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Light Therapy For Peripheral Neuropathy

Updated: Sep 28


Benefits of Infrared Light Systems for the Treatment of Peripheral Neuropathy


Introduction


The treatment of peripheral neuropathy (PN) is a large and growing medical specialty as we are finding that it is a treatable condition. PN involves damage to nerves at their most distant point in the body.


Infrared light systems have been shown to help patients suffering from a variety of pain conditions, including peripheral neuropathy. In this chapter, we investigate the science between health light systems and peripheral neuropathy. We discuss how health light therapy helps relieve pain and its other benefits to the human body system.




Light as a Tool for Therapy

The first recorded treatment with light was with the Egyptians. History had it that they built special temples for healing with colored light and sunlight. The Assyrians and the Babylonians also practiced “sunbathing”. They believe different light colors have different healing powers.


The use of light for therapy continued to evolve with time and history. In the mid-1890s, Neils Ryberg worked on the use of red-light therapy for healing smallpox, skin tuberculosis, and lupus.


The work and research of the use of light continue to emerge and take more leaps in medicine and therapy. However, In 1941, the first use of light for nerve therapy first emerged when Harry Riley Spitler developed the principles of Syntonics. The principles require the use of light to balance the sympathetic and parasympathetic nervous systems. This is the first major modern step to phototherapy.


Modern Light therapy, also known as phototherapy and heliotherapy, is a treatment in which a patient is exposed to light for medical purposes. Light therapy is a technology that uses near-infrared (NIR) wavelengths of light to stimulate cellular repair. By improving blood circulation and directing cells to repair damaged tissue, practitioners report reductions in pain and accelerated healing for patients.


Discovery of the Infrared Light System

Light as a form of medicine keeps evolving and continues to be in the limelight of research for the cure of physical and psychiatric diseases, such as depression and anxiety. In a broader sense, light has become part of a whole medical system known as the Infrared Light System.


Two major activities in the 1990s changed the history of light into a widely acceptable form of non-invasive therapy in the medical field. First, in 1993, Duke University researchers discovered the benefits of red light therapy. Conlan and its coauthors gave a detailed review of their studies as well as other studies involving harnessing near-infrared laser light therapy for treatment e,g. wound healing.


After Conlan’s review, in 1998 three researchers, Robert Furchgott, Louis Ignarro, and Ferid Murad were awarded the Nobel Prize for Physiology and Medicine for their discoveries concerning nitric oxide as a signaling molecule in the cardiovascular system (Nobel, 2021). Nitric oxcide works as a vasodilator by dilating blood vessels and reducing chest pain. Vasodilators are compounds with the ability to dilate blood vessels, increasing circulation to the organs.


Although the discovery of nitric oxide and the benefits of infrared light therapy may seem like two separate events, they led to the development of a light therapy system. After the discovery of nitric oxide as a blood vessel dilator, it was considered a good candidate for the treatment of angina and pain.


The discovery of infrared light created a new way; applying Red and infrared lights to specific areas of the body produces NO locally. The result is increased blood flow and reduced pain.


Since the discovery of the systemic and neurophysiological effects of red and near-infra-red light, many medical and home care devices have been developed that emit light within this wavelength for pain relief and the treatment of peripheral neuropathy. These devices are known as Health light System (HLS) devices.




What is the Health Light System?

Health Light technologies are breakthrough red-light systems for mental and physical well-being. Utilizing the therapeutic effect of red light, health light products are created with precision-engineered spectra-balanced light sources designed to synergistically combine full red light and near-infrared light spectrum to target the visible blood vessels close to the surface of your skin, turning your blood into a more powerful healing agent.


Red light therapy has been used in clinical settings to treat patients with acne, wound healing, hair regrowth, plaque psoriasis, scleroderma, eczema, psoriasis, atopic dermatitis, and many other conditions. Red light therapy is also used in cosmetology.


Most of these therapeutic systems are personal wellness portable devices that use red light therapy to deliver the benefits of increased blood flow and accelerated healing. These devices are not intended to diagnose a disease or replace medical treatment; their unique, intense form of blood stimulation is clinically shown to reduce pain, circulation problems, inflammation, swelling, and other health issues that cause discomfort.


Common examples of technological devices are the photo-modulated (pulsed, light-emitting diode) light pads for the ankle, hand, and foot. They are designed to emit the therapeutic red light. The red light is concentrated on a particular region of the body using the noninvasive method to increase the flow of blood.


Light pads are designed to treat different body parts. The ankle pad is effective for treating mild cases of chronic arthritis, particularly in the area of the shin, although they may be used to treat other types of pain as well. The red light not only stimulates tissue but also increases blood circulation and decreases muscle spasms.


Health Light System: Mechanism of Action

A health light system uses low-level laser therapy (LLT) to stimulate the body's natural healing process, without the need for surgery or drugs. The device emits a low-powered laser beam of 1-1000 mW, at wavelengths from 632-1064nm (Hashimi et al, 2010; Smith, 2005).


