Common Pain Relievers Raise Heart Risk For Healthy Adults

Common Pain Relievers Raise Heart Risk for Healthy Folks

 TUESDAY, June 8 (HealthDay News) — Healthy people who take nonsteroidal anti-inflammatory drugs to relieve minor aches and pains may raise their risk of dying from heart-related problems, a Danish study finds.

The American Heart Association and the U.S. Food and Drug Administration already warn people with heart disease to be cautious about taking NSAIDs, which include ibuprofen (brand named Advil, Motrin) and diclofenac.

 The new study is the first to show the same kind of increased risk among people without cardiac problems, says a report in the July issue of Circulation: Cardiovascular Quality and Outcomes, published online June 8.

 “Very few studies have been designed to answer the important question: Do NSAIDs also increase the cardiovascular risk among healthy people who use these drugs for minor complaints?” said lead author Dr. Emil L. Fosbol, a cardiologist at Gentofte University Hospital in Hellerup. “This study is the first to confirm that the cardiovascular risk is indeed increased when healthy individuals use some of the drugs.”

 The risks for different NSAIDs — found in an analysis of national medical records of more than one million Danes from 1997 to 2005 — varied widely. Participants, whose average age was 39, who used ibuprofen had a 29 percent greater risk of fatal or nonfatal stroke, compared to those who took no NSAID.

 Use of diclofenac (Voltaren and Cataflam) was associated with a 91 percent higher risk of death from all cardiovascular diseases, while rofecoxib (Vioxx) use was associated with a 66 percent increased risk. But the study found no increased risk of cardiovascular problems — indeed, a slightly lower risk of death — associated with naproxen, sold over the counter with brand names including Aleve.

 For people taking the largest doses, diclofenac was associated with a doubled risk of heart attack, and rofecoxib (Vioxx) was associated with a threefold increased risk of heart attack. Vioxx was taken off the U.S. market in 2004 because of a study finding high rates of heart attack and stroke.

 “These findings are completely consistent with what we have found in patients with cardiovascular disease,” Dr. Michael E. Farkouh, a clinical cardiologist at Mount Sinai Cardiovascular Institute in New York City, said of the Danish study. “Drugs that elevate blood pressure and are associated with a thrombotic [artery-blocking] effect can be harmful in patients who are otherwise healthy.” 

The percentage increases in the study were large, but the absolute overall risk in otherwise healthy people was small, Farkouh said. Nevertheless, “before you take any medication, you should consult with a physician, particularly these medications,” he said.

 That warning applies especially to people who exercise regularly and are thus more likely to take an NSAID for muscle and joint pain, Farkouh said. Regular use of an NSAID increases the risk not only of cardiovascular problems but also of bleeding, a known side effect of the medications, he said.

 In fact, the Danish study found an increased incidence of major bleeding events, some fatal, from all NSAIDs except celecoxib (Celebrex). Celecoxib did not appear to raise the risk of coronary death or stroke either.

 The Danish findings are consistent with a 2007 American Heart Association (AHA) scientific statement about the increased risk of heart attack and stroke associated with NSAID use, said Dr. Elliott Antman, professor of medicine at Harvard Medical School and Brigham and Women’s Hospital, lead author of that paper, in a statement issued Tuesday by the AHA.

 The recommendations we made were based on our best estimates from the existing pharmacological and biological research available at the time,” Antman said. “I find this new study reassuring because it endorses the recommendations we made using a large body of actual clinical evidence.” 

Antman’s advice for anyone taking an NSAID regularly is that “it is advisable to discuss with your physician why it was originally recommended or prescribed, whether you need to continue taking it, and at what dose.”

 t may be wise to consider alternatives, the study authors and other experts said.”The majority of studies have shown that naproxen has a safe cardiovascular risk profile and that ibuprofen in low doses (1200 mg and below per day) also is safe in respect to the cardiovacular risk,” Fosbol said.

