Sciatica pain –- low level laser approach

A person seeks for help, sometimes due to pain. This the one reason patients come to a Physical Medicine & Rehabilitation specialist. Now, I’m running my own private clinic, using low level laser as the major equipment.

Last Wednesday, a patient came to me due to pain felt from her back downward. It was sciatica pain. I have given her ILIB (Intravascular Laser Irradiation on Blood) for 20 minutes, and diode laser applied to 10 points. Immediately after the treatment, the pain had gone, and she could walk properly.

Discussion:

Low power laser has physiological effect to relieve pain. Low power laser equipments are relatively easy to be applied. Just turn on the power, and follow the merchant's instruction. But, in practice, it is not that simple. As a doctor, diagnosis is the most important point. For this lady, the therapy must be followed by the use of orthose for the lumbosacral and exercise.

Low Level Laser in Rheumatoid Arthritis

Tiur Farida*, Nury Nusdwinuringtyas*, Satrio Tjondro*,,Yoga Iwanoff Kasjmir**, ,Sumedi Sudarsono,***

*Physical Medicine & Rehabilitation Department, Cipto Mangunkusumo Hospital, Jakarta, Indonesia

** Internal Medicine Department, Cipto Mangunkusumo Hospital, Jakarta, Indonesia

*** YARSI Medical School, Jakarta, Indonesia

Objective : To evaluate the influence of low level LASER therapy, isometric hand strengthening and routine medications in patient with hand rheumatoid arthritis (RA) to reduce pain and increase the range of motion of the metacarpophalanges (MCP)

Design : Pre and post treatment

Setting : Medical Rehabilitation policlinic, Physical Medicine and Rehabilitation Department, Cipto Mangunkusumo Hospital, Jakarta

Participants : Twenty five female patients with hand rheumatoid arthritis in Cipto Mangunkusumo Hospital. Six subjects did not meet the inclusion criteria, two subjects dropped out from the study

Intervention : Between July and November 2004, seventeen female patients with hand rheumatoid arthritis, who were classified in the inclusion criteria were given low level LASER therapy, isometric hand strengthening exercise and routine medications for four weeks.

Results : After four weeks of intervention there was significant decrease on MCP joint pain, marked by decrease in Visual Analog Scale (VAS) (p<0,001)>

Conclusion : Low level LASER therapy combine with isometric hand strengthening exercise can reduce pain and increase the MCP range of motions in patients with hand rheumatoid arthritis

Keyword : RA hand – LASER therapy – Visual analog scale – isometric hand strengthening exercise – range of joint motion

What do "rehabilitation" and "physical medicine" mean?

Traditionally, the central concern of rehabilitation has been the restoration of function so that persons can perform to their fullest physical, emotional, social, and vocational potential. From another perspective, rehabilitation involves behavioral changes and emphasizes coping with a physical impairment caused by disease or injury and learning to adapt in one's own environment.

The terms "rehabilitation" and "physical medicine" are often used synonymously. In fact, they share much in common but are not identical. Physical medicine traditionally has been concerned with the diagnosis and treatment of physical disorders, with special emphasis on the use of neurodiagnostic techniques such as electromyography and the therapeutic application of physical agents such as heat, cold, water, and electricity. Rehabilitation, a broader term, has been associated more with the diagnosis and treatment of functional disorders, with emphasis on the practical, functional assessment of motor, sensory, and cognitive skills and treatment aimed at enhancing function and altering behavior.