THE BATTLE OF LASER THERAPY AGAINST MEDICATION IN MUSCULOSKELETAL DISORDERS: COLLABORATION, ALLIANCE OR ENEMY?

Abstract

Low reactive-level laser therapy (LLLT) is now used routinely in many sports medicine facilities, but little study has been done on whether the concomitant application of LLLT with analgesics and anti-inflammatories results in no change in either modality when used alone, produces a synergistic effect or actually weakens the reaction. The present study examines first the scientific literature on the effect of LLLT on concomitantly ingested medication. The study comprises three parts: first, the literature study; second, how the literature has reported on possible LLLT-pain medication interactions; and third, the principal author's own study on laser pharmacology and Achilles tendinitis. The Achilles tendon, although the largest and strongest in the human body, has since classical times been recognized as a weak point. In the case of the legendary Achilles, he was dipped in the river Styx by his mother, rendering him invulnerable, except for the portion of his heel where he was held, thus giving rise to the 'Achilles' heel'. However, an arrow guided by Apollo pierced Achilles' heel, severed the tendon and killed him through the only point on his body which was vulnerable. In the case of real-life athletes, it is repetitive body load which does the damage to the tendon which bears Achilles name. The whip effect of pronation in the running gait and potential intrinsic weakness or collagen deterioration with age makes this tendon very vulnerable to damage. The poor results in the treatment of Achilles tendinopathy with conservative therapy and even low level laser therapy on its own pushed us to use a combination of LLLT and local infiltration of concomitant medication. The subjects were 100 successive athletes, with chronic Achilles tendinopathy. These patients had already undergone conservative treatment for six months without positive results. Our method was a combination of laser photodynamic therapy (PDT) with Plenosol® intradermally and 660 nm LLLT followed by a cooling down treatment with Ubiquinon, Ferrum and Cu++ infiltrated subcutaneously, together with LLLT at 660 nm, 830 nm and 904 nm. With an average of 4 treatments within 14 days, we reached a healing time of 16 days to restart training, with an overall success rate of 90%. With these results, we concluded that a good knowledge of interaction between laser and pharmacology can reduce our treatment time, even for chronic diseases.