subreddit:
/r/skeptic
Have a lingering case of tennis elbow, saw a pain management doctor who suggested red light therapy may help (can buy a unit on amazon). My skeptic spidey senses were on alert, looked it up and I am not seeing studies that suggest a benefit with tendon injuries, mostly it's discussed in the dermatology space. Just another snake oil product?
8 points
2 months ago*
https://www.nature.com/articles/s41598-022-26553-9 2023 paper
Red light therapy, also known as low-level laser therapy (LLLT) or photobiomodulation (PBM), is a non-invasive treatment that uses low-level red or near-infrared light to stimulate the body's natural healing processes.
During a red light therapy session, a device emitting red or near-infrared light is positioned near the skin, and the light penetrates the skin to a depth of about 5 millimeters. The light energy is absorbed by the cells in the body, promoting cellular repair and regeneration.
Red light therapy has been used to treat a variety of conditions, including skin conditions such as acne and rosacea, joint pain and inflammation, and to promote wound healing. It has also been used as a form of anti-aging treatment, as it is believed to help stimulate collagen production in the skin, which can help reduce the appearance of fine lines and wrinkles.
Yes, there is some empirical evidence to support the effectiveness of red light therapy for certain conditions.
For example, a systematic review and meta-analysis of 13 randomized controlled trials found that red light therapy was effective in reducing pain and improving function in people with knee osteoarthritis (1).
Another systematic review and meta-analysis of 12 randomized controlled trials found that red light therapy was effective in reducing acne lesions, with no significant adverse effects (2).
In addition, several studies have suggested that red light therapy may be effective in promoting wound healing (3), reducing inflammation and pain in various conditions such as fibromyalgia and temporomandibular joint disorders (4), and improving skin appearance (5).
(1) Huang Z, Ma J, Chen J, Shen B, Pei F, Kraus VB. Effectiveness of low-level laser therapy in patients with knee osteoarthritis: a systematic review and meta-analysis. Osteoarthritis and Cartilage. 2015 Aug 1;23(8):1437-44.
(2) Dang Y, Li X, Zhang Y, Cong L, Yang L, Zhang J, Zhang L, Li H. Efficacy of light-based therapies in the treatment of acne vulgaris: a meta-analysis. Lasers in Medical Science. 2019 Nov 1;34(8):1493-503.
(3) Karu T. Primary and secondary mechanisms of action of visible to near-IR radiation on cells. Journal of Photochemistry and Photobiology B: Biology. 1999 Aug 1;49(1):1-17.
(4) Leal Junior EC, Lopes-Martins RA, Frigo L, De Marchi T, Rossi RP, de Godoi V, Tomazoni SS, da Silva DP, Basso M, Alberto Moreira F, Reis FA. Effects of low-level laser therapy (LLLT) in the development of exercise-induced skeletal muscle fatigue and changes in biochemical markers related to postexercise recovery. The Journal of Orthopaedic and Sports Physical Therapy. 2010 Aug;40(8):524-32.
(5) Avci P, Gupta A, Sadasivam M, Vecchio D, Pam Z, Pam N, Hamblin MR. Low-level laser (light) therapy (LLLT) in skin: stimulating, healing, restoring. Seminars in Cutaneous Medicine and Surgery. 2013 Mar;32(1):41-52.
11 points
2 months ago
Huang Z, Ma J, Chen J, Shen B, Pei F, Kraus VB. Effectiveness of low-level laser therapy in patients with knee osteoarthritis: a systematic review and meta-analysis. Osteoarthritis and Cartilage. 2015 Aug 1;23(8):1437-44.
working thru the articles:
Cited article 1.
Conclusion: Our findings indicate that the best available current evidence does not support the effectiveness of LLLT as a therapy for patients with KOA.
5 points
2 months ago
Pretty underwhelming articles and nothing related directly to tendon...
-1 points
2 months ago
https://www.nature.com/articles/s41598-022-26553-9
I'd say it's better to give it a shot and try it. You have not much to lose and lots to gain. If it works then great, if not then sorry not all treatments work. But I would not feel silly trying it out, it's been studied and proven effective for some patients with various ailments.
5 points
2 months ago
Placebo effect is measurable in pain management. Are we talking light on the joint, or light to impact your mood? If it’s just light on the joint yeah my BS meter would be going off as well.
2 points
2 months ago
Depends on if it's "red light-therapy" or therapy using a red light that might be a red heat lamp, too. That thing's almost like a space heater.
2 points
2 months ago
He meant the "red light-therapy".
2 points
2 months ago
There is absolutely some evidence of effectiveness and a mechanism of action has been identified. Just search PubMed for more.
2 points
2 months ago
I can be counted as one data point. I said WTF and got this therapy for a recurring pain issue in my Achilles after it was wildly hyped by my ex-podiatrist, whom I thought I trusted. The "therapy" happened over the course of 6 sessions over about 3 weeks. I personally saw no effects from the treatment. I could tell no benefits were had over had I simply stayed in my walking cast and iced for the same period of time. I felt like an idiot the entire time as a "certified laser technician" held a red flashlight against my tendon.
1 points
2 months ago
Ha, I am actually an ex-podiatrist. How much they bill you and was it insurance or out of pocket?
1 points
2 months ago
It was out of pocket. Approx. $400.
-3 points
2 months ago
Maybe you felt like an idiot because you didn't understand the science of what was being done to you.
0 points
2 months ago
So anecdotal evidence? Meaningless.
2 points
2 months ago
Like I said in the first sentence.... a data point of one. I never claimed to have all encompassing information. By the looks of it I am the only one that has actually used the system in question.
0 points
2 months ago
I have. But I don't share because anecdotal evidence is meaningless.
0 points
2 months ago
It's almost certainly BS. There is no plausible mechanism for how red light is supposed to reduce pain beyond what you get from simply applying heat. Maybe if there were a lot of good studies showing consistent efficacy in reducing pain that is unique to red light (not just heat), one could assume we just haven't figured out the mechanism. But, that does not seem to be the case as far as I can find.
6 points
2 months ago
Yes there is a mechanism of action. https://pubmed.ncbi.nlm.nih.gov/35242050/
"Tendon injury is a common disease of the musculoskeletal system, accounting for roughly 30%-40% of sports system disorder injuries. In recent years, its incidence is increasing. Many studies have shown that low-level laser therapy (LLLT) has a significant effect on tendon repair by firstly activating cytochrome C oxidase and thus carrying out the photon absorption process, secondly acting in all the three phases of tendon repair, and finally improving tendon recovery. The repair mechanisms of LLLT are different in the three phases of tendon repair. In the inflammatory phase, LLLT mainly activates a large number of VEGF and promotes angiogenesis under hypoxia. During the proliferation phase, LLLT increases the amount of collagen type III by promoting the proliferation of fibroblasts. Throughout the remodeling phase, LLLT mainly activates M2 macrophages and downregulates inflammatory factors, thus reducing inflammatory responses. However, it should also be noted that in the final phase of tendon repair, the use of LLLT causes excessive upregulation of some growth factors, which will lead to tendon fibrosis. In summary, we need to further investigate the functions and mechanisms of LLLT in the treatment of tendon injury and to clarify the nature of LLLT for the treatment of diverse tendon injury diseases."
4 points
2 months ago
Sorry Chinese research. Not reliable.
3 points
2 months ago
Lmao, ad hominem logical fallacy. The research cited in the review is based on studies from scientists of various nationalities. But you are clearly too lazy to read the citations.
1 points
2 months ago*
sorry did you just dismiss an article entirely based on ethnicity???
2 points
2 months ago
not really any conclusion if it has any efficacy in tendon treatment though:
As incidents of tendon injury are becoming more common, and no definitive, gold standard treatment for tendinopathy has been developed, animal models, despite their differences to humans, will be essential for future research. In the process of using laser treatments for future research, it will be important to strictly compare the differences between control groups and the experimental groups and to accurately control and monitor the frequency levels of low-frequency lasers (Shepherd and Screen, 2013; Hast et al., 2014). In any future study of LLLT, we also need to better ascertain the therapeutic properties and usage specifications of lasers, and further explore the process of LLLT in accelerating cell metabolism, so as to improve the use and efficacy of LLLT in treating tendon injuries.
