The F Word
Fibromyalgia is a difficult disease to those afflicted in a multitude of ways. It’s invisible and only apparent to those dealing with the tenderness and stiffness as a result of the disease process. It is difficult to diagnose in that you have to rule out the disease processes before you make the diagnosis of fibromyalgia. It can be especially difficult to treat – relying on a variety of treatments including cognitive behavioral therapy (CBT), physical therapy, and medication management with common medications like Lyrica and Cymbalta. Sometimes patients will resort to opioid therapy for pain control. But honestly this is not a good choice since you are trying to treat a neurological condition with a mechanical pain medication. This can set the patient up for difficulties later in life with dependency, social stigma associated with opioids, and difficulty with pain control after surgeries.
One possible option for pain control is low level laser therapy (LLLT) applied to the affected areas. In randomized control trials this therapy has shown significant improvement in pain control, but the difficulty has been determining what level of energy to use for each application as there are a variety of manufacturers all using different energy levels. As a review, the goal of LLLT is to deliver light energy to damaged cells using infrared radiation to stimulate the release of nitric oxide, improve cellular energy by stimulating ATP production, and increase cell growth and metabolic activity. LLLT laser use near infrared non thermal lasers with a wavelength between 600-980 nm. The frequency is important because the higher frequencies reduce absorption by hemoglobin and melanin. The thinking is that a more powerful laser could theoretically function at longer wavelengths to stimulate larger tissue areas while also penetrating more deeply into soft tissue.
Currently there is a study being performed at UT Southwestern to further investigate how effective this therapy can be in a larger case study. Results should be published close to May 2020 and I’m hopeful this can become an effective alternative to pharmacotherapy to provide patients a way to control their chronic discomfort in a safe non habit forming way.
-Dr. Mike Martinez