Photobiomodulation for modulation of neuropathic pain and improvement of scar tissue

Ronaldo Santiago, Shannon Gomes, Jak Ozsarfati, Michael Zitney, Ronaldo Santiago, Shannon Gomes, Jak Ozsarfati, Michael Zitney

Abstract

Background: This case-report explores the effects of photobiomodulation therapy (PBMT) on the healing of scar tissue. The patient was a 32-year old female two years post cholecystectomy resulting in a 15 cm linear scar that was causing severe pain.

Methods: Treatment was initiated using the BIOFLEX® therapist device which consists of LED arrays and laser probes of a specific wavelength, power and frequency applied directly on the skin overlying the scar. The frequency and duration of treatment was every other day for six weeks in a clinic setting, followed by three times a week for two months at home. Then the patient continued to use the BIOFLEX® therapist home device on an as-needed basis.

Findings: The final result of this patient's treatment was significant flattening and decreased redness of her scar. Her self-reported pain decreased to a 6/10. At the one year follow up, the patient reported that she stopped taking her opioids, antidepressant and sleeping pills and that her pain decreased to a 4/10. At the last review her pain score was 1/10; and she had returned to work and took Tylenol (acetaminophen) occasionally for breakthrough pain.

Conclusions: We attribute the patient's improvement in scar appearance and pain symptoms to PBMT. Since pain is often associated with depressed mood and sleep disturbances, it cannot be determined whether PBMT was the direct or indirect cause of this patient's improved mood. For future studies, we propose the use of control subjects with similar scars treated with sham treatment compared to those who will receive the PBMT and observed for the same duration of time and compare the overall results.

Lay summary: Dermatological applications, especially wound healing; are accepted indications for photobiomodulation therapy (PBMT). The expansion into other clinical applications, particularly neurological ones show potential benefit. We present a case of a patient with a hypertrophic scar associated with severe neuropathic pain and concurrent depression, all of which improved directly or indirectly with PBMT. Although the original focus of treatment was dermatological the improvement in pain plus the discontinuation of therapy (opioids, antidepressants and benzodiazepines) were considered to be due to the PBMT.

Keywords: Neuropathic pain; chronic pain; hypertrophic scar; laser therapy; pain treatment; photobiomodulation.

Conflict of interest statement

The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: RS, SG, and JO are employees of Meditech Rehabilitation Centre and MZ is the medical director of Meditech Rehabilitation Centre. Meditech International is the parent company of Meditech Rehabilitation Centre and the manufacturer of BIOFLEX® devices.

© The Author(s) 2022.

Figures

Figure 1.
Figure 1.
Appearance of two-year-old post-surgical hypertrophic scar on presentation prior to initiation of PBMT. Appearance of ecchymoses is noted surrounding the scar after resolution of hematomata.
Figure 2.
Figure 2.
Appearance of post-surgical scar after two weeks of every other day treatment with PBMT.
Figure 3.
Figure 3.
Appearance of scar after one year of PBMT home treatment with flatter overall appearance and no pigmentation. The treatment was continued up to the current time mostly to modulate the pain symptoms, but the effect of PBMT on improving the superficial appearance of a two-year-old hypertrophic scar is noticeable.
Figure 4.
Figure 4.
Mode of application of LED arrays across the skin.
Figure 5.
Figure 5.
Mode of application of laser probes.

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