Light Therapy for Neuropathy

PBM Light therapy, also known as photobiomodulation (PBM), low-level laser therapy (LLLT) or cold laser therapy, is a non-invasive medical treatment that uses low-intensity light to stimulate cellular function. It is emerging as one of the safest and most effective treatments for acute and chronic pain, including neuropathic pain. It not only decreases pain and inflammation, it also promotes cellular healing. Even better, many home use devices have been developed, reducing the effort and cost involved in treatment.

 

What does PBM Light therapy do?

 

PBM involves the application of specific wavelengths of light to targeted areas of the body, typically using lasers or light-emitting diodes (LEDs). Here's how it can help with pain:

1. Anti-inflammatory effects: PBM has been found to reduce inflammation by inhibiting pro-inflammatory cytokines and increasing anti-inflammatory cytokines. This can help alleviate pain associated with inflammatory conditions such as neuropathy, arthritis or sports injuries.
2. Analgesic effects: PBM can modulate pain signaling pathways by activating peripheral nerve cells called nociceptors. This can result in a reduction in pain transmission and perception, providing analgesic effects.
3. Increased circulation: PBM treatment can improve blood flow and microcirculation in the treated area. Enhanced circulation can promote tissue healing and reduce pain by supplying oxygen and nutrients to the tissues and removing waste products.
4. Accelerated tissue repair: PBM stimulates the production of adenosine triphosphate (ATP), which is the energy currency of cells. This increase in cellular energy can promote tissue repair processes, including collagen synthesis, cellular proliferation, and migration. By accelerating tissue repair, PBM can help reduce pain associated with tissue damage or wounds.
5. Nerve regeneration: PBM has been shown to support nerve regeneration and repair damaged nerves. This can be beneficial for conditions involving nerve damage, such as peripheral neuropathy or nerve injuries, leading to pain relief.

 

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What wavelengths have been shown to be most effective in PBM?

 

Wavelength is a property of light that determines its color or hue. Different colors of light correspond to different wavelengths within the electromagnetic spectrum. The choice of wavelength can have different effects and interactions with biological tissues.

In PBM light therapy, different wavelengths of light have been studied for their effectiveness in producing therapeutic effects. The choice of wavelength depends on the specific application and desired outcomes. Here are some commonly studied wavelengths and their associated effects:

1. Red Light (around 630-660 nm): Red light has been extensively studied in PBM therapy. It has been shown to have various beneficial effects, including increased cellular metabolism, improved circulation, and enhanced tissue healing. Red light is often used for superficial treatments, such as wound healing, skin rejuvenation, and pain management.
2. Near-Infrared (NIR) Light (around 800-900 nm): Near-infrared light has good tissue penetration and can reach deeper structures compared to visible light. It has been found to stimulate mitochondrial activity, increase ATP production, and modulate cellular signaling pathways. NIR light is commonly used for applications such as pain management, tissue repair, and promoting muscle recovery.
3. Combined Red and NIR Light: Some studies have investigated the use of a combination of red and NIR light in PBM therapy. The rationale behind combining these wavelengths is to take advantage of the unique properties of both. This combination has shown promising results in various applications, including wound healing, neuropathic pain, and musculoskeletal conditions. 

 

Are LEDs as effective as lasers in PMB light treatment?

 

LEDs are much less expensive than lasers. Most home use devices use LEDs.

Both lasers and LEDs (light-emitting diodes) can be used in PBM therapy, and both have been shown to be effective in various applications. While there are some differences between lasers and LEDs, such as the coherence and spatial distribution of light, both modalities can deliver therapeutic benefits in PBM. Here's a comparison of lasers and LEDs in PBM therapy:

1. Coherence: Lasers emit coherent light, meaning the light waves are aligned and have a specific phase relationship. This coherence allows lasers to deliver light in a focused, directional beam. LEDs, on the other hand, emit incoherent light, meaning the light waves are not aligned and have random phase relationships. The coherence of lasers may allow for deeper tissue penetration and more precise targeting of specific areas.
2. Wavelength options: Both lasers and LEDs can be designed to emit specific wavelengths of light, depending on the desired therapeutic effects. They can cover a wide range of wavelengths, including red, near-infrared, and sometimes other colors. The choice of wavelength depends on the intended treatment and the target tissue.
3. Power density: Lasers typically have higher power density (energy per unit area) compared to LEDs. This higher power density can allow for more efficient light absorption by the target tissue. However, LEDs can compensate for this by using larger treatment areas or longer treatment times.
4. Cost and versatility: LEDs are generally more cost-effective compared to lasers, making them more accessible for clinical and home use. LEDs also have the advantage of being available in various sizes and configurations, allowing for flexible treatment options and covering larger treatment areas.
5. Clinical efficacy: Studies have shown positive outcomes using both lasers and LEDs in PBM therapy. The choice between lasers and LEDs may depend on the specific condition being treated, the desired penetration depth, and the clinician's expertise and equipment availability.

