Research Highlights: The Effectiveness of Low-Level Laser Therapy for Lumbar Disk Herniation Pain

Low-Level Laser Therapy (LLLT), also known as Cold Laser Therapy, has been gaining attention in recent years as a non-invasive treatment option for various musculoskeletal conditions.

Among these, its application in alleviating lumbar disk herniation pain stands out due to the promising outcomes reported in numerous studies.

This article explores the effectiveness of LLLT in managing pain related to lumbar disk herniation, integrating recent research findings, including those from a significant study, to provide a comprehensive overview.

Understanding Lumbar Disk Herniation

Lumbar disk herniation, often known as a slipped or ruptured disk, is a medical condition characterized by the displacement of the inner core of the intervertebral disk, known as the nucleus pulposus. This nucleus protrudes through a tear in the outer fibrous ring called the annulus fibrosus.

When the herniated disk material extends beyond its normal boundaries, it can exert pressure on the nearby spinal nerves. This compression typically results in a variety of symptoms, including severe lower back pain, sciatica (pain that radiates along the sciatic nerve down one or both legs), as well as numbness and tingling sensations that can affect the lower extremities.

To manage lumbar disk herniation, several treatment options are available, ranging from conservative to invasive procedures.

Conservative approaches commonly include physical therapy, which aims to strengthen the muscles supporting the spine and improve flexibility, and medications such as analgesics and anti-inflammatory drugs to alleviate pain and reduce inflammation.

In cases where conservative treatments fail to provide adequate relief, more invasive measures may be considered. These can include epidural steroid injections to decrease inflammation around the affected nerves, and in severe cases, surgical interventions such as a discectomy, where the herniated portion of the disk is removed to relieve the pressure on the spinal nerves.

Mechanism of Low-Level Laser Therapy

LLLT operates by emitting light at specific wavelengths, which is absorbed by tissues. This absorption induces photochemical reactions that can modulate pain and promote healing. The mechanisms by which LLLT exerts its effects include:

o Reduction of inflammation: LLLT modifies inflammatory processes by decreasing nerve conduction, releasing endogenous opioids, and inhibiting the release of pro-inflammatory mediators like prostaglandins and cytokines.

o Increased blood flow: Enhances local microcirculation through angiogenesis, which facilitates tissue repair and regeneration.

o Pain relief: Alleviates pain through the inhibition of nociceptive signals and the release of pain-relieving peptides.

Research on LLLT for Lumbar Disk Herniation

A pivotal study conducted by (Bandpei et al. 2022) investigated the effectiveness of LLLT in conjunction with conventional physical therapy for patients suffering from discogenic lumbar radiculopathy. The double-blind randomised controlled trial included 110 participants who were divided into two groups: one receiving LLLT combined with physical therapy, and the other receiving only conventional physical therapy over an 18-session period.

Key Findings:

● Pain Reduction: Patients treated with LLLT showed a significant reduction in pain intensity, as measured by the Visual Analogue Scale (VAS), compared to the control group.

● Functional Improvement: Improvement in functional disability, assessed using the Oswestry Disability Index (ODI), was more pronounced in the LLLT group.

● Enhanced Range of Motion: There was a marked increase in lumbar range of motion (LROM) and a higher positive outcome in the straight leg raise test for the LLLT group.

The statistical analysis, using the Wilcoxon signed-rank test and Mann–Whitney U test, confirmed that the differences in outcomes between the groups were significant (p < 0.05), underscoring the efficacy of LLLT as an adjunctive treatment to conventional physical therapy.

Clinical Implications for Chiropractors

For chiropractors, especially those practising in Adelaide, incorporating LLLT into treatment protocols for lumbar disk herniation can offer patients an effective, non-invasive option that complements traditional therapies.

Given the findings from Bandpei et al.'s study, practitioners can confidently recommend LLLT to improve pain management and overall functional outcomes in patients with discogenic lumbar radiculopathy.

Practical Considerations:

Dosage and duration: Adjusting the wavelength and duration of LLLT sessions to align with the parameters used in effective studies can enhance treatment outcomes.

Combining therapies: Integrating LLLT with exercises and other physical therapies can maximise patient benefits.

Conclusion

The evidence supporting the use of Low-Level Laser Therapy for managing lumbar disk herniation pain is robust, highlighting its potential as a valuable adjunct to conventional physical therapy.

Studies such as the one conducted by Bandpei et al. provide a solid foundation for chiropractors to consider the incorporation of LLLT into their practice, offering patients a promising approach to alleviating pain and improving functionality.

References

1. https://www.ncbi.nlm.nih.gov/books/NBK560878/

2. Ahmed, I., Bandpei, M. a. M., Gilani, S. A., Ahmad, A., & Zaidi, F. (2022b). Effectiveness of Low-Level Laser Therapy in Patients with Discogenic Lumbar Radiculopathy: A Double-Blind Randomized Controlled Trial. Journal of Healthcare Engineering, 2022, 1–11. https://doi.org/10.1155/2022/6437523