 

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Cold Laser Saves Legs

COLD LASER SAVES LEGS

About one million people in the United States suffer from a condition called critical limb ischemia, or CLI. It’s common among people with diabetes and leads to about 100,000 amputations a year. Now, a procedure that’s changing that statistic.

At 77, Rene Heredia has had his share of frustration.

Most of that frustration came from dealing with the pain in his legs.

Rene Heredia
Suffered severe pain
“I swear, the pain was so intense. I don’t wish that pain to my worst enemy.”

Rene has critical limb ischemia — a painful condition that blocks blood flow in his legs. A simple cut can have devastating consequences.

Daniel Garnic, M.D.
Cardiovascular & Interventional Radiologist
Glendale Memorial Hospital
Glendale, CA
“It leads from a minor scrape or cut to what could end up as an amputation.”

In fact, the condition leads to about 100,000 amputations every year. Smoking, diabetes and high cholesterol raises the risk.

Now, doctors are saving legs with this, a cold laser that can eat through plaque.

Daniel Garnic, M.D.
“At the tip of the laser, the light energy touches the plaque and vaporizes it.”

It’s called clirpath and it lets doctors work through blockages they couldn’t get through before. This image shows three blocked areas of the leg. After clirpath, the increased blood flow is obvious. Studies show the laser can save 93 percent of limbs from being amputated.

Daniel Garnic, M.D.
“This is the best thing that’s come down in peripheral vascular disease, I think, in the last 20 years.”

It worked for Rene.

Rene Heredia
“No more complaints. No more pain.”

With his pain gone, Rene now has time to deal with life’s smaller frustrations.

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Cold Laser: Improving a Pain Sufferer’s Quality of Life

I like to spend some of my day (in between clients) to add interesting articles about advancements in all things cold laser. It is amazing how LLLT has transformed the lives of millions of people suffering from chronic pain, addiction, and even Alzheimer’s Disease.

Here is just two more clinical examples of how cold laser is improving a pain sufferer’s quality of life without medication, etc:

Acute Cervical Pain is Relieved with Gallium Arsenide (GaAs) Laser radiation: A Double Blind  Study

Study Design/Patients and Methods: Seventy‐one patients with acute cervical pain were randomized in two groups.
Group A, 37 patients were irradiated with a pulsed GaAs diode laser, 904 nm, pulse width 200 nsec, pulse frequency
10,000 Hz, peak power of 20 W, average power 40 mW, spot size 150 um2 in area (incident power density of
approximately 26 W/cm2) and an angle of divergence of 6o. The laser was applied in the point technique with a dose of 4 J/cm2 per point in the area of pain. Group B, 34 patients, was treated with sham irradiation with a deactivated laser system. Neither the patients nor the operator knew which group each patient was randomly assigned to. The use of analgesic drugs and physical therapy was excluded in both groups. Pain was evaluated through a linear colour scale.
Laser treatment was considered effective when pain relief was more than 60%. Efficacy of Low Power Laser Therapy in Fibromyalgia: A Single‐Blind, Placebo‐Controlled Trial .LLLTof pain and pain sites. The aim of this work is to evaluate the real therapeutic effect versus the placebo effect of laser therapy in patients with acute cervical pain in both the immediate effect and the possible latency of the pain relief with  different kindslaser into our therapeutic arsenal and up to date we have irradiated more than two thousand patients with  GaAslaser radiation is an efficient and safe treatment for patients with acute cervical pain. Six years have passed since we incorporated the  GaAsThese results suggest that  

Results: The treatment was effective in 94.59% of patients in group A and 38.24% of group B (p < 0.0019). The pain was relieved completely in 67.56% of patients in group A and in 17.65% in group B. In patients in whom the response to the treatment was effective, the pain returned in the six months following treatment in 14.28% of Group A, but in 58.33% of group B (p < 0.005). No side effects were observed.

Conclusion:

 Objective: The aim of this study was to evaluate the effectiveness of 904‐nm low‐level laser therapy (LLLT) in the
management of fibromyalgia.

Background: Low energy lasers are widely used to treat a variety of musculoskeletal conditions including fibromyalgia.
Methods: A randomised, single‐blind, placebo‐controlled study was conducted to evaluate the efficacy of low‐energy
laser therapy in 40 female patients with fibromyalgia. Patients with fibromyalgia were randomly allocated to active (Ga‐As) laser or placebo laser treatment daily for two weeks except weekends. Both laser and placebo laser groups were evaluated for the improvement in pain, number of tender points, skinfold tenderness, stiffness, sleep disturbance, fatigue, and muscular spasm.

Results: In both groups, significant improvements were achieved in all parameters (p<0.05) except sleep disturbance, fatigue and skinfold tenderness in the placebo laser group (p>0.05). It was found that there was no significant difference between the two groups with respect to all parameters before therapy whereas a significant difference was observed in parameters as pain, muscle spasm, morning stiffness and tender point numbers in favour of laser group after therapy (p<0.05). None of the participants reported any side effects.

Conclusion: Our study suggests that laser therapy is effective on pain, muscle spasm, morning stiffness, and total tender point number in fibromyalgia and suggests that this therapy method is a safe and effective way of treatment in the cases with fibromyalgia

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Ministry of Public Health Study: LLLT reduced headache frequency by 73%!

I just wanted to share another interesting study that demonstrates efficacy of cold laser for tension headaches:

Low-Level Laser For Treating Tension-Type Headache
T. Y. Guseinov

A new technique for treating patients with chronic headache and pericranial muscular-sceletal dysfunction has been developed (methodological recommendations of RF Ministry of Public Health 961/255, 1997). This technique includes low-level laser therapy, manual therapy and training on muscular relaxation. Good and excellent results were seen in 61,7% of patients after treatment. The frequency of headache attack was reduced by 73%, duration – by 66%, intensity – by 40%. Low-level laser therapy promotes muscular and joint trigger points inactivation and is perspective for treating chronic tension-type headache.

Non-Pharmacological Approaches To Chronic Headaches: Transcutaneous Electrical Nerve Stimulation, Laser Therapy And Acupuncture In Transformed Migraine Treatment Allais G, De Lorenzo C, Quirico P E, Lupi-G et al. Neurological Sciences. 2003; 24, Suppl 2.

In an open, randomized trial, we evaluated transcutaneous electrical nerve stimulation (TENS), infrared laser therapy and acupuncture in the treatment of transformed migraine, over a 4-month period free of prophylactic drugs. Sixty women suffering from transformed migraine were assigned, after a one month run-in period, to three different treatments: TENS (Group T; n=20), infrared laser therapy (Group L; n =20) or acupuncture (Group A; n=20). In each group the patients underwent ten sessions of treatment and monthly control visits. In Group T patients were treated for two weeks (5 days/week) simultaneously with three TENS units with different stimulation parameters (I: pulse rate = 80 Hz, pulse width = 120 micros; II: 120 Hz, 90 micros; III: 4 Hz, 200 micros). In Group L an infrared diode laser (27 mW, 904 nm) was applied every other day on tender scalp spots. In Group A acupuncture was carried out twice a week in the first two weeks and weekly in the next 6 weeks.

A basic formula (LR3, SP6, LI4, GB20, GV20 and Ex-HN5) was always employed; additional points were selected according to each patient’s symptomatology. The number of days with headache per month significantly decreased during treatment in all groups. The response in the groups differed over time, probably due to the different timing of applications of the three methods. TENS, laser therapy and acupuncture proved to be effective in reducing the frequency of headache attacks.

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Soy Diet May Help Manage Pain

	Traditional therapies for chronic pain include opiate and morphine medication, which can be addictive and cause unpleasant side effects. However, chronic pain sufferers may be able to find relief in a diet based on soy protein, according to new research presented at the annual American Pain Society meeting in March in Baltimore.“Studies have shown that chronic pain patients are undertreated due to physicians’ lack of proper and full education about pain management, in addition to the physicians’ concerns about the addictive properties of morphine and opiates and the tendency for patients to build up a tolerance to the medication over time,” says Jill M. Tall, a lead author of the unpublished study and a postdoctoral fellow in Johns Hopkins Medical Institutions’ division of anesthesiology and critical care medicine. Chronic pain is a condition suffered by millions of Americans, and it often leads to partial or complete disability, according to the Centers for Disease Control and Prevention. Although the underlying cause of pain may vary, many cases share the feature of inflammation. Besides causing edema (accumulation of excess fluid under the skin), inflammation also causes hyperalgesia, an enhanced response to painful stimuli such as heat and pressure. Under the direction of Srinivasa N. Raja, Hopkins’ director of pain research, Tall and her colleagues tested 2 groups of 10 rats each. For 2 weeks, one group was fed a diet based on soy protein and the other a diet based on casein (a milk protein found in cheese). Researchers randomly injected each rat’s hind paw with either a placebo or a solution designed to cause inflammatory pain. Researchers measured inflammation and fluid buildup in the afflicted paw and then tested pain tolerance in the paw by applying heat. Finally, they applied a series of nylon filaments to the paw to test pressure sensitivity. These tests were repeated 6, 24, 48, and 96 h after the injection. “Our results showed that the edema and fluid buildup were less in the animals on the soy protein diet in comparison to other animals,” Tall explains. “We also found that animals consuming soy were able to tolerate the heat stimulus longer. The two groups showed no difference in reaction to the pressure stimulus.” Tall and her colleagues plan to publish this study in the near future. “While stressing that this is a preclinical animal model, we are finding that there are dietary influences that can have a positive effect on pain management,” says Tall. “Hopefully in the future, we will have complementary and possibly alternative therapies to offer chronic pain sufferers.”

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Acute Pain: The Misunderstood Illness

Fibromyalgia: The Misunderstood Disease

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Fourteen years ago, Josephine began to experience severe pain throughout her body. As her symptoms became worse, she sought help from a variety of specialists, but no one could diagnose her condition.

“I was told they didn’t know what was wrong with me; the blood tests came back good, x-rays came back clear,” she says. “They had no idea and they’d shuffle me to another doctor, another specialist.” She saw rheumatologists, neurologists, internists, and blood specialists, but there was still no answer.

After more than a year, she was finally diagnosed with fibromyalgia, a chronic and debilitating condition that causes severe pain throughout the body. Ongoing research at the University of Michigan is demonstrating that fibromyalgia may affect millions of Americans, and research using sophisticated imaging techniques is helping the medical community better understand this disease.

“Fibromyalgia is a condition that’s characterized by widespread pain involving the muscles, the joints, and in fact, any area of the body,” explains Daniel Clauw, M.D., director of the U-M Chronic Pain and Fatigue Research Center. “In addition to pain, individuals with fibromyalgia often experience sleep fatigue, difficulties with sleep, and difficulties with memory and concentration, among other symptoms.”

Josephine’s symptoms included extreme fatigue, recurring headaches, chest pains, stomach and intestinal problems, muscle fatigue and weakness, restricted mobility, and anxiety. At her worst point, Josephine was bed-ridden and medicated to the point that she wasn’t functioning due to the pain.

However, there is hope. “Fibromyalgia is gaining respect in both the scientific and the lay community because of all the research that’s been conducted first, showing that it’s a real disease, and second, showing that there are drugs that specifically work to treat fibromyalgia,” Clauw says. “Our group and others at the University of Michigan have been very involved in looking at the underlying mechanisms of fibromyalgia.”

Clauw and his colleagues use a technique called functional imaging, which allows scientists to look at how different areas of the brain function when people are given painful stimuli. What they have found is that for the same amount of damage or inflammation in the peripheral tissues, a fibromyalgia patient would feel significantly more pain than the average person. Patients with fibromyalgia can also experience pain throughout their entire body even without any damage or inflammation of the peripheral tissues.

