C

M

Y

CM

MY

CY

CMY

K

THOR logo 450 WIDE.pdf 26/9/07 22:55:23

Rheumatoid Arthritis

Keywords Rheumatoid Arthritis RA

Treatment Plan

Twice a week for four weeks. Then weekly for four weeks, then space out or in response to symptoms.If patient is hypersensitive, then start with 50% of recommended treatment times and increase dose if not effective. As this is an inflammatory condition, regular blood work to check inflammatory markers may be beneficial. whilst having LLLT treatment.

IntentionStimulate lymph nodes to reduce inflammation

& oedema

Heal injuries and reduce local inflammation

De-activate trigger points

Analgesia

Probe

LED Cluster LED Cluster 810nm 200mW laser 810nm 1W laser Cluster

Pulse 2.5Hz 2.5Hz Continuous Continuous

Tx Time 1 Min 1 Min 30 seconds 30 seconds

Tx Targets

Treat all major lymphatics: sub-clavicular, cervical, axillary, inguinal, popliteal associated with affected joints on appropriate side.

Treat joint synovium of any affected joints (anterior, posterior, medial and lateral aspects depending on size of joints and time available)

Local associated myofascial trigger / tender points - depending on number and time available. (Sites shown below are examples)

Treat ipsilateral nerve root exits and spinous processes of nerve supply to most painful sites (areas shown below are examples)

The colours represent which probe to use and where to place it.

version 16.1

Specific Evidence:

Alves AC, de Carvalho PD, Parente M, Xavier M, Frigo L, Aimbire F, Leal Junior EC, Albertini R Low-level laser therapy in different stages of rheumatoid arthritis: a histological study. Lasers Med Sci 2012 Apr 27

Brosseau L1, Welch V, Wells G, Tugwell P, de Bie R, Gam A, Harman K, Shea B, Morin M. Low level laser therapy for osteoarthritis and rheumatoid arthritis: a metaanalysis. J Rheumatol. 2000 Aug;27(8):1961-9.

[The influence of intravenous laser therapy on the endothelial function and the state of microcirculation in the patients presenting with rheumatoid arthritis]. Vopr Kurortol Fizioter Lech Fiz Kult 2014 May-Jun (3) 9-12

Starodubtseva IA, Vasil'eva LV. [The analysis of dynamics of oxidative modification of proteinsin the blood sera of the patients presenting with secondary osteoarthrosis associated with rheumatoid arthritis and treated by laser therapy].Vopr Kurortol Fizioter Lech Fiz Kult. 2015 Jan-Feb;92(1):19-22.

Imaoka A, Zhang L, Kuboyama N, Abiko Y Reduction of IL-20 Expression in Rheumatoid Arthritis by Linear Polarized Infrared Light Irradiation. Laser Ther 2014 Jul 1 23(2) 109-14

Yamaura M, Yao M, Yaroslavsky I, Cohen R, Smotrich M, Kochevar IE Low level light effects on inflammatory cytokine production by rheumatoid arthritis synoviocytes. Lasers Surg Med 2009 Apr 41(4) 282-90

Ekim A, Armagan O, Tascioglu F, Oner C, Colak M Effect of low level laser therapy in rheumatoid arthritis patients with carpal tunnel syndrome. Swiss Med Wkly 2007 Jun 16 137(23-24) 347-52

Aimbire F, Albertini R, Pacheco MT, Castro-Faria-Neto HC, Leonardo PS, Iversen VV, Lopes-Martins RA, Bjordal JM Low-level laser therapy induces dose-dependent reduction of TNFalpha levels in acute inflammation. Photomed Laser Surg 2006 Feb 24(1) 33-7

Juhl, C Short term beneficial effects of low level laser therapy for patients with rheumatoid arthritis. Aust J Physiother 2006 52(3) 224

Gür A, Karakoc M, Nas K, Cevik R, Sarac J, Ataoglu S. (2002) Effects of low power laser and low dose amitriptyline therapy on clinical symptoms and quality of life in fibromyalgia: a single-blind, placebo-controlled trial. Rheumatol Int. Sep; 22(5): 188-93. http://www.ncbi.nlm.nih.gov/pubmed/12215864

General evidence across disease category:arthropathies, soft tissue inflammation, joint inflammation, tendon inflammation, pain

C

M

Y

CM

MY

CY

CMY

K

THOR logo 450 WIDE.pdf 26/9/07 22:55:23