Conventional LLT devices work by emitting photons in the ultraviolet to infrared ranges, which are absorbed by the target’s cells. These photons are converted into heat energy during their interaction with the cell’s membrane, resulting in biostimulation known as photobiomodulation or photo-biostimulation (Robinjns et al., 2017). Photobiomodulation utilizes endogenous photosensitizers to target therapeutic levels of light energy at a tissue site.


The biological response is due to photonic radiation and thermal processes. This is due to the absorption of red light by mitochondria, which in turn produces biological stimulation through red light absorbed by cytochrome oxidase (Karu et al., 2004).


Red light therapy (RLT) uses red low-level wavelengths of visible light for different benefits. RLT is also known as photobiomodulation, or PBM for short, and is part of a larger group of light therapies often referred to as biostimulation light therapies.


The red wavelengths are not visible to the naked eye but can be seen when looking through special filters that block out longer wavelengths.


In practice, RLT works in two main ways:


1) Mitochondria stimulation: Red wavelengths have antioxidant properties that have positive effects on the skin. It has been reported that red light promotes cellular respiration and metabolism by increasing cytochrome C oxidase activity in the mitochondria of the skin cells. This stimulates blood circulation. By increasing blood circulation in one area, it also increases it in surrounding areas, providing a more even distribution of nutrients throughout the body.



2) Oxidative effects: Some studies suggest that red wavelengths work by other mechanisms such as increasing collagen synthesis and reducing oxidative stress, increased oxygen consumption by quickening the rate of a redox reaction, increased ATP (adenosine triphosphate) synthesis, increased production of anti-inflammatory cytokines.




Red Light Health therapy systems and other types of light systems

Light therapy is a non-invasive, drug-free treatment that uses light to treat skin conditions such as acne and psoriasis. It delivers therapeutic wavelengths of light to the skin through special devices called "light sources," which can be lamps, LED arrays, or lasers.


In light therapy, the choice of a light source depends on the condition being treated and its severity. For instance, some acne patients may only need a light source while others may need a combination of treatments such as chemical peels and red light therapy.


There are three types of light therapy systems that are based on the type and wavelength of light used. They are:


  1. Blue-light therapy

Blue-light therapy systems are commonly seen in offices or homes. The blue light emitted by the LEDs mimics daylight and improves sleep patterns.


Additionally, blue light is one of the most common treatments for mild to moderate psoriasis, and it's safe for most people to be treated with this type of light. Blue light can also be used in conjunction with other therapies, such as dithranol (a topical treatment) or corticosteroids (injected medications).


Blue light works by targeting the immune cells that are responsible for causing the inflammation associated with psoriasis. It also slows down the rapid cell growth that makes plaques grow larger and more inflamed.


  1. Green Light Therapy

Green Light is made up of light, often appearing green or teal, which exists in the spectrum somewhere between the visible light wavelengths 480 nm and 570 nm.


Greenlight therapy systems in recent years have become increasingly popular with migraine sufferers. This is because, despite the fact that research into green therapy is still in its early stages, there are already several studies that have indicated that green therapy may be able to help people suffering from migraines (Ibrahim et al., 2017).


Treatment with light therapy is known to help with both depression and anxiety, two conditions often associated with severe migraines. It has also been suggested that green light therapy can be effective for sufferers of Seasonal Affective Disorder (SAD) (Slipman, 2020).



  1. Red and Near-Infrared (NIR) Light therapy


Red and near-infrared (NIR) light therapy is a non-invasive skincare system that delivers light at wavelengths of between 635 nm and 940 nm. It improves cellular function by increasing energy in cells; this helps them to repair and regenerate more quickly.


The red light is used to promote better sleep quality, increase your metabolism and decrease cellulite. Near-infrared light (NIR) is used to stimulate the production of collagen and elastin, which makes your skin look more radiant, reduces wrinkles, and stimulates hair growth.


Near-infrared light is also used for pain management. NIR light penetrates 1/3 of an inch into the body so it can reach muscle tissue bundles. Additionally, Red and near-infrared light (NIR) therapy has been implicated in the treatment of peripheral neuropathy (Lin et al., 2021).



