Could “Hands” be a New Treatment to Fibromyalgia?

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Ultra laser treatment for fibromyalgia yields 75 percent pain reduction when applied to the hands

A new device that combines low-intensity laser light and therapeutic ultrasound

A new device that combines low-intensity laser light and therapeutic ultrasound considerably reduces the pain experienced by patients with fibromyalgia. A scientific study has shown that application to the palms instead of to tender points on different parts of the body has better analgesic and anti-inflammatory effects. As a result of pain reduction, patients also sleep better and are able to perform daily tasks with less discomfort.

Their overall quality of life also improves. In an article published in the Journal of Novel Physiotherapies, researchers at the Optics and Photonics Research Center (CEPOF), one of the Research, Innovation and Dissemination Centers (RIDCs) supported by the São Paulo Research Foundation – FAPESP, describe the concomitant application of low-intensity laser light and therapeutic ultrasound for three minutes to the palms of the hands of patients diagnosed with fibromyalgia. The treatment consisted of ten twice-weekly sessions.

Mechanism of action

“The study describes two innovations: the device and the treatment protocol. By emitting laser light and ultrasound simultaneously, we succeeded in normalizing the patient’s pain threshold. Application to the palms differs from the focus on tender points found practically everywhere today in fibromyalgia care,” said Antônio Eduardo de Aquino Junior, a researcher at the University of São Paulo’s São Carlos Physics Institute (IFSC-USP) in Brazil and a coauthor of the article. Low-intensity laser application is used for its anti-inflammatory and analgesic properties and for improving energy production in cells, while therapeutic ultrasound is well-known for easing pain.

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Ultralaser

A team from the Optics and Photonics Research Center in Brazil developed a prototype that enables the simultaneous use of ultrasonic emission and light energy, or ultrasound plus laser, an approach they are calling ultralaser.

A total of 48 women with fibromyalgia, ages 40-65, were divided into six groups of eight patients each, who received either the combined ultralaser strategy, only laser, or only ultrasound, applied to the palms of the hands or to a tender point located in the trapezius muscle (in the back).

Tender points are areas of tenderness around joints typically used to diagnose fibromyalgia. Researchers decided to test the palms of the hands based on the reported high number of sensory nerve fibers near blood vessels in the hands of fibromyalgia patients.

Point to be noted

We therefore changed focus to test the direct action of the technique on these sensory cells in the hands rather than just so-called pain trigger points, such as the trapezius, which is typically very painful in fibromyalgia patients,” Juliana da Silva Amaral Bruno, a physical therapist and the first author of the study, said in a press release.

Tender points

The idea of testing the effects of the new device in application to the palms of the hands arose from a review of the scientific literature. “Previous studies showed that patients with fibromyalgia had larger numbers of neuroreceptors near blood vessels in the hands. Some patients even had red points in this region.

We therefore changed focus to test the direct action of the technique on these sensory cells in the hands rather than just so-called pain trigger points, such as the trapezius, which is typically very painful in fibromyalgia patients,” said Juliana da Silva Amaral Bruno, a physical therapist and first author of the study. The study showed that application to the hands affects all pain points in the patient’s body.

The same FAPESP-funded center group had previously published an article in the Journal of Novel Physiotherapies describing a case study in applying the device to pain points. Although the results of this first study were satisfactory, global pain reduction proved impossible.

Important finding

They found that application to the hands was significantly more effective than to the trapezius muscle regardless of the technique used, as assessed by the Fibromyalgia Impact Questionnaire (FIQ) of functional status and the Visual Analogue Scale (VAS) for Pain.

The combined therapy was applied for three minutes over 10 twice-weekly sessions. By emitting laser light and ultrasound simultaneously, we succeeded in normalizing the patient’s pain threshold,” said Antônio Eduardo de Aquino Junior, the study’s senior author. Targeting the trapezius muscle with ultralaser led to a significant improvement over laser in both FIQ and VASP scores, and a 57.72% (FIQ) and 63.31% (VASP) benefit over ultrasound, though not statistically different.

Targeting the palms with ultralaser resulted in a significant improvement over laser in both FIQ and VASP, and a 46.6% (FIQ) and a statistically significant (VASP) benefit over ultrasound.

Combined application of ultrasound and laser to pain points

“Combined application of ultrasound and laser to pain points such as the trapezius was highly effective but did not succeed in reaching the other main innervations affected by the disorder,” Bruno said. “Application to the palms of the hands had a global result, restoring the patient’s quality of life and eliminating her pain.”

The team suggested that the systemic benefits achieved with application of ultralaser to the hands are derived from the normalization of blood flow, metabolism, and body temperature.

Application of the palms treatment

“The application of the palms treatment, in relation to the traditional protocols, shows a new and effective possibility of treatment for fibromyalgia, not depending on chemical treatment and avoiding patient exposure to pain,” the investigators wrote in the study.

Of note, a prior case report from the same team had previously shown that this combination of ultrasound and laser to the palms enabled a reduction in pain as well as an improvement in FIQ score in a 61-year-old woman with fibromyalgia.

According to Aquino, the new device should reach the market in early 2019. It is currently being tested for osteoarthritis, knees, hands and feet, “and the results have been interesting,” he said.

 

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Reference: Research Article:

Could Hands be a New Treatment to Fibromyalgia? A Pilot Study by Juliana Silva Amaral Bruno and Others via Journal of Novel Physiotherapies. Ref

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