet Sci Pract. 2018;35:8–17; doi: 10.1016/j.msksp.2018.01.011.
 
7.
Resende L, Merriwether E, Rampazo ÉP, Dailey D, Embree J, Deberg J, et al. Meta-analysis of transcutaneous electrical nerve stimulation for relief of spinal pain. Eur J Pain. 2018;22(4):663–678; doi: 10.1002/ejp.1168.
 
8.
Hidalgo B, Hall T, Bossert J, Dugeny A, Cagnie B, Pitan­ce L. The efficacy of manual therapy and exercise for treating non-specific neck pain: a systematic review. J Back Musculoskelet Rehabil. 2017;30(6):1149–1169; doi: 10.3233/BMR-169615.
 
9.
Noormohammadpour P, Tayyebi F, Mansournia MA, Sha­rafi E, Kordi R. A concise rehabilitation protocol for sub-acute and chronic non-specific neck pain. J Bodyw Mov Ther. 2017;21(3):472–480; doi: 10.1016/j.jbmt.2016.07.005.
 
10.
Khalil MA, Alkhozamy H, Fadle S, Hefny AM, Ismail MA. Effect of Mulligan upper cervical manual traction in the treatment of cervicogenic headache: a randomized controlled trial. Physiother Quart. 2019;27(4):13–20; doi: 10.5114/pq.2019.87738.
 
11.
Debre E, Alptekin K, Alptekin JÖ, Giritharan A. Study on the effect of TENS, exercise and friction massage on the masseter regarding masseter-derived cervical myofascial pain. Adv Rehabil. 2020;34(2):1–9; doi: 10.5114/areh.2020.94316.
 
12.
Chow RT, Johnson MI, Lopes-Martins RAB, Bjordal JM. Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials. Lancet. 2009;374(9705):1897–1908; doi: 10.1016/S0140-6736(09)61522-1.
 
13.
Ezzati K, Fekrazad R, Raoufi Z. The effects of photobiomodulation therapy on post-surgical pain. J Lasers Med Sci. 2019;10(2):79–85; doi: 10.15171/jlms.2019.13.
 
14.
Gendron DJ, Hamblin MR. Applications of photobiomodulation therapy to musculoskeletal disorders and osteoarthritis with particular relevance to Canada. Photobiomodul Photomed Laser Surg. 2019;37(7):408–420; doi: 10.1089/photob.2018.4597.
 
15.
De Oliveira Gomes A, Silvestre AC, da Silva CF, Go­mes MR, Bonfleur ML, Bertolini GRF. Influence of different frequencies of transcutaneous electrical nerve stimulation on the threshold and pain intensity in young subjects. Einstein. 2014;12(3):318–322; doi: 10.1590/s1679-45082014ao3092.
 
16.
Campos GRS, de Moura KMB, Barbosa AM, Zamuner LF, Nadur-Andrade N, Dale CS, et al. Light emitting diode (LED) therapy reduces local pathological changes induced by Bothrops asper snake venom. Toxicon. 2018;152:95–102; doi: 10.1016/j.toxicon.2018.07.029.
 
17.
Cidral-Filho FJ, Mazzardo-Martins L, Martins DF, Santos ARS. Light-emitting diode therapy induces analgesia in a mouse model of postoperative pain through activation of peripheral opioid receptors and the L-arginine/nitric oxide pathway. Lasers Med Sci. 2014;29(2):695–702; doi: 10.1007/s10103-013-1385-3.
 
18.
Cidral-Filho FJ, Martins DF, Moré AOO, Mazzardo-Martins L, Silva MD, Cargnin-Ferreira E, et al. Light-emitting diode therapy induces analgesia and decreases spinal cord and sciatic nerve tumour necrosis factor- levels after sciatic nerve crush in mice. Eur J Pain. 2013;17(8):1193–1204; doi: 10.1002/j.1532-2149.2012.00280.x.
 
19.
Martinez JE, Grassi DC, Marques LG. Analysis of the applicability of different pain questionnaires in three hospital settings: outpatient clinic, ward and emergency unit [in Portuguese]. Rev Bras Reumatol. 2011;51(4):299–308; doi: 10.1590/S0482-50042011000400002.
 
20.
Bennett M. The LANSS Pain Scale: the Leeds Assessment of Neuropathic Symptoms and Signs. Pain. 2001;92(1–2):147–157; doi: 10.1016/s0304-3959(00)00482-6.
 
21.
Schestatsky P, Félix-Torres V, Chaves MLF, Câmara-Ehlers B, Mucenic T, Caumo W, et al. Brazilian Portuguese validation of the Leeds Assessment of Neuropathic Symptoms and Signs for patients with chronic pain. Pain Med. 2011;12(10):1544–1550; doi: 10.1111/j.1526-4637.2011.01221.x.
 
22.
Melzack R. The McGill pain questionnaire: from description to measurement. Anesthesiology. 2005;103(1):199–202; doi: 10.1097/00000542-200507000-00028.
 
23.
Zheng Y, Tang K, Ye L, Ai Z, Wu B. Mapping the neck disability index to SF-6D in patients with chronic neck pain. Health Qual Life Outcomes. 2016;14(1):21; doi: 10.1186/s12955-016-0422-x.
 
24.
Chow R, Armati P, Laakso E-L, Bjordal JM, Baxter GD. Inhibitory effects of laser irradiation on peripheral mammalian nerves and relevance to analgesic effects: a systematic review. Photomed Laser Surg. 2011;29(6):365–381; doi: 10.1089/pho.2010.2928.
 
25.
Panhoca VH, de Fatima Zanirato Lizarelli R, Nunez SC, de Andrade Pizzo RC, Grecco C, Paolillo FR, et al. Comparative clinical study of light analgesic effect on temporomandibular disorder (TMD) using red and infrared led therapy. Lasers Med Sci. 2015;30(2):815–822; doi: 10.1007/s10103-013-1444-9.
 
26.
El-Gendy MH, Lasheen YR, Rezkalla WKS. Multimodal approach of electrotherapy versus myofascial release in patients with chronic mechanical neck pain: a randomized controlled trial. Physiother Quart. 2019;27(4):6–12; doi: 10.5114/pq.2019.87735.
 
27.
De Freitas LF, Hamblin MR. Proposed mechanisms of photobiomodulation or low-level light therapy. IEEE J Sel Top Quantum Electron. 2016;22(3):7000417; doi: 10.1109/JSTQE.2016.2561201.
 
28.
Karu T. Mitochondrial mechanisms of photobiomodulation in context of new data about multiple roles of ATP. Photomed Laser Surg. 2010;28(2):159–160; doi: 10.1089/pho.2010.2789.
 
29.
Jagdeo J, Austin E, Mamalis A, Wong C, Ho D, Siegel DM. Light-emitting diodes in dermatology: a systematic review of randomized controlled trials. Lasers Surg Med. 2018;50(6):613–628; doi: 10.1002/lsm.22791.
 
30.
Požgain I, Požgain Z, Degmečić D. Placebo and nocebo effect: a mini-review. Psychiatr Danub. 2014;26(2):100–107.
 
31.
Brody H. Meaning and an overview of the placebo effect. Perspect Biol Med. 2018;61(3):353–360; doi: 10.1353/pbm.2018.0048.
 
32.
Damien J, Colloca L, Bellei-Rodriguez C-É, Marchand S. Pain modulation: from conditioned pain modulation to placebo and nocebo effects in experimental and clinical pain. Int Rev Neurobiol. 2018;139:255–296; doi: 10.1016/bs.irn.2018.07.024.
 
eISSN:2544-4395
Journals System - logo
Scroll to top