Treatment of Scapulohumeral Periarthritis and Post-traumatic Joint Pain
In this issue, I want to share with you an interesting study from Russia that I came across several months ago. One of the most interesting features of the study is that it was done at one of the largest medical institutions in Russia having a hospital staff of 920.
This study reported on the results of utilizing a magneto-infrared laser in the treatment of scapulohumeral periarthritis and post-traumatic injury of the joints. This study was overseen by Colonel, Professor Alexander S. Shets, Doctor of Science.1 He is the head of the main clinical hospital in the city of Moscow. This hospital is one of the main hospitals of the Ministry of Internal Affairs of the Russian Federation. It provides medical services to the employees of the Ministry of Internal Affairs.
The hospital staff of 920 includes 11 Doctors of Science and 38 PhDs. This hospital is equipped with the most contemporary medical diagnostic and therapeutic equipment available.
This clinical study was performed in the trauma department. This study was performed from February 2000 to October 2000 on patients that were suffering from scapulohumeral periarthritis and post-traumatic joint injuries. Patient demographics are presented in Table 1.
Medical history of condition:
Medical history of condition:
Patients of each condition—scapulohumeral periarthritis or post-traumatic injury of joints—were divided into three groups and treated as follows:
- 3 therapeutic departments
- 2 surgical departments including surgical blocks and a trauma unit
- burn center
- physiotherapy and rehabilitation department
- clinical and diagnostic laboratories • functional diagnosis department
- Group 1: treated with conventional pharmacological, surgical and physiotherapeutic modalities
- Group 2: treated with magneto-laser therapy
- Group 3: treated with placebo laser (applicable only to the post-traumatic joint injury cohort)
Patients in group 2 were treated by magneto-laser protocols established by the developer, Medical Quant, and documented in the equipment’s user manual. Figure 1 illustrates treatment of the scapulohumeral region. The treatment consisted of 12 – 15 sessions of daily magneto-laser therapy. The outcome criteria included decrease in pain, improved locomotor function, and positive x-ray examination changes.
Figure 2 presents a diagrammatic representation of the four technologies used in the emitter of the laser device that was utilized in this study. It incorporates GaAs Infrared laser, pulsed broadband non-coherent IR , red non-coherent light, and a static magnetic field. Doug Johnson, ATC, reviewed some of the concepts relating to how these technologies work together in his article Therapeutic Laser Evolution–Part I in the October 2008 issue of PPM.2
We will recall that laser and light therapy initiates a multi-faceted cascade of biochemical and physiological effects. These include:
- Stabilization of the cell membrane3
- Research in laser and light therapy has documented that red and near infrared light reduces pain by a combination of these responses:
- Increases in ß-Endorphins
- Blocked depolarization of C-fiber afferent nerves11
- Axonal sprouting and nerve cell regeneration12
- Decreased Bradikynin levels
- Ion channel normalization
|Nosology||Number of Patients||Treatment Results|
|Scapulohumeral periarthritis||90||40||50||0||Positive effect 63%||
|Post-traumatic injury of joints||90||45||40||5||Positive effect 56%||
||Positive effect 17%|
Figure 3 summarizes the mechanism of biological and therapeutic effects of low level laser radation. These multiple biochemical effects can account for much of the clinical results reported in this study.
The results for each of the patient cohorts are presented in Table 2. Improved pain relief, less dependency on pharmaceuticals, and a shorter recovery was experienced in the magneto-laser group for both conditions. This is an interesting hospital-based study in that it had 90 subjects per condition and contained a broad range of patient ages, duration of condition prior to treatment, and the post-traumatic joint injury cohort also had a small group of patients subjected to sham laser.
- Enhancement of ATP synthesis4
- Stimulated vasodilation along with increased histamine, NO, and serotonin5
- Acceleration of leukocyte activity
- Increased Prostaglandin synthesis6
- Reduction in Interleukin-1 levels7
- Increased angiogenesis8
- Enhanced superoxide dismutase9
- Decreased C-reactive protein and neopterin levels10