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Laser light not much good for diabetic nerve pain

NEW YORK (Reuters Health) - Nerve damage in the legs and feet caused by diabetes can give rise to severe pain, which is often difficult to treat. There has been some evidence that the condition can be eased by shining low-intensity laser light on the affected area, but the results of a new clinical study are discouraging.

Canadian investigators report "a trend to improvement" with low-intensity laser therapy (abbreviated to LILT), but after four weeks of treatment there were no clinical differences compared to treatment with a sham laser.

Because painful diabetic neuropathy is often not improved with medication, Dr. Vera Bril and colleagues explain in the medical journal Diabetes Care, they evaluated the application of LILT as an additional or alternative therapy.

The researchers at Toronto General Hospital recruited 50 people with diabetes who reported pain intensities in both feet of 4 or higher on an 11-point scale. The participants' medications remained unchanged for at least 4 weeks before and throughout the study.

Twice-weekly treatment was administered to two painful areas on each foot for five minutes. First, all participants were given sham treatment for two weeks, then laser treatment was randomly assigned to 25 patients while the other 25 continued on the sham treatment.

Both groups reported a decrease in average weekly pain scores after the two weeks of sham therapy. After six weeks, there was no further change in pain scores in the sham group and only a small drop in the active treatment group. The difference in pain scores between groups was not significant, statistically.

Also, there were no significant changes in measurable factors such as nerve conduction, skin responses to stimulus, and sensory tests.

However, the change in pain scores from before the study started to the end of laser treatment were "clinically meaningful," the authors write, so "the observed trend warrants further investigation."

And because longer duration or more frequent laser treatment could perhaps produce greater benefit, they advocate the development of home laser equipment as a more convenient option for patients.

Diabetes Care 2004;27:921-924.


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