“We think that one of the primary abnormalities in fibromyalgia is an imbalance between the levels of neurotransmitters in the brain that affect pain sensitivity,” Clauw says. With this knowledge, new treatments are being developed to combat the condition’s symptoms. “Although right now there are no drugs approved to treat fibromyalgia, within three years it its likely that there will be three, if not four, drugs specifically approved to treat the condition,” he says.

These drugs fall into two general classes. One class raises the levels of neurotransmitters that normally stop the spread of pain, while another class lowers the levels of neurotransmitters that normally increase the spread of pain.

The American College of Rheumatology estimates that about 3 percent of Americans suffer from fibromyalgia, but Clauw notes that this may not accurately reflect the number of people with this condition. “It’s widely agreed that their definition is very restrictive. In fact, it’s probably more like 5 or 6 percent of Americans,” he says.

There are other misunderstandings about fibromyalgia. Some physicians believe that its symptoms are all psychological. “The doctors say, ‘Well it’s all in your head, you just need to get some extra rest and you’ll be fine, toughen up,'” Josephine remembers. Another misconception about the disease is that it is caused by inflammation in the muscles. Doctors now know that neither of these theories is true. “This is not an inflammatory disorder and this is not a primary psychological condition,” Clauw clarifies. “Pain is always a subjective matter, but everything that we can measure about the pain in fibromyalgia shows that it is real.”

Unfortunately, patients are often misdiagnosed as having disorders such as rheumatoid arthritis, chronic fatigue syndrome, or irritable bowel syndrome. Fibromyalgia has no definitive diagnosis, so doctors must rely on a patient’s medical history and symptoms when diagnosing the illness, excluding conditions that might cause similar amounts of widespread pain.

The condition’s cause is still unknown, although it is probably a combination of genetics and environment. “A person is about eight times more likely to develop fibromyalgia if one of their relatives has it,” says Clauw. “But there are also certain environmental triggers. For example, people develop fibromyalgia after motor vehicle accidents, or after certain types of infections or biological stress,” he continues. Although the disease is more common in women, there are no real demographic factors that can predict its development.

Clauw recommends that anyone who experiences pain or fatigue that is severe enough to inhibit day to day functioning seek medical attention, even if the symptoms have only lasted a couple of days. “It’s better to get medical attention and appropriate treatment early for this condition,” he says.

As for Josephine, maintaining a positive attitude and acknowledging and accepting the disease has helped her live a more normal life. “I know that I will always have this disease, but now I see myself as a survivor,” she says.

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A Client’s Story: Pain Reduction with Cold Laser

“My experience with Pacific Laser Therapy has only just started, but already the improvements to recent surgical areas (as well as life-long chronic pain points) have been nothing short of amazing. 

My left rotator cuff and bicep muscle were both torn severely and a large bone spur had developed which needed to be ground down.  This surgery was quite extensive and painful with medication and physical therapy prescribed for nearly 6 months.  However, after only one laser therapy session, there has already been a noticeable lessening in the pain I experience (both muscular and deep tissue). 

This not only makes the physical therapy more effective and less uncomfortable, but also allows me to get through the day with considerably less pain medication.”

– Lisa C., Santa Barbara, CA

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Low Level laser Therapy or NSAIDS?

Low Level Laser Therapy (LLLT) or NSAIDs ?

NSAIDs slow healing and often have side effects whereas LLLT actually improves healing, as well as reducing inflammation and pain.

