Efficacy of Low Level laser therapy on painful Diabetic Peripheral Neuropathy
This research study was conducted to assess how the symptoms associated with Type 2 Diabetes related peripheral neuropathy respond to cold laser therapy.
Commonly, in patients with Type 2 diabetes there are vascular implications, which lead to pain. According to the Center for Diabetes Research, diabetic peripheral neuropathy accounts for more hospitalization than all the other complications of type 2 diabetes. Reductions in microcirculation is responsible, in part, for injury to the nerves and atrophy of the nerves leading to tissue damage, according to BBA on the Molecular Basis of Disease. These symptoms generally show up in distal extremities, such as the soles of the feet and toes.
During this study the researchers found that pain levels were subjectively reported by participants to be significantly lower following a course of low-level laser therapy. The researches postulated that the reduction in pain could have been due to a few possibilities:
Improved microcirculation which improved regeneration of nerve injury and reduced perceived pain
Increased ATP production by the mitochondria
Increased cellular oxygen consumption by nerve regeneration
To make this information more easily understood, we will break down their hypothesized reasons for positive response to laser therapy:
One of the most significant issues with type-2 diabetes is the damage done to nerves in our extremities, most significantly in our feet and toes. This occurs due to a decrease in our body’s ability to adequately circulate blood. Due to the feet and toes being the furthest from the heart and having to fight gravity to pump the blood back up and out of the region, they suffer the greatest, thus “feeling” the most symptoms.
When blood flow is interrupted or decreased in an area the tissues who need their supply of nutrients from local circulation suffer. All types of nerves are impacted by this reduced blood flow. In particular, the small nerve fibers which transmit pain and temperature are the most susceptible to damage.
The decrease in functionality of the nerves in the feet leads to an increased risk of damage and/or dysfunction to arise to the joints in the area. This is due to the fact that the normal protective mechanisms or responses to pain become dampened, thus placing the individual at an increased risk of injury. In addition to this, the muscles that provide the “internal support” or structural support the all the small bones of the foot, which gives it its shape, begin to break down and atrophy. This can lead to a change in the way you walk or where you distribute the pressure on your foot as you walk, resulting in poor mechanics and subsequent pain.
There are many options available to patients suffering from diabetic peripheral neuropathy pain. If you have ever watched TV then you know there is a laundry list of prescription medications available, and while these may prove effective in some cases, they also come with a laundry list of side effects. In addition to this, the authors of this study go on to say that these medications also do nothing to help slow down or stop the “advancement of the underlying neuropathy”, or in other words the continued spread of dysfunction causing your symptoms. They did however find that the laser therapy was able to reduce the signs of degeneration and help with “re-generation” of the nerve structure and function to the area.
With the prevalence of type 2 diabetes on the rise and the debilitating symptoms of diabetic neuropathy that come with it, any avenue or option that is safe for patients and without contraindication should be made available and discussed. I hear the stories of constant suffering my new patients so often complain of, and I feel fortunate that we have a potential solution to this issue available in our office. Utilizing our Class IV K-Laser we have been able to help many patients suffering from diabetic neuropathy pain.
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