A randomised, placebo controlled trial of low level laser therapy for activated Achilles tendinitis with microdialysis measurement of peritendinous prostaglandin E2 concentrations

Bjordal JM, Lopes-Martins RAB, Iversen VV

Low Level laser therapy (LLLT) has gained increasing popularity in the management of tendinopathy and arthritis.  Results from in vitro and in vivo studies have suggested that inflammatory modulation is one of several possible biological mechanisms of LLLT action.  Seven patients with bilateral Achilles tendinitis (14 tendons) who had aggravated symptoms produced by pain inducing activity immediately before the study.  Ultrasonography doppler measurements at baseline showed minor inflammation through increased intratendinous blood flow in all 14 tendons and measureable resistive index in eight tendons of 0.91 (95% confidence interval 0.87 to 0.95).  Prostaglandin E2 concentrations were significantly reduuced 75, 90, and 105 minutes after active LLLT compared with concentrations before treatment (p= 0.012) after active LLLT compared with placebo LLLT: the mean difference in the change between the groups was 0.40 kg/cm2 (95% confidence interval 0.10 to 0.70).   LLLT at a dose of 5.4 J per point can reduce inflammation and pain in activated Achilles tendinitis.  LLLT may therefore have potential in the management of diseaes with an inflammatory component. 

Br. J. Sports Med. 40, 76-80.
Dr. Alan Shih
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