By Dava Stewart
As more is learned about low level laser therapy (LLLT), it is being tested more and more as a treatment for a wider variety of conditions, illnesses, and injuries. Since the therapy has no known side effects and has been shown to have analgesic properties, it is being used to treat many soft tissue conditions, from carpal tunnel syndrome to osteoarthritis. Some practitioners are now exploring the use of LLLT to relieve the pain of patients with postherpetic neuralgia, which is a complication of herpes zoster, commonly known as shingles.
Shingles is characterized by a painful rash, which is caused by a reactivation of the varicella zoster virus—the same virus that causes chicken pox. The rash usually goes away within a few weeks; however, some people develop postherpetic neuralgia (PHN). When a person has PHN, the pain of the shingles rash stays, even after the rash has gone away, and the pain can be debilitating.1
Many treatments are available for PHN, but none are known to be completely effective and many have side effects. LLLT is emerging as a valuable tool for practitioners treating patients who have PHN, as it reduces inflammation and appears to relieve the associated pain.2 Multiple studies have produced positive results, though research continues.1
In one study, patients experienced a 40 percent to 95 percent drop in pain, and the majority of them (80 percent) reported that they were still maintaining far lower levels of pain at a three-month and a six-month follow up.3
By and large, people who develop PHN are over the age of 55, with the majority being over the age of 60. There is some evidence that the condition is related to the natural degradation of the immune system that happens with aging, or immunosenescence.3
If your practice includes an aging patient population, there is a good chance that some of your patients have or will develop PHN. A total of 10 percent of the overall patient population has PHN, but 50 percent of patients over 60 do, and an astonishing 75 percent of patients over 70 years old suffer from the condition.4
Although LLLT is still considered an experimental treatment option and most insurance companies will not reimburse for it, patients who are suffering are often willing to pay out of pocket. LLLT has no known side effects, few contraindications, and treatments are non-invasive.
1Kneebone W. Therapeutic Laser in the Treatment of Herpes Zoster. Practical Pain Management. http://www.practicalpainmanagement.com/therapeutic-laser-treatment-herpes-zoster. Published January 2010. Accessed October 2014.
2Knapp DJ. Postherpetic neuralgia: case study of class 4 laser therapy intervention. Clin J Pain. 2013:29(10);6-9.
3Kahn F, Merrick R, Saraga F. Treatment of Postherpetic Neuralgia With Low Level Laser Therapy. Practical Pain Management. http://www.practicalpainmanagement.com/treatment-postherpetic-neuralgia-low-level-laser-therapy. Posted July 2013. Accessed October 2014.
4Carmichael B. What Are Treatment Options for Post-Herpetic Neuralgia? Medscape. http://www.medscape.com/viewarticle/413595. Published November 2000. Accessed October 2014.