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Photobiomodulation for Pain

We have a client at Peak who suffers from arthritis. It affects her hands, and she finds on most days she cannot straighten her fingers. She tried all the conventional treatments: pain medications, heat, cold, supplements, hand exercises. Nothing relieved the pain completely, until she tried a session of photobiomodulation (PBM). She came out of the session looking at her extended fingers, insisting it was the first time in months she’d been able to straighten them. Her story suggests photobiomodulation can be useful for chronic pain.

Her case is what researchers would call “anecdotal.” That is the same term Dr. Fauci has used to describe evidence that the malaria drug helps with Covid-19. “Anecdotal” is the kiss of death for a medical treatment. You can’t prove a treatment’s effectiveness with anecdotes. And yet, these anecdotes of PBM for pain keep piling up.

Perception of Pain Varies

Can PBM help with your pain? Maybe. Your perception of pain depends a great deal on your genes and the culture you grew up in. Genes influence the way you actually experience pain. Culture influences your expectations of it, which can inform your perception of it.

The experience of pain varies a great deal not only from individual to individual. The experience also varies in the same individual, depending on the environmental and emotional context of the pain. A lower-back pain you would not be able to tolerate in one context (say, taking out the trash) can go all but unnoticed in another (say, crossing the finish line in a hard-run marathon).

Perception of Pain Is Subjective

I am sure it frustrates doctors that there is no objective measurement for pain. It’s not like blood pressure, or weight, or respiratory rate. The doctor can observe you in certain postures or watch your reaction to different stimuli. But mostly, your pain is what you say it is. This may be changing. Recent research in fMRI (a type of brain scan) offers a way to determine objectively if pain exists. But fMRI cannot measure pain intensity. So pain will probably always be at least somewhat subjective.

That pain is subjective, however, doesn’t mean PBM will not help it. The sheer quantity of clinical research on PBM is promising for anyone seeking pain relief.

Photobiomodulation for Pain

A 2019 comprehensive review of studies, for example, concluded that low level laser therapy (LLLT) can relieve post-surgical pain. LLLT is the former name of photobiomodulation. It noted how much research is ongoing in this field: “Previous studies have documented various mechanisms for the efficacy of laser on pain relief, including photobiomodulation, which caused certain reactions such as increased production of ATP, prostaglandins and beta-endorphins, decreased bradykinin levels, inhibition signal transduction from type C fibers, and increased secretion of pain relief neurotransmitters such as serotonin.” It also noted that LLLT increases blood flow, which provides more oxygen to injured tissue and helps divert pain factors.

A 2015 paper in Arthritis Research and Therapy reviewed seven published trials in which PBM was compared to placebo for sufferers of low back pain. Five of those seven studies (i.e., more than 70%!) found that PBM was significantly better than placebo in alleviating low back pain.

On the other hand, PBM has significant advantages over most other pain relief strategies: no risk and no documented side effects. It doesn’t even take very long. If you have chronic pain, and you’re not getting relief from any other strategy, book a series of PBM sessions. Maybe you can be an anecdote, too.