CLINICAL APPLICATIONS:

• Acute or chronic tendinopathies
• Sprains and strains
• Neck and back pain
• Osteoarthritis
• Post-operative pain
• Tissue healing

NSAIDs ADVERSE EFFECTS

“If deaths from gastrointestinal toxic effects from NSAIDs were tabulated separately in the National Vital Statistics reports, these effects would constitute the 15th most common cause of death in the United States”
Wolfe et al, New England Journal of Medicine 1999

Selective cyclo-oxygenase-2 inhibitors have been shown to be detrimental to tissue-level repair. They have been shown to impair mechanical strength return following acute injury to bone, ligament and tendon. This may have clinical implications for future injury susceptibility. However, it should be noted that the current animal studies have limited translation to the clinical setting. Adverse effects related to the CNS and gastrointestinal adverse reactions are commonly reported in connection with NSAID use also in elite athletes. In addition to the potential for adverse effects, recent studies have shown that NSAID use may negatively regulate muscle growth by inhibiting protein synthesis
Alaranta et al, Sports Med, 2008

Another interesting revelation is the adverse effects of NSAIDs, laboratory research shows that use of steroids and Non Steroidal Anti-Inflammatories (NSAIDs) reduce tendon to bone healing, doubles the risk of sudden heart failure and causes erectile dysfunction. Laser on the other hand improves healing and achieves better pain relief in clinical trials. With over 100 randomised double blind placebo controlled clinical trials (RCTs) published in peer reviewed scientific journals LLLT has one of the strongest evidence, a very strong evidence base in rehabilitation medicine and should be used as the first therapeutic intervention after injury and instead of NSAIDs.

An excellent alternative to NSAIDs

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New England Patriots Players Heal with Cold Laser, Washington Post Article

 

Cold Laser Therapy Is Joining the Injury Treatment Team By Lois Lindstrom The Washington Post, Tuesday Feb. 17, 2004

The New England Patriots won Super Bowl XXXVIII with some help from a little-known form of laser technology that could change the way athletic injuries and chronic pain are treated. The treatment, known as “cold” laser therapy or low-level laser therapy (LLLT), has been used internationally for 18 years to treat soft tissue injuries, cervical neck pain, carpal tunnel syndrome, repetitive stress injuries, tendonitis, hamstring injuries, arthritis and wound healing, among others. The lasers — hand-held, flashlight-like devices that direct a beam of narrow-spectrum (but not hot) light at injured tissue beneath the skin — have been integrated into medical practice in Japan, Russia and the United Kingdom. In the United Kingdom, cold laser therapy has become a preferred treatment for “whiplash” injuries, neuralgia and shingles. In Japan, the lasers were approved in 1987 and are in widespread use today. In the United States, the technology received marketing clearance from the Food and Drug Administration (FDA) in 2002 for treating carpal tunnel syndrome, a painful inflammation of the wrists and hands that results from repetitive motion. But the mainstream medical establishment still considers the cold laser’s benefits un-proven. Most U.S. users are athletic trainers, chiropractors and practitioners of alternative medicine. “The medical community needs more scientific studies done in the United States,” said Wayne Good, a general surgeon in Waterford, Mich., who participated in the clinical trials that led to FDA clearance of the laser device. Good worked with General Motors Corp., which hosted the double-blind, placebo-controlled trials on serious carpal tunnel sufferers as a way to seek more cost-effective treatment for the condition, which affects many auto workers. Good said the treatment proved about 70 percent effective in getting injured workers, most of whom had failed to respond to other treatments, back on the job. GM offers the treatment to injured workers in its in-plant medical clinics. But insurance payment for the procedure is also an issue holding doctors back, Good said. Many U.S. insurers will not pay for cold laser treatment, citing the need for further research proving its benefits. “If the major insurance companies… do not pay for the technology,” Good said, “the doctor cannot be reimbursed for treating his patients.” Sport and Health While mainstream medicine remains on the sidelines, practitioners of sports medicine, who are highly motivated to find new ways to heal soft-tissue injuries and bruises, are getting right into the cold laser game. In the week preceding the Super Bowl, Boston based registered nurse Ellen Spicuzza treated more than 10 Patriot players with cold laser therapy for tendon and muscle injuries. “A couple of days prior to the Super Bowl weekend, I treated [Patriot wide receiver] David Givens, who had a locked-up hamstring,” she said. She rotated the $4,000, pen-like laser over the “belly” of his hamstring muscle for about five minutes, she said. “The laser released it.” Spicuzza, an independent nurse/physical therapist in Boston, usually treats Patriot players’ injuries with medical massage. For the big game, she for the first time used low level laser therapy on the athletes’ most troublesome pain spots. Before using the cold laser, Spicuzza was skeptical. “I am not into gimmicks,” she said. “I didn’t think it would help.” But she changed her mind after seeing how the laser expedited healing of some players’ soreness and pain. “I don’t think [the improved recoveries were] a coincidence,” Spicuzza said. “It did help. I used it on a flared-up sciatic nerve, and the player had relief soon after treatment.”

