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Objective: The semiconductor or laser diode (GaAs, 904 nm) is the most appropriate choice in pain reduction therapy., Summary Background Data: Low-power density laser acts on the prostaglandin (PG) synthesis, increasing the change of PGG2 and PGH2 into PG12 (also called prostacyclin, or epoprostenol). The last is the main product of the arachidonic acid into the endothelial cells and into the smooth muscular cells of vessel walls, that have a vasodilating and anti-inflammatory action., Methods: Treatment was performed on 372 patients (206 women and 166 men) during the period between May 1987 and January 1997. The patients, whose ages ranged from 25 to 70 years, with a mean age of 45 years, suffered from rheumatic, degenerative, and traumatic pathologies as well as cutaneous ulcers. The majority of patients had been seen by orthopedists and rheumatologists and had undergone x-ray examination. All patients had received drug-based treatment and/or physiotherapy with poor results; 5 patients had also been irradiated with He:Ne and CO2 lasers. Two-thirds were experiencing acute symptomatic pain, while the others suffered long-term pathology with recurrent crises. We used a pulsed diode laser, GaAs 904 nm wavelength once per day for 5 consecutive days, followed by a 2-day interval. The average number of applications was 12. We irradiated the trigger points, access points to the joint, and striated muscles adjacent to relevant nerve roots., Results: We achieved very good results, especially in cases of symptomatic osteoarthritis of the cervical vertebrae, sport-related injuries, epicondylitis, and cutaneous ulcers, and with cases of osteoarthritis of the coxa., Conclusions: Treatment with 904-nm diode laser has substantially reduced the symptoms as well as improved the quality of life of these patient, ultimately postponing the need for surgery.

Between 1980 and 1991, ionizing radiation was applied for analgesic purposes to 181 patients (97 men, 84 women, mean age 54 [29-81] years) with degenerative-inflammatory skeletal disease. The long-term effects were evaluated by questionnaire. Radiation of 2.5 to 6.0 Gy achieved lasting pain relief in 21 of 30 patients (70%) with arthritis of the shoulder or humeroscapular periarthritis, 15 of 21 (71%) with arthritis of the hip, in 12 of 15 (80%) with heel spurs or Achilles tendon bursitis and 10 of 11 (91%) with epicondylitis. Pain relief lasted for longer than two years in 41 of the 77 patients (53%). There were no side effects at the stated dosage. According to dose measurements the theoretical risk of malignant tumour induction is 20-40/million radiated patients and thus four orders of magnitude below the spontaneous malignant tumour incidence rate. The genetic risk is even lower. Ionizing radiation of degenerative-inflammatory diseases is thus an effective form of treatment with few side effects.

This study was carried out to explore the pain-alleviating effect of Ga-As + He-Ne laser (gallium-arsenide + helium-neon) in lateral epicondylalgia. A Space Mid Laser Mix 5-up laser was used. The probe consisted of five Ga-As emitters and one He-Ne emitter in the center. The parameters for Ga-As were wavelength, 904nm; average output power, 4mW, peak power, 10W; pulse frequency, 3800Hz; pulse duration, 180nsec; divergence, 70mrad. The He-Ne parameters were wavelength, 632.8nm; continuous; power output, 5mW, divergence 60mrad. A pen laser (Ga-As) was also included in the equipment. Two machines were available; one of them had no output in the Ga-As diodes, and the He-Ne emitter was replaced with a red light emitter. Fifty-eight patients were consecutively assigned to two groups for laser or placebo. The probe was applied perpendicularly over the painful area for eight minutes, and then the pen probe was applied to two acupuncture points, LI 11 and LI 12, for two minutes per point. The treatments were given three to four times weekly, ten treatments in all. Follow-ups were done after 3, 6, and 12 months. The treatment procedure was performed exactly according to the manufacturer's manual for this diagnosis. No other therapeutic measures were used, and medication use was proscribed during the treatments and the follow-up period. The statistical analysis showed no significant differences in subjective or objective outcome between the laser and placebo treatments after the treatment period. However, the objective outcome indicated a difference in favor of the placebo treatment (p less than .06).(ABSTRACT TRUNCATED AT 250 WORDS)