 

What other variables are important in a PBM treatment?

 

The therapeutic effectiveness of PBM light therapy is influenced by various factors, including the power or energy density of the light used during treatment. However, it's important to note that there is no universally defined "optimal" power level for all PBM applications, as the appropriate power level can vary depending on the specific condition being treated, the target tissue depth, and other individual factors.

The power density or irradiance is typically measured in units such as milliwatts per square centimeter (mW/cm²) or joules per square centimeter (J/cm²). The recommended power density for PBM can range from a few milliwatts per square centimeter to up to 100 milliwatts per square centimeter, depending on the clinical application and the specific device being used.

Beware of devices being sold that refer to power in watts, rather than milliwatts. These are the equivalent of light bulbs and will not be therapeutic.

 

Why do some devices include the use of pulsed frequencies in PBM?

 

In PBM therapy, using different pulsed frequencies refers to the modulation of light delivery in terms of the frequency or pattern of light pulses. Pulsed frequencies can have different effects on cellular responses and biological processes compared continuous wave (CW) light.

Here are some potential effects and considerations of using different pulsed frequencies in PBM treatment:

1. Modulation of cellular signaling: Pulsed frequencies can influence cellular signaling pathways and gene to expression, potentially leading to specific therapeutic effects. Different frequencies may target specific cellular mechanisms, such as activating or inhibiting specific enzymes or genes.
2. Enhanced energy efficiency: Pulsed frequencies can help optimize the energy delivery in PBM. By using pulsed light instead of continuous wave light, the overall energy dose can be more efficiently absorbed and utilized by the targeted tissue, potentially resulting in improved therapeutic outcomes.
3. Prevention of thermal effects: Pulsed frequencies can reduce the risk of thermal damage to tissues by allowing sufficient time for heat dissipation between pulses. This is particularly relevant when treating sensitive or heat-sensitive tissues.
4. Influence on cellular response: Different pulsed frequencies may elicit specific cellular responses, such as modulation of mitochondrial activity, cellular proliferation, or anti-inflammatory effects. The choice of frequency may depend on the desired therapeutic outcome and the specific cellular responses being targeted.

 

 

What is the evidence that PBM light therapy can reduce pain and regenerate nerves?

 

A variety of research studies, including randomized controlled trials, systematic reviews, and meta-analyses, have examined the efficacy of PBM in pain management and tissue healing. These studies have investigated PBM's effects on various conditions, such as musculoskeletal pain, osteoarthritis, wound healing, neuropathic pain, and sports injuries, among others. The vast majority of studies reported positive results.

Studies in both animals and humans have found that PBM is effective in reducing neuropathic pain and regenerating damaged nerves for a wide range of neuropathic conditions, including diabetic peripheral neuropathy, chemotherapy-induced peripheral neuropathy, sciatica, facial pain subsequent to dental surgery, post-herpetic neuralgia and more. For example, Rosso et al. (2018) conducted a systematic review of PBM in peripheral nerve regeneration that included 26 studies. The review concluded that PBM was able to accelerate the process of nerve regeneration, increasing the number of myelinated fibers, improved electrophysiological function and immunoreactivity, decreased inflammation and pain, increased the release of growth factors, and increased the vascular network and collagen.

Here are links to 364 full text articles related to PBM light therapy 

 

So why are conventional doctors still prescribing dangerous and ineffective drugs like gabapentin for neuropathy instead of PBM?

 

I don’t know. Ask your doctor.

 

Find a Healthcare Provider Who Offers PMB Light Therapy

 

See Our Recommended Light Therapy Devices

 

The author, Cindy Perlin, is a Licensed Clinical Social Worker, certified biofeedback practitioner and chronic pain survivor. She is the founder and CEO of the Alternative Pain Treatment Directory and the author of  The Truth About Chronic Pain Treatments: The Best and Worst Strategies for Becoming Pain Free. She's located in the Albany, NY area, where she has been helping people improve their health and emotional well-being for over 30 years. See her provider profile HERE.  She also provides virtual pain consults. She wrote this article with the help of chatCPT.

 

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