Complex Regional Pain Syndrome / Reflex Sympathetic Dystrophy

Vojnosanit Pregl. 2010 Sep;67(9):755-60.

Evaluation of low level laser and interferential current in the therapy of complex regional pain syndrome by infrared thermographic camera.

[Article in Serbian]

Koci M, Lazovi M, Dimitrijevi I, Manci D, Stankovi A.

Klinicki centar Nis, Klinika za fizikalnu medicinu, rehabilitaciju i protetiku, Nis, Srbija. kocicm60@gmail.com

Abstract

BACKGROUND/AIM; Complex regional pain syndrom type I (CRPS I) is characterised by continuous regional pain, disproportional according to duration and intensity and to the sort of trauma or other lesion it was caused by. The aim of the study was to evaluate and compare, by using thermovison, the effects of low level laser therapy and therapy with interferential current in treatment of CRPS I.

METHODS: The prospective randomized controlled clinical study included 45 patients with unilateral CRPS 1, after a fracture of the distal end of the radius, of the tibia and/or the fibula, treated in the Clinical Centre in Nis from 2004 to 2007. The group A consisted of 20 patients treated by low level laser therapy and kinesy-therapy, while the patients in the group B (n = 25) were treated by interferential current and kinesy-therapy. The regions of interest were filmed by a thermovision camera on both sides, before and after the 20 therapeutic procedures had been applied. Afterwards, the quantitative analysis and the comparing of thermograms taken before and after the applied therapy were performed.

RESULTS: There was statistically significant decrease of the mean maximum temperature difference between the injured and the contralateral extremity after the therapy in comparison to the status before the therapy, with the patients of the group A (p < 0.001) as well as those of the group B (p < 0.001). The decrease was statistically significantly higher in the group A than in the group B (p < 0.05).

CONCLUSIONS: By the use of the infrared thermovision we showed that in the treatment of CRPS I both physical medicine methods were effective, but the effectiveness of laser therapy was statistically significantly higher compared to that of the interferential current therapy.

Bosn J Basic Med Sci. 2009 Feb;9(1):59-65.

Laser therapy of painful shoulder and shoulder-hand syndrome in treatment of patients after the stroke.

Karabegovi A1, Kapidzi-Durakovi S, Ljuca F.

Author information

  • 1Clinic for Physical Medicine and Rehabilitation, University Clinical Centre, Faculty of Medicine, University of Tuzla, Trnovac b.b., 75 000 Tuzla, Bosnia and Herzegovina.

Abstract

The common complication after stroke is pain and dysfunction of shoulder of paralyzed arm, as well as the swelling of the hand. The aim of this study was to determine the effects of LASER therapy and to correlate with electrotherapy (TENS, stabile galvanization) in subjects after stroke. We analyzed 70 subjects after stroke with pain in shoulder and oedema of paralyzed hand. The examinees were divided in two groups of 35, and they were treated in the Clinic for Physical Medicine and Rehabilitation in Tuzla during 2006 and 2007. Experimental group (EG) had a treatment with LASER, while the control group (CG) was treated with electrotherapy. Both groups had kinesis therapy and ice massage. All patients were examined on the admission and discharge by using the VAS, DASH, Barthel index and FIM. The pain intensity in shoulder was significantly reduced in EG (p<0,0001), swelling is lowered in EG (p=0,01). Barthel index in both groups was significant higher (p<0,01). DASH was significantly improved after LASER therapy in EG (p<0,01). EG had higher level of independency (p<0,01). LASER therapy used on EG shows significantly better results in reducing pain, swelling, disability and improvement of independency.

Masui. 2006 Sep;55(9):1104-11.

Equipment for low reactive level laser therapy including that for light therapy.

[Article in Japanese]

Saeki S.

Department of Anesthesiology, Nihon University School of Medicine (Surugadai Nihon University Hospital), Tokyo.

Abstract

Equipments used for light therapy include machinery used for irradiation by low reactive level laser, xenon light and linear polarized infra-red ray. Low reactive level laser is divided into two types of laser according to the medium by which laser is obtained ; semiconductor laser and helium-neon laser. Low reactive level laser has only one wave length and produces analgesia by action of light itself. On the other hands, Xenon light and linear polarized infra-red ray produce analgesia by warming effect induced by light in addition to the action of light itself. There are four methods of irradiation by these light sources; irradiation of acupuncture points, of trigger points, along nerves causing pain and of stellate ganglion area. Indication for light therapy includes various kinds of diseases such as herpes zoster, post herpetic neuralgia, cervical pain, lumbago due to muscle contracture, complex regional pain syndrome, arthralgia etc. However, we have to know that light therapy does not exert analgesic effects equally to all patients. But light therapy does not accompany pain and rarely shows any side effects. Therefore it is thought to be an alternative for patients who reject injection or patients who are not indicated for nerve block because of patients’ conditions such as bleeding tendency.

Chonnam Med J. 2001 Mar;37(1):49-54. Korea

Effects of Stellate Ganglion Irradiation by the Low-level Laser Therapy on Reflex Dystrophy of the Hemiplegic Arm.

Wee JS, Jung JC, Han JY, Lee SG, Rowe SM.

Department of Rehabilitation Medicine, Chonnam National University Medical School, Kwangju, Korea.  Research Institute of Medical Sciences, Chonnam National University, Kwangju, Korea.

To evaluate the efficacy of low-level laser therapy (LLLT) on reflex sympathetic dystrophy (RSD) of the hemiplegic arm as an addition to a standardized treatment regimen. Twenty patients were assigned equally to a laser treated limb (LL) and a control limb (CL) group. All pateints received 20-minutes laser irradiation, 5 times weekly for a period of 6 weeks. Follow-up studies were also performed in all patients from the initial stage to the end stage of LLLT. A significant improvement in the LL compared to the CL group was found on visual analog scale (p<0.05), subjective and objective symptoms (p<0.01), swelling in hands (p<0.05) and elevation of body temperature in digital infrared thermal imaging (p<0.01) after 6 weeks. From these results it is inferred that LLLT is an useful method of treatment which is able to reduce the symptom of RSD.; however, as a sole treatment for syndrome of RSD it is of limited value. Further studies are needed to evaluate the reliability of our findings and to compare LLLT to other established treatment methods.

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