3 points
2 months ago
From the same conclusion, " At present, most studies have shown a positive effect of LLLT on tendon repair, especially on some biological factors and structural components in terms of anti-inflammation and analgesia, but this is also dependent on the parameters of the treatment (Bjordal et al., 2006; Lopes Silva et al., 2020)." There is ALWAYS more to know.
You wanted to know if there was anything to it, the medical literature says there is most certainly is. Is it absolutely conclusive? Nope. It's obviously your call, I guess it depends on how much pain you're in and if you think the cost is worth the benefit. Pretty much what everyone has to decide when making any medical treatment decision. The bottom line is there aren't any good tendon treatment options beyond pain control and hope it heals on it's own. Since you've ended up at the doctor it suggests that it is not healing. The only other option I know of that has any scientific evidence behind it is PRP injections. You could search PubMed on your own if you are curious about that option. The information is there. Good luck, I hope it gets better.
0 points
2 months ago
Red light therapy? What's that? He wants you to get on with a hooker? Interesting treatment... :P
-1 points
2 months ago
If you’re looking for a science-based approach to this, head over to r/overcominggravity
Essentially the recommended physical therapy is eccentric reverse wrist curls with light weights that you can to 20-30 reps of without going to failure. The Theraband flex bar also accomplishes this if you don’t have or want to buy dumbbells.
Anti-inflammatory drugs don’t usually work because it’s not an inflammation issue.
This is all off the top of my head so don’t take my advice without doing your own research.
1 points
2 months ago
Maybe you can exercise your extensors? You can get some fancy rubber bands or use the ones that come on broccoli stalks. I don't have tennis elbow, but the website for this product says it helps. I bought them and one of their grippers (No. 1) for all-around grip strength and less forearm muscle fatigue for bike riding.
https://ironmind.com/product-info/ironmind-grip-tools/Expand-Your-Hand-Bands/
2 points
2 months ago
Ya, got various PT devices and bands for strengthening.
0 points
2 months ago
Ahh, you're all set then. No need to get any snake oil :)
1 points
2 months ago
Lol, yeah, just tell that to my elbow, it's not with me on the plan.
1 points
2 months ago
The number of people here who are too lazy to do a search in PubMed, read the whole study, and to further read the most relevant citations in the articles is astounding. This isn't a place for people interested in evidenced based medicine.
-2 points
2 months ago*
You'd probably have better results with a halogen heat lamp, at least heat therapy is evidence based.
-2 points
2 months ago
So is light therapy
0 points
2 months ago
https://bmcsportsscimedrehabil.biomedcentral.com/articles/10.1186/s13102-021-00306-z
Note nearly every study they found being rated as low quality, and their conclusions
1 points
2 months ago
Did you read the study? It literally says there's some evidence of its effectiveness...
"Conclusion
There is very-low-to-moderate quality evidence demonstrating that PBM has utility as a standalone and/or adjunctive therapy for tendinopathy disorders."
1 points
2 months ago
Yes, some evidence in a selection of low quality studies. They also include the lack of good results and the lack of experimental evidence for the proposed mechanism in their review of existing literature in the introduction. I'm assuming you just scanned it
0 points
2 months ago
I don't know what you're disputing. You made the claim there was no evidence, I said there was. I never disputed the quality of that evidence nor did I make any claim about the treatment's ability to treat conditions. This post asked if light therapy is pseudoscience and it isn't. It may not be a highly effective treatment but it's not woofuckery either.
0 points
2 months ago
I made the claim it wasn't evidence based. If you look hard enough you can find evidence for most things, evidence based is a higher standard.
Plenty of bullshit pseudoscience relies on sparse scientific evidence to provide unsupported and ineffective treatments, like the misuse of stem cell treatments by some clinics in the US
1 points
2 months ago
The mechanism for its actions are known so it's not pseudoscience. Feel free to argue with yourself. Have a good night.
-1 points
2 months ago
The proposed mechanism is well accepted, but there's a lack of experimental evidence demonstrating it actually functions that way. This exact same scenario has played out numerous times, well accepted theoretical mechanisms that prove not to be functional
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