Raynaud’s Phenomenon

Scleroderma and raynaud’s phenomenon improve with high-peak power laser therapy: a case report.
St Surin-Lord S, Obagi S.
Dermatol Surg. 2011 Oct;37(10):1531-5. doi: 10.1111/j.1524-4725.2011.02093.x. Epub 2011 Jul 25. No abstract available.

J Rheumatol. 2004 Dec;31(12):2408-12.

Low level laser therapy in primary Raynaud’s phenomenon–results of a placebo controlled, double blind intervention study.

Hirschl M, Katzenschlager R, Francesconi C, Kundi M.

Department of Angiology, Hanusch Hospital, Heinrich Collinstrasse 30, A-1140 Vienna, Austria. Mirko.Hirsch@wgkk.sozvers.at

Abstract

OBJECTIVE: To assess the efficacy of low level laser therapy in patients with primary Raynaud’s phenomenon and predict the success of laser therapy by clinical characteristics.

METHODS: Forty-eight patients were included in a randomized placebo controlled, double blind crossover study. Laser and sham therapy each were applied 5 days a week for 3 weeks. Clinical symptoms, exposure to triggers, and frequency and intensity of attacks were recorded in diaries. Results of infrared thermography before onset and at the end of both irradiation sequences were evaluated. Primary endpoint was the average intensity of attacks; secondary endpoints were average number of attacks and thermography results. Age, sex, duration of symptoms, age at onset of symptoms, evoking conditions other than cold, maximum temperature drop after cold provocation, and rewarming time after cold provocation were tested as potential predictors.

RESULTS: Number of attacks and their intensity were significantly reduced during laser therapy compared to sham treatment. Thermographic parameters did not reach statistical significance. In a stepwise multiple regression analysis, evoking conditions other than cold (stress, wetness as additional triggers), rewarming time, and temperature decrease after cold provocation were significant predictors of therapeutic efficacy.

CONCLUSION: Low level laser therapy reduces frequency and severity of Raynaud attacks. The effect is most pronounced in patients with signs of decreased threshold for vasospasm and less effective in patients with delayed hyperemia.

Vasa. 2004 Feb;33(1):25-9.

Low level laser therapy for treatment of primary and secondary Raynaud’s phenomenon.

al-Awami M, Schillinger M, Maca T, Pollanz S, Minar E.

Department of Medical Angiology, University of Vienna, Austria. mahdi.al-awami@akh-wien.ac.at

BACKGROUND: We recently performed a pilot study which suggested that clinical and thermographic improvements occurred in patients with primary and secondary Raynaud’s phenomenon (RP) following treatment with low level laser irradiation (LLLI). In view of these findings, we have proceeded with a double blind, placebo-controlled study.

METHODS: Forty seven patients suffering from primary or secondary RP were randomly assigned in a double-blind manner to receive either 10 sessions of distant LLLI (16 f, 8 m, median age 45 years) or placebo irradiation (21 f, 2 m, median age 46 years) during winter months. The attack frequency of RP was measured by a diary count; its severity was assessed by means of visual analogue scale. Response to cold challenge test before and after LLL or placebo treatment was assessed by infrared thermography.

RESULT: Overall a significant reduction of the frequency as well as the severity of RP in patients with either LLLI (frequency p < 0.0001, severity p < 0.0001) or placebo treatment (frequency p < 0.0001, severity p = 0.02) was found, but patients in the LLLI group exhibited a statistically more significant improvement of the frequency at 6 weeks p = 0.007 and 3 months p = 0.02 and the severity p = 0.02, p = 0.04 of RP. Thermographic response to cold challenge improved only in patients treated with LLL but not in those treated with placebo.

CONCLUSION: LLLI significantly lowers the frequency and severity of Raynaud’s attacks in patients with primary and secondary RP. Since this therapeutic modality is a safe, and non-invasive treatment, it might be considered as an alternative to existing therapeutic regimes.

Vasa 2002 May 31:91-4

Double-blind, randomised, placebo controlled low level laser therapy study in patients with primary Raynaud’s phenomenon.

Hirschl M, Katzenschlager R, Ammer K et al.

No causal treatment of primary Raynaud’s phenomenon is available due to its unclear aetiology. Low level laser therapy (LLLT) is applied in a multitude of medical conditions often without sufficient evidence of efficacy and established mechanisms. To asses the effect of this therapy in patients with primary Raynaud’s phenomenon a randomised, double blind, placebo controlled cross over study was designed.: Absolute and relative frequency and intensity of vasospastic attacks during three weeks of either LLLT or placebo therapy and results of infrared thermography before onset and at the end of both therapy sequences were evaluated in 15 patients with primary Raynaud’s phenomenon.

RESULTS: Frequency of Raynaud’s attacks was not significantly affected by low level laser therapy. Compared to placebo a significantly lower intensity of attacks during laser irradiation was observed, but no transfer effect occurred. Additionally the mean temperature gradient after cold exposure was reduced after laser irradiation, while the number of fingers showing prolonged rewarming was unaffected. Though further studies are necessary to confirm these results we could demonstrate for the first time in a double blind placebo controlled clinical trial that low laser therapy is a potential candidate for an effective therapy of Raynaud’s phenomenon, although effects seem to be of short duration.

Vasa – Journal of Vascular Diseases. 2001; 30 (4): 281-284.

Low level laser treatment of primary and secondary Raynaud’s phenomenon.

Al Awami M, Schillinger M, Gschwandtner M E et al.

This pilot study was performed to evaluate the efficacy of LLLT as a new non-drug non-invasive treatment for patients with primary and secondary Raynaud’s phenomenon Forty patients ( 29 female, 11 male, mean age 51 years) with active primary (28%) and secondary(72%)Raynaud’s phenomenon received 10 sessions of LLLT distant irradiation during winter months. Assessment of subjective and objective parameters was performed at baseline, one week after the last session and three months later. Variations of subjective parameters as number of daily acute episodes and severity of discomfort were assessed by a coloured visual analogue scale. A standardised cold challenge test using computed thermography of continuous temperature recordings by means of infrared telethermography was used to assess the digital blood flow. A significant improvement was noticed clinically and thermographically after 6 weeks and 3 months, respectively.

Masui. 1992 Nov;41(11):1814-7.

Polarized light irradiation near the stellate ganglion in a patient with Raynaud’s sign

[Article in Japanese]

Otsuka H, Okubo K, Imai M, Kaseno S, Kemmotsu O.

Department of Anesthesiology, Hokkaido University School of Medicine, Sapporo.

Polarized light irradiation near the stellate ganglion was performed in a 55-year-old female with Raynaud’s sign. She was suffering from cold and numb pain in bilateral fingers for 1 year. Stellate ganglion block and low reactive-level laser therapy near the stellate ganglion were not sufficient to relieve this symptom. Polarized light irradiation near the stellate ganglion induced a sting stimulation and warm sensation in her hands. Thermograms revealed a remarkable increase in temperature of her hands. The results imply that polarized light irradiation near the stellate ganglion increases blood flow of forearms and relieves Raynaud’s sign.