GreenLight Therapy System Blue Light SystemRed-Light (Health Light System)Wavelength Between 480 nm and 570 nm.Between 450 nm and 495 nmBetween 635 nm and 940 nmTargeted AreaBrain Cortex, RetinaSebaceous glandEpidermis Mechanism of ActionLighten Hyperpigmentation spot. Calming effect on brain cortex and retinaAbsorption by Polyphrins for acne treatment Induce Cellular signaling.Dilate Blood vessels. Increase local NO production. Mitochondria stimulation Therapeutic Effects Under research for treatment of migraine. Promotes anti-inflammatory effects. Treat Acne, Sunburn, and Malignant cancer growth. FDA Approved. Relieves pain Treat Peripheral Neuropathy



Table 1. Differences between the three major forms of light therapy system


The three types of light treatments have been implicated in managing medical conditions. However, Red and Near-Infrared light therapy have been more commonly used in treating certain diseases (e.g pain treatment and peripheral neuropathy). Health Light system devices that use red and near-infrared light have been approved by FDA are listed in non-invasive medical treatment devices at home. Also, there are many other light therapies, such as UVA and UVB light, infrared light, and bright light therapy, but only LLLT utilizes low-level (low wattage) lasers and is completely non-invasive.




Red and Near-infrared light and Peripheral Neuropathy Treatment

Laser therapy for neuropathy has been studied in several double-blind trials using both low-level lasers and non-laser controls for diabetic and non-diabetic peripheral neuropathies. The studies have shown that LLLT works well in relieving the symptoms of neuropathy and many patients report immediate and long-lasting relief from their symptoms.


Peripheral neuropathy, the loss of nerve function

Neuropathy is a condition of the peripheral or central nervous system, which consists of nerves and their extensions such as the spinal cord. This condition results from damage to these nerve cells and/or their supporting structures. It is categorized into primary and secondary neuropathies.


  • Primary neuropathies are divided into inflammatory, metabolic, traumatic, and degenerative.

  • Secondary neuropathies are caused by other conditions, such as diabetes or leprosy.


Primary neuropathies are further divided into hereditary peripheral neuropathies (HPNs), idiopathic peripheral neuropathies (IPNs), and acquired peripheral neuropathies (APNs).


Peripheral Neuropathy is commonly associated with diabetes, but it can also be caused by vitamin deficiency, alcoholism, chemotherapy, and certain medications. Pain is often experienced as a burning or tingling sensation that may radiate to different parts of the body and cause loss of sensation and muscle weakness. Neuropathy is often accompanied by poor circulation and skin problems.



Additionally, the neuropathic condition can be difficult to treat because no two people experience pain in the same way, and every case has unique characteristics. Common treatments include medications such as tricyclic antidepressants (TCAs), anticonvulsants (e.g., gabapentin), opioids, and anti-seizure drugs (e.g., pregabalin).


Recently, much research has implicated the use of low light laser therapy (LLLT) for the reversal and management of neuropathy. This moth has gained popularity because of its efficacy and non-invasiveness compared to other treatment methods.


The Treatment of Peripheral Neuropathy with LLLT Health Light System

Laser therapy for neuropathy has been studied in many double-blind trials using both low-level lasers and non-laser controls for diabetic and non-diabetic peripheral neuropathies. The studies have shown that LLLT works well in relieving the symptoms of neuropathy and many patients report immediate and long-lasting relief from their symptoms.




Mechanism of Action

The home light system that uses red and infra-red works in many ways from inducing mitochondria activity to increasing oxygen and blood flow. Research is still ongoing, however, here is some mechanism that has been identified in the literature:


  1. Balance Oxidative stress and Free Radical Scavenging

In the case of peripheral neuropathy, the nerves become damaged from excessive stress or trauma. When this occurs, there is a disruption in the balance between oxidative stress and free radical scavenging. This imbalance is thought to be responsible for many of the symptoms associated with peripheral neuropathy including pain, numbness, and tingling. LLLT restores this balance by stimulating mitochondrial activity within cells through photobiomodulation (reduction of oxidative stress), inhibition of nitric oxide synthesis (anti-inflammatory effect), and enhancement of antioxidant defense systems (free radical scavenging).



  1. ATP Generation

Low-Level Laser Therapy has also been shown to stimulate the production of ATP (the energy molecule in the body), which is depleted in areas of nerve damage or disease. This can help regenerate nerves and improve blood flow to the area of concern. The laser light also increases the permeability of cell membranes, which enables greater access to nutrients and oxygen delivered by blood vessels.


  1. Inhibition of ligand-activated Nuclear Factor Kappa B (NFkB)

Low-level laser therapy has also been shown to inhibit ligand-activated Nuclear Factor Kappa B (NFkB) which upregulates inflammatory mediators like Tumor Necrosis Factor-alpha (TNF-a) and Interleukin-6 (IL-6). NFkB activation is dependent on the presence of Ligand Activated Receptor (LAR) on immune cells. Stimulation of cell surface LAR increases NFkB which promotes inflammation via proinflammatory cytokine production. Using low-level lasers can inhibit this process by decreasing NFkB activation (Chen et al., 2011).





  1. Increase Blood flow

Additionally, LLLT works in peripheral neuropathy by a mechanism involving increased blood flow into nerve tissue that results from decreases in blood flow-mediated vascular resistance. Peripheral nerves contain blood vessels that surround them; the nerves use these blood vessels for their purposes (to bring nutrients to them and get rid of waste products). The increased blood flow around the nerves helps nourish them and decrease pain and paresthesia



  1. Inducing Mitochondrial Biogenesis

The mechanism of action for LLLT is inducing mitochondrial biogenesis (mitochondria are the powerhouse of cells ) and increasing the mitochondria's ability to produce ATP energy. This increase in mitochondria can be extremely beneficial in PN patients because their mitochondria are damaged. Mitochondrial disease is often associated with PN, so increasing the number of mitochondria will help with nerve damage.



Efficacy of Treatment and Mechanism of Action

The use of low-level lasers has been tried in several medical conditions recently including Diabetic Neuropathy (Shanb et al., 2020). One of the most important problems that patients with Diabetic Neuropathy face is peripheral neuropathy. Neuropathy occurs when nerve damage affects the balance or motor skills of patients. This happens because glucose cannot get into the nerves properly, affecting their function.


Diabetic Peripheral Neuropathy manifests itself through various symptoms like pain, numbness, and tingling sensation in hands and feet which can cause difficulty in walking or even standing.


In a study aimed to evaluate if LLLT could enhance the effects of medications for the treatment of Peripheral Neuropathy after the patients were treated to Low-Level Laser Therapy (LLLT) and Gabapentin, the primary outcome was subjective pain score reduction and secondary outcomes were objective sensory and motor function improvement. After 8 weeks, the addition of LLLT to medication provided a significantly higher improvement than medication alone. No adverse events were reported during the treatment period (Abdel-Wahhab et al., 2018).


Additionally, other research also suggested that Laser therapy can be applied safely to patients with Peripheral Neuropathy and has the potential to improve their conditions if added to their medications (Abdel-Wahhab et al., 2018; Shanb et al., 2020)


Duration and Frequency of Therapy

As a general rule, the more severe the condition of the patient, the longer it takes to produce results and the length of treatment is dependent upon how long the neuropathy has been present. Some patients respond within a few days of beginning treatment; others may take several weeks before they notice an improvement in their symptoms.


Research shows the longer the duration the better the chances that patients will have a reversal of their peripheral neuropathy. The effects of low light laser therapy are cumulative, so patients will notice an improvement after every session during the treatment period.




Summary and Conclusion

The use of low-level laser therapy (LLLT) as a treatment for peripheral neuropathy and other pain syndromes has gained traction and is now considered a viable alternative or adjunctive treatment.


Health Light Systems have been shown to effectively treat peripheral neuropathy in patients with diabetic peripheral neuropathy. The low frequency of side effects and a high satisfaction rate of patients make this a very promising form of treatment. Its benefits seem to be great for almost all the patients treated while the inconveniences are mild and not unbearable for the patient.


Health light systems using Low-level laser therapy are a relatively safe, painless, comforting method of treatment for people with neuropathic disorders. It has significantly relieved the symptoms of peripheral neuropathy in many patients without the side effects usual with traditional and alternative therapies.


Low-level laser (LLLT) therapy is thought to induce healing by reducing inflammation, increasing tissue oxygenation, and stimulating glucose transportation to tissues. These beneficial effects of LLLT can lead to decreased pain; increased range of motion; improved physical functioning; and improved quality of life among patients with neuropathy. Patients with debilitating diabetic peripheral neuropathy may benefit from preventing further progression of the disease or even reversing it using moderate frequency LLLT.


The usefulness of the LLLT Health Light device for the treatment of diabetic peripheral neuropathy is enhanced by its portability, low cost, and non-invasive nature, however further research is necessary to assess its effectiveness across multiple case studies and larger populations.



References


  1. Abdel-Wahhab, K. G., Daoud, E. M., El Gendy, A., Mourad, H. H., Mannaa, F. A., & Saber, M. M. (2018). Efficiencies of low-level laser therapy (LLLT) and gabapentin in the management of peripheral neuropathy: diabetic neuropathy. Applied biochemistry and biotechnology, 186(1), 161-173.

  2. Chen, A. C., Arany, P. R., Huang, Y. Y., Tomkinson, E. M., Sharma, S. K., Kharkwal, G. B., & Hamblin, M. R. (2011). Low-level laser therapy activates NF-kB via generation of reactive oxygen species in mouse embryonic fibroblasts. PloS one, 6(7), e22453.

  3. Hashmi, J. T., Huang, Y. Y., Osmani, B. Z., Sharma, S. K., Naeser, M. A., & Hamblin, M. R. (2010). Role of low‐level laser therapy in neurorehabilitation. Pm&r, 2, S292-S305.

  4. Ibrahim, M. M., Patwardhan, A., Gilbraith, K. B., Moutal, A., Yang, X., Chew, L. A., & Khanna, R. (2017). Long-lasting antinociceptive effects of green light in acