The effects of low-level laser in the treatment of myofascial pain syndrome: systematic review
Os efeitos do laser de baixa intensidade no tratamento da síndrome da dor miofascial: revisão sistemática
Marina Gomes Fagundes; Jéssica Rodrigues dos Santos Albuquerque; Emanuelly Juliane Santos Silva; Ana Caroline Victor Dantas; Thiago Bezerra Wanderley e Lima
Abstract
BACKGROUND AND OBJECTIVES: Among the approaches inherent to conservative treatment, the low-level laser therapy (LLLT) is one of the most used resources in the treatment of myofascial pain. This research sought to search the literature for the available evidence on the treatment of myofascial pain syndrome with LLLT in order to analyze the reported effects of this intervention.
CONTENTS: Medline/PubMed, SCOPUS, Web of Science, Cochrane Central Registry of Controlled Trials (CENTRAL) and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) by Ebsco was used to search for articles on randomized clinical trials that related myofascial pain syndrome with LLLT. Studies were systematically selected by two reviewers independently, through title, abstract and, later, full text. Ten articles that met the criteria were included in this integrative review. In six of these articles, the improvement in pain compared to placebo group was presented right after LLLT session, although these results did not remain in the follow-ups of the studies that performed follow ups.
CONCLUSION: LLLT seems to be a resource that decreases pain in patients with myofascial pain syndrome. Despite the positive results in reducing pain with the use of LLLT in some studies, this review admits the heterogeneity of studies with conflicting results related to the effectiveness of LLLT. Research that defines the parameters and adequate therapeutic dosages are necessary for a better understanding of the real effects of LLLT on this clinical condition.
Keywords
Resumo
JUSTIFICATIVA E OBJETIVOS: Das abordagens inerentes ao tratamento conservador, o laser de baixa intensidade (LBI) é um dos recursos mais utilizados no tratamento da dor miofascial. Esta pesquisa buscou avaliar na literatura as evidências disponíveis sobre o tratamento da síndrome da dor miofascial com o LBI para analisar os efeitos reportados dessa intervenção.
CONTEÚDO: Foram utilizadas as bases de dados Medline/Pubmed, SCOPUS, Web of Science, Registro Central Cochrane de Ensaios Controlados (CENTRAL) e Cumulative Index to Nursing and Allied Health Literature (CINAHL), da Ebsco, para busca de artigos de ensaios clínicos randomizados que relacionassem síndrome da dor miofascial com LBI. Os estudos foram selecionados sistematicamente por dois revisores, independentemente, por meio do título, resumo e, posteriormente, texto completo. Dez artigos que se adequaram aos critérios foram incluídos nessa revisão sistemática. Em seis destes artigos, foi apresentada a melhora da dor comparada ao grupo placebo logo após a sessão de LBI, embora esses resultados não tenham permanecido nos acompanhamentos dos estudos que realizaram follow-ups.
CONCLUSÃO: O LBI parece ser um recurso que diminui a dor em pacientes com síndrome da dor miofascial. Apesar dos resultados positivos na diminuição da dor com o uso do LBI em alguns estudos, esta análise admite a heterogeneidade dos estudos com resultados conflitantes relacionados à efetividade do LBI. Pesquisas que definam os parâmetros e dosagens terapêuticas adequadas são necessárias para um melhor entendimento sobre os reais efeitos do LBI sobre essa condição clínica.
Palavras-chave
Referências
1 Barbero M, Schneebeli A, Koetsier E, Maino P. Myofascial pain syndrome and trigger points: evaluation and treatment in patients with musculoskeletal pain. Curr Opin Support Palliat Care. 2019;13(3):270-6.
2 Lew J, Kim J, Nair P. Comparison of dry needling and trigger point manual therapy in patients with neck and upper back myofascial pain syndrome: a systematic review and meta-analysis. J Man Manip Ther. 2021;29(3):136-46.
3 Afonso C, Jacinto J. Síndrome miofascial: diagnóstico e abordagem em MFR I. Rev Soc Port Med Fís Reabil. 2009;17(1):39-42
4 Momenzadeh S, Akhyani V, Razaghi Z. Evaluation of the effects of intravenous and percutaneous low level laser therapy in the management of shoulder myofascial pain syndrome: A controlled randomized clinical trial. J Lasers Med Sci. 2016;7(1):16-20.
5 Dundar U, Evcik D, Samli F, Pusak H, Kavuncu V. The effect of gallium arsenide aluminum laser therapy in the management of cervical myofascial pain syndrome: a double blind, placebo-controlled study. Clin Rheumatol. 2007;26(6):930-4.
6 Barbero M, Schneebeli A, Koetsier E, Maino P. Myofascial pain syndrome and trigger points: evaluation and treatment in patients with musculoskeletal pain. Curr Opin Support Palliat Care. 2019;13(3):270-6.
7 Baldry, Peter. Acupuncture, Trigger Points and Musculoskcletal Pain. 2nd ed. Churchill Livingstone, New York. 1993.
8 Clijsen R, Brunner A, Barbero M, Clarys P, Taeymans J. Effects of low-level laser therapy on pain in patients with musculoskeletal disorders: a systematic review and meta-analysis. Eur J Phys Rehabil Med. 2017;53(4):603-10.
