Laser treatment for peripheral neuropathy

Where opioids have failed, DCs are reporting laser treatment for peripheral neuropathy showing an 80% success rate

PERIPHERAL NEUROPATHY (PN), THE RESULT OF DAMAGE TO NERVES THAT CARRY MESSAGES TO AND FROM THE BRAIN AND SPINAL CORD, FROM AND TO THE REST OF THE BODY, can be caused by diabetes, chemotherapy, exposure to toxic chemicals (i.e. Agent Orange), chronic alcoholism, prescription medications and more. Some signs and symptoms of PN include bilateral gradual onset of numbness or tingling in the feet or hands; sharp, jabbing or burning pain; and extreme sensitivity to touch.

Common opioid and medical treatments for PN

Current medical treatments for PN may include opioid pain medications with high potential for addiction and abuse. Lyrica (pregabalin) was originally FDA-approved as an anti-epileptic drug but is also prescribed to PN patients. It works by slowing down impulses in the brain, thus numbing the brain from the painful signals associated with PN.

Side effects from Lyrica include infection, ataxia, blurred vision, constipation, dizziness, drowsiness, fatigue, headache, peripheral edema, tremor, abnormal gait, abnormality in thinking, amnesia, arthralgia, cognitive dysfunction, confusion, edema, neuropathy and more.2 Gabapentin is another anti-convulsant drug that is prescribed to PN patients.

Laser therapy and PN

Photobiomodulation (PBM, or as it can be applied, laser treatment for peripheral neuropathy) is the application of red and infrared laser light at appropriate dosages to manage pain and inflammation and enhance tissue healing.3 Laser treatment for peripheral neuropathycan modulate neuropathic pain by altering chronic inflammation, decreasing mechanical allodynia, suppressing conduction velocity and reducing amplitude of action potentials.

Class 4 therapeutic lasers are FDA-cleared prescription medical devices that can deliver photons of red and infrared laser light to the large volume of tissue required for treatment of peripheral neuropathy.

Study results on laser treatment for peripheral neuropathy

One study assessed the safety and efficacy of class 4 laser therapy on pain management and overall quality of life for diabetic patients suffering from PN. No adverse events were reported, pain levels were significantly lower, and other factors improved.

Another study investigated photobiomodulation treatments with a class 4 therapy laser for patients suffering from chemotherapy-induced PN. The study concluded, “Photobiomodulation is an effective, low-toxicity treatment for CIPN. Nearly 90% of patients experience significant improvement in modified total neuropathy scores that begins within weeks of initiating treatment and persists for at least 10 weeks after the conclusion of therapy.”

“Class 4 laser therapy should be a staple in all medical offices as it helps patients with so many conditions, even beyond PN,” said Robert Patterson, MD, from Sanford, N.C. “It’s important to be properly trained in treating and managing the PN patient. This will give you confidence in the PBM protocols and you will become a more successful provider.”

Patterson also reports, “Our laser therapy treatments have worked well; we have an 80% success rate. All for people where traditional medicine has told them, ‘Sorry, you will just have to learn to live with it,’ or they are heavily drugged with medications, still hurting and they have no quality of life.”

PBM in chiropractic practice

Greg Lewis of Lewis Family Chiropractic in Westminster, Md., also utilizes laser treatment for peripheral neuropathy.

“There is a huge, and growing, population of PN patients and they really have no solution with traditional medical approaches to PN,” Lewis said. “Just treating the PN symptoms via psychotropic medication does nothing to stop the progression of the disease, and for many people it does not really effectively suppress the symptoms.

“Chiropractors, with our intimate knowledge of neurology, anatomy and our diagnostic skills, are uniquely positioned to deliver this non-invasive, drug-free, very low-risk therapy that is highly effective,” continued Lewis. “It also allows chiropractors to tap into the 90% of the population that do not normally go to chiropractors. Most of my new PN patients have never before been to a chiropractor.”

“We’ve also found many PN patients that were already in our practice, but they did not say anything because they did not think we could help them. They are desperate for help, and PN is a progressive disease. It is the number one cause of non-traumatic amputation.”

Lewis says his success rate has been more than 90%.

“I define ‘success’ in my office as a 30-100% reduction in symptoms, and significant improvement in pinprick and vibration sense restoration,” he says. “We do balance training as part of our protocol, so we expect balance to improve as well. Most of our PN patients get 80-100% symptom-free. A few have many medical complications that prevent complete recovery; however, even 30-50% improvement is life-changing for these patients. We’ve treated over 150 peripheral neuropathy patients and I can only recall two that we were not able to help at all.”

Peripheral neuropathy is a serious problem, and traditional medical treatments with opioids and psychotropic drugs are not the answer. Chiropractors are in a unique position to safely and effectively apply laser treatment for peripheral neuropathy delivered from a class 4 therapeutic laser.

Phil Harrington, DC, CMLSO, FASLMS, is clinical manager, human medical director and laser safety officer at Summus Medical Laser. To learn more go to summuslaser.com/why-summus.

REFERENCES

1 https://www.mayoclinic.org/diseases-conditions/peripheral-neuropathy/symptoms-causes/syc-20352061

2 https://www.drugs.com/sfx/lyrica-side-effects.html

3 “Class IV Therapy Lasers Maximize Primary Biostimulative Effects”, Vickers and Harrington; Practical Pain Management, January 2012.

4 “The Mechanistic Basis for Photobiomodulation Therapy of Neuropathic Pain by Near Infrared Laser Light”, Holanda et al; Lasers in Surgery and Medicine. 2017 Jul;49(5):516-524

5 “Effect of deep tissue laser therapy treatment on peripheral neuropathic pain in older adults with type 2 diabetes: a pilot randomized clinical trial”, Chatterjee et al; BMC Geriatrics (2019) 19:218. [1] “The effect of photobiomodulation on chemotherapy-induced peripheral neuropathy: A randomized, sham-controlled clinical trial”, Argenta, et al; Gynecologic Oncology 144 (2017) 159–166.