Cervical Radiculopathy

Pain Med. 2010 Aug;11(8):1169-78.

Low-level laser therapy for acute neck pain with radiculopathy: a double blind placebo-controlled randomized study.

Konstantinovic LM, Cutovic MR, Milovanovic AN, Jovic SJ, Dragin AS, Letic MDj, Miler VM. Clinic for Rehabilitation, Medical School, University of Belgrade, Sokobanjska 13, Belgrade, Serbia.

Abstract

Objective. The objective of the study was to investigate clinical effects of low-level laser therapy (LLLT) in patients with acute neck pain with radiculopathy. Design. Double-blind, randomized, placebo-controlled study. Setting. The study was carried out between January 2005 and September 2007 at the Clinic for Rehabilitation at the Medical School, University of Belgrade, Serbia. Patients and Intervention. Sixty subjects received a course of 15 treatments over 3 weeks with active or an inactivated laser as a placebo procedure. LLLT was applied to the skin projection at the anatomical site of the spinal segment involved with the following parameters: wavelength 905 nm, frequency 5,000 Hz, power density of 12 mW/cm(2), and dose of 2 J/cm(2), treatment time 120 seconds, at whole doses 12 J/cm(2). Outcome measures. The primary outcome measure was pain intensity as measured by a visual analog scale. Secondary outcome measures were neck movement, neck disability index, and quality of life. Measurements were taken before treatment and at the end of the 3-week treatment period. Results. Statistically significant differences between groups were found for intensity of arm pain (P = 0.003, with high effect size d = 0.92) and for neck extension (P = 0.003 with high effect size d = 0.94). Conclusion. LLLT gave more effective short-term relief of arm pain and increased range of neck extension in patients with acute neck pain with radiculopathy in comparison to the placebo procedure.

SUCCESSFUL MANAGEMENT OF FEMALE OFFICE WORKERS WITH “REPETITIVE STRESS INJURY” OR “CARPAL TUNNEL SYNDROME BY A NEW TREATMENT MODALITY – APPLICATION OF LOW LEVEL LASER

E. Wong G LEE J. Zu CHERMAN and D. P. MASON

Western Heart Institute and St. Mary’s Spine Center St. Mary’s Medical Center. San Francisco. CA. USA and Head and Neck Pain Center, Honolulu HL. USA

Abstract. Female office workers with desk jobs who are incapacitated by pain and tingling in the hands and fingers are often diagnosed by physicians as “repetitive stress injury” (RSI) or “carpal tunnel syndrome” (CTS). These patients usually have poor posture with their head and neck stooped forward and shoulders rounded; upon palpation. they have pain and tenderness at the spinous processes C5 – T1 and the medial angle of the scapula. In 35 such patients we focused the treatment primarily at the posterior neck area and not the wrists and hands. A low level laser ( 100 mW) was used and directed at the tips of the spinous processes C5 – Tl. The laser rapidly alleviated the pain and tingling in the arms, hands and fingers. and diminished tenderness at the involved spinous processes. Thereby, it has become apparent that many patients labeled as having RSI or CTS have predominantly cervical radicular dysfunction resulting in pain to the upper extremities which can be managed by low level laser. Successful long-term management involves treating the soft tissue lesions in the neck combined with correcting the abnormal head, neck and shoulder posture by taping. Cervical collars, and clavicle harnesses as well as improved work ergonomics.

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