9 Tomazoni SS, Almeida MO, Bjordal JM, Stausholm MB, Machado CDSM, Leal-Junior ECP, Costa LOP. Photobiomodulation therapy does not decrease pain and disability in people with non-specific low back pain: a systematic review. J Physiother. 2020;66(3):155-65
10 Gross AR, Dziengo S, Boers O, Goldsmith CH, Graham N, Lilge L, Burnie S, White R. Low level laser Therapy (LLLT) for neck pain: a systematic review and meta-regression. Open Orthop J. 2013;7:396-419.
11 Kitchen S. Eletroterapia: prática baseada em evidências. 1ª ed. Manole; 2003.
12 Cotler HB, Chow RT, Hamblin MR, Carroll J. The use of low level laser therapy (LLLT) for musculoskeletal pain. MOJ Orthop Rheumatol. 2015;2(5):00068.
13 Shiwa SR, Costa LOP, Moser ADL, Aguiar IC, de Oliveira LVF. PEDro: a base de dados de evidências em fisioterapia. Fisioter Mov. 2011;24(3):523-33
14 Gur A, Sarac AJ, Cevik R, Altindag O, Sarac S. Efficacy of 904 nm Gallium Arsenide low level laser therapy in the management of chronic myofascial pain in the neck: a double-blind and randomize-controlled trial. Lasers Surg Med. 2004;35(3):229–35.
15 Lee JH, Han J T. The dose-dependent effect of an 830-nm, 450-mW low-level laser therapy on the myofacial trigger point of the upper trapezius muscle: a randomized, double-blinded, clinical trial. J Phys Ther Sci. 2011;23(6):933-5.
16 Torsen H, Gam AN, Svensson BH, Jess M, Jensen MK, Piculell I, Schack LK, Skjøtt K. Low level laser therapy for myofascial pain in the neck and shoulder girdle. A double-blind, cross-over study. Scand J Rheumatol. 1992;21(3):139-41
17 Ceylan Y, Hizmetli S, Siliğ Y. The effects of infrared laser and medical treatments on pain and serotonin degradation products in patients with myofascial pain syndrome. A controlled trial. Rheumatol Int. 2004;24(5):260-3.
18 Ilbuldu E, Cakmak A, Disci R, Aydin R. Comparison of laser, dry needling, and placebo laser treatments in myofascial pain syndrome. Photomed Laser Surg. 2004 Aug;22(4):306-11.
19 Altan L, Bingöl U, Aykaç M, Yurtkuran M. Investigation of the effect of GaAs laser therapy on cervical myofascial pain syndrome. Rheumatol Int. 2005;25(1):23-7.
20 Rayegani S, Bahrami M, Samadi B, Sedighipour L, Mokhtarirad M, Eliaspoor D. Comparison of the effects of low energy laser and ultrasound in treatment of shoulder myofascial pain syndrome: a randomized single-blinded clinical trial. Eur J Phys Rehabil Med. 2011;47(3):381-9.
21 Manca A, Limonta E, Pilurzi G, Ginatempo F, De Natale ER, Mercante B, Tolu E, Deriu F. Ultrasound and laser as stand-alone therapies for myofascial trigger points: a randomized, double-blind, placebo-controlled study. Physiother Res Int. 2014;19(3):166-75.
22 Kadhim-Saleh A, Maganti H, Ghert M, Singh S, Farrokhyar F. Is low-level laser therapy in relieving neck pain effective? Systematic review and meta-analysis. Rheumatol Int. 2013;33(10):2493-501.
23 Tehrani MR, Nazary-Moghadam S, Zeinalzadeh A, Moradi A, Mehrad-Majd H, Sahebalam M. Efficacy of low-level laser therapy on pain, disability, pressure pain threshold, and range of motion in patients with myofascial neck pain syndrome: a systematic review and meta-analysis of randomized controlled trials. Lasers Med Sci. 2022;37(9):3333-41.
24 Stausholm MB, Naterstad IF, Joensen J, Lopes-Martins RÁB, Sæbø H, Lund H, Fersum KV, Bjordal JM. Efficacy of low-level laser therapy on pain and disability in knee osteoarthritis: systematic review and meta-analysis of randomised placebo-controlled trials. BMJ Open. 2019;9(10):e031142.
25 Naruseviciute D, Kubilius R. The effect of high-intensity versus low-level laser therapy in the management of plantar fasciitis: randomized participant blind controlled trial. Clin Rehabil. 2020;34(8):1072-82.
26 Glazov G, Yelland M, Emery J. Low-level laser therapy for chronic non-specific low back pain: a meta-analysis of randomised controlled trials. Acupunct Med. 2016;34(5):328-41.
27 Baxter GD, Bleakley C, McDonough S. Clinical effectiveness of laser acupuncture: a systematic review. J Acupunct Meridian Stud. 2008;1(2):65-82
28 Chow RT, Johnson MI, Lopes-Martins RA, 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):1897-908.
Submetido em:
15/11/2022
Aceito em:
24/02/2023
Facebook
Google+
Twitter
LinkedIn
Mendeley
Email