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Dr Ashleigh Bhanjan

Fibromyalgia, could Laser Therapy be the missing piece of the pain puzzle ?

Updated: Aug 25, 2023




Fibromyalgia is a chronic disorder characterized by widespread pain and tenderness. Patients with fibromyalgia often suffer from fatigue, sleep disturbance, and memory problems “brain fog”.


Neurological complaints such as paresthesia, blurred vision, numbness, and weakness are also commonly seen .

Its estimated prevalence is 2.1% to 5.3% in the general population, with women experiencing more severe symptoms.


This syndrome typically occurs in middle-aged adults, but it can develop in any age group, including childhood, adolescence, as well as in the elderly

Although the cause of fibromyalgia is uncertain, central nervous system sensitization is considered to be its major pathogenesis.


External factors such as infection, trauma, and stress may precipitate it .

 

Current treatment options


No curative treatment for fibromyalgia is available thus far. A combination of pharmacological and nonpharmacological treatments is generally recommended for adequate symptom relief .


The US Food and Drug Administration approved duloxetine (Cymbalta), milnacipran (Savella), and pregabalin (Lyrica) for treating fibromyalgia.

Duloxetine and milnacipran help control pain levels by changing some of the brain neurotransmitters (serotonin and norepinephrine), whereas pregabalin blocks the overactivated neurons involved in pain transmission.


Physical exercise and cognitive behavior therapy are the non pharmacological options with stronger evidence of efficacy in fibromyalgia. Other interventional approaches with lower levels of evidence include occipital nerve stimulation, lidocaine infusion, and hyperbaric oxygen therapy.


 

Low level laser therapy, for Fibromyalgia


Low-level laser therapy (LLLT) is an emerging, noninvasive alternative treatment with some efficacy in relieving musculoskeletal or neuropathic pain and improving the quality of life. The mechanism is believed to involve photochemical reactions, which alter cell membrane permeability, increase messenger RNA buildup, and lead to cell proliferation.


The light emitted during LLLT reacts with cytochrome c oxidase, a respiratory enzyme in mitochondria, and increases adenosine triphosphate (ATP) production and reduces reactive oxygen species levels; this helps reduce cell inflammation and death.





LLLT has been introduced as a non-invasive, therapeutic intervention for pain in several musculoskeletal disorders.


Some mechanisms, such as increased nociceptive threshold, endorphin production, and downstream opioid receptors, have been postulated to explain the analgesic effect of phototherapy.



Other hypotheses include anti-inflammation due to a decrease in prostaglandin-2 and cyclooxygenase-2 levels, proliferation and neovascularization of connective tissue cells , and increase in blood flow and promotion of healing by increase in the levels of nitric oxide, a powerful vasodilator


The first systematic review and meta-analysis including 9 RCTs involving 325 patients to specifically evaluate the efficacy of LLLT in fibromyalgia. Our results demonstrated that LLLT provided significant improvement in FIQ score, pain severity, number of tender points, fatigue, stiffness, depression, and anxiety compared to placebo.


However, when compared with pure exercise therapy, LLLT with exercise therapy did not show more benefits.


On the other hand, the single RCT using LLLT/LED showed significant improvement in the above-mentioned outcomes, except for depression, when compared to placebo. When compared with patients with fibromyalgia who received exercise therapy, combined LLLT/LED phototherapy and exercise therapy had additional benefits in reducing the severity of pain, number of tender points, and fatigue.

 

Patient Testimonial


I am Shireen Mansoor and I have Fibromyalgia..

After the passing of my dad, 16 yrs ago a lot changed in my life. from careers, to homes, to priorities and of course my health.

From a person who managed to not take any sick leave, being in labour and still being at work and delivering a baby a few hours after leaving the office, i became a person who was constantly ill. In and out of drs rooms, being nebulised daily, being fatigued for no reason, being totally dazed in the mornings or not getting out of bed at all, migraines that never seemed to ease no matter what the dr prescribed, body pains where i felt i was beaten up, to depression and total mental instability.

I had lost all hope, with drs not knowing what was wrong with me.

It was then that i heard of Fibromyalgia.

Looking up the symptoms, i was shocked.

I was already suffering with 90% of the symptoms.

Western meds was worsening my state and i saw myself physically and mentally slipping away.

Worse was the people who i needed to support me, failed. They thought i was acting sick, being lazy, or worse it was all in my head.

I started on a journey of unconventional, herbal remedies that i tried on and off with unconditional support from people that were new in my life.

It was not an easy road. Anything and everything put me off course and it meant the climb was harder, sticking to routine was difficult and life's demands meant i was overstressed which didn't help either.

Its been a long journey with many twists and turns, many fails and some success. Nonetheless no matter how many times i fall off track, i try my best to pick myself up and get back on track. It doesnt make the journey easy but the effort pays.

It's been about 7 yrs since my diagnosis. I take turmeric concoction daily, coupled with a host of herbal meds.

Last yr i tried out laser therapy at Durban Neuro laser clinic which brought me a lot of ease with regards to my pains and my response to pain tabs that i take occasionally.

As a dr, Dr Bhanjan has been the only one u have come across who has vast knowledge on Fibromyalgia.

To further ease my inflammation causing pains, i have stopped dairy and gluten products in my diet. That too has had a positive impact on my life.

Life's demands are such that i could never afford to sit back and give in to my pain and ailments, i had no choice but to get up and earn a living to support myself. And this has played a major role in my pushing to not allow my ailments to disable me from the land of living.

This and my support system has proven to be a true blessing in my life and it has helped me live my life as normal as possible and i constantly use every opportunity to push myself to go beyond my limits.

I am forever grateful to the Almighty and for my support system that has brought me this far and not giving up on me



 

Patient Video Testimonial, Fibromyalgia



These videos, and patient testimonial have veen relaeased with signed consent, as per POPIA regulations.


 


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