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Objective: The aim of this clinical study is to determine the efficacy of the JR diode laser 904 nm pulsed on pain reduction
therapy. Summary Background Data: With respect to pain, the existence of a filter (Rolando's substantia gelatinosa) in the
spinal marrow is fundamental. Opening or closing, this filter is able to block transmission of pain impulses to a higher
cerebral center. This is in proportion with the A big fibres and C small fibres. The action of the laser influences this
mechanism. Additionally, laser interferes in the cytochines (TNf-α , interleukin-1 and interleukin-6) that drive inflammation
in the arthritis and are secreted from CD4 e T cells. Low power density laser increases the endorphin synthesis in the dorsal
posterior horn of the spinal cord. Besides, laser causes local vasodilatation of the capillaries and an improved circulation of
drainage liquids in interstitial space causing an analgesic effect. Methods: Treatment was carried out on 482 cases and 464
patients (274 women and 190 men) in the period between 1987 and 2000. The patients, whose age ranged from 25 to 70,
with a mean age of 45 years, were suffering from rheumatic, degenerative and traumatic pathologies as well as cutaneous
ulcers. The majority of the patients had been seen by orthopaedists and rheumatologists and had undergone x-ray,
ultrasound scanning, TAC, RM examination. All patients had previously received drug-based treatment and/or
physiotherapy with poor results. Two thirds were experiencing acute symptomatic pain, while the others presented a chronic
pathology with recurrent crises. We used a pulsed JR diode laser, GaAs 904 nm wavelength. Results: Jn the evaluation of
the results the following parameters have been considered: disappearance of spontaneous and induced pain, anatomic and
functional evaluation of the joints, muscular growth, verbal rating scales, hand dinamometer, patient's pain diary. Very
good results were achieved especially with cases of symptomatic osteoarthritis of the cervical vertebrae, with sport-related
injuries, with epicondylitis, tendinitis, periarthritis and neuritis. The total relief of pain was achieved in 82% of acute and
65% ofchronic cases. Conclusions: Treatment with 904 nm JR diode laser interrupts the "circulus vitiosus" ofthe origin of
the different pains (neuropathic, metabolic, traumatic, toxic, immune-mediated, ischaemic) and its development. LLLT
brings a normal physiological condition back to the tissue, thus myofascial pain relief, decreases tension and substantially
reduces the symptoms as well as improves the quality of life of the patients. Our fourteen years of experience indicates that
LLLT is a low cost, non-invasive method and easy to be applied.
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