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Great Article- Cold Laser Therapy Zaps Tendonitis!

‘Cold’ laser therapy will zap tendonitis

By Brian Diaz, Guest Columnist
Publication: The Herald-Sun (Durham, NC)
Date: Thursday, March 5 2009

 

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Following an overwhelming response to a previous topic covered, tendonitis in the knees, I have been asked several questions about treatment options for current and chronic tendonitis.

I previously have covered proper training and exercise technique to hopefully prevent tendonitis in the knees.

Unfortunately, most of us don’t like to take preventative measures and only seek treatment after it becomes a problem. Although I did briefly discuss traditional treatment practices for tendonitis, I have decided to address some of the “newer,” trendier, treatment options for various musculoskeletal ailments including knee and other types of tendonitis.

The first treatment option that I will cover is low-level laser therapy.

Low-level laser therapy gets its more common name of “cold laser therapy” from the type of compressed light of a wavelength from the red part of the light spectrum, or the cold part. It is important to note that this in not a heat treatment. The effects are photochemical, and while the patient does not feel cold, it definitely does not have the warming effect on the soft tissue when compared to the more traditional ultrasound modality.

The physiological and scientific theory behind the cold laser process is that the body’s cells are exposed to the light photon energy (either red or infrared), which in turn directly affects the cells metabolism and mitochondrial production of ATP. This, in theory, will aid in several things including muscle tissue and collagen development, as well as improved blood circulation and tissue repair. Advocates of cold laser treatment also add other types of interactions ranging from improvement of the nervous and immune systems to healing of wounds. But for the sake of this article, the buildup of the tendon matrix and its recovery is our main focus.

Upon review of the literature, there are over several hundred published laboratory studies of the effects of cold laser treatment on tendonitis and inflammation. Although many are randomized, double blind, controlled trials, several lack the number of participants to draw any statistically significant results.

Nonetheless, one fairly large systemic review of the studies by a group out of Australia did find significant benefit in reduction of inflammation of the tendon. In another study, a group of subjects with chronic tendonitis that had previously tried traditional physical therapy, anti-inflammatories (both pills and injections), and/or surgery, had an 87 percent success rate in pain and symptom reduction following the application of cold laser.

So would I recommend its application? Yes. The studies that support its effectiveness far outweigh the other neutral studies (none reported that the treatment made symptoms worse). And even though the support isn’t overwhelming just yet, new studies are being done every year, and wouldn’t you want to know you have tried all you can before resorting to your 3rd cortisone injection of the year, or even worse, surgery? At the clinic where I work, I apply the cold laser to almost all cases of tendonitis as an adjunct to other manual therapy techniques and traditional modalities. But let us not forget, prevention of the inflammation is even more critical, and in many cases you will need a comprehensive strengthening program before returning to your activity or sport.

Low-level laser therapy is performed on a patient with tendonitis. The therapy helps both current and chronic tendonitis. Low-level laser therapy gets its more common name of “cold laser therapy” from the type of compressed light of a wavelength from the red part of the light spectrum, or the cold part. The effects are photochemical, and while the patient does not feel cold, it definitely does not have the warming effect on the soft tissue when compared to the more traditional ultrasound modality.

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