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Objective: The evidence in medical literature is that a beneficial analgesic effect can only be obtained by employing laser radiation of relatively low power density and wavelengths which are able to penetrate tissue. For this reason the semiconductor, or laser diode (GaAs, 904 nm), is the most appropriate choice in pain-reduction therapy. Summary Background Data: Low power laser (or LLL) acts on the Prostaglandins synthesis, increases the endorphins synthesis in the Rolando gelatinous substance and in the dorsal horn of the spinal cord. The L-Arginine, which is the classic substrate of nitric oxide, carries on vasodilatory and anti- inflammatory action. Methods: Treatment was carried out on 447 cases and 435 patients (250 women and 185 men) between 20th May 1987 and 31st December 1999. The patients, whose age ranged from 25 to 70, were suffering from rheumatic, degenerative and traumatic pathologies as well as cutaneous ulcers. The majority of patients had been seen by orthopaedists and rheumatologists and had undergone x-ray, ultrasound scan, etc. All patients had previously received drug-based treatment and/or physiotherapy, with poor results. Two thirds were experiencing acute symptomatic pain, while the others presented a chronic pathology with recurrent crises. We used a pulsed IR diode laser, GaAs emitting at 904 nm. Frequency of treatment: 1 application per day for 5 consecutive days, followed by a 2-day interval. The percentage reduction in symptoms or improvement in functional status were determined on the basis of objective analysis as it happens in the Legal and Insurance Medicine field. Results: Very good results were achieved especially with cases of symptomatic osteoarthritis of the cervical vertebrae, with sport-related injuries, epicondylitis, osteoarthritis of the knee, periarthritis and with cutaneous ulcers. The beneficial action of the LLLT in the latter pathology is linked to the increase in collagen and to fibroblast proliferation. The total relief of the pain was achieved in 80% of acute and 65% of chronic cases. Conclusions: Treatment with 904 nm IR diode laser has substantially reduced the symptoms as well as improved the quality of life of the patient, thus postponing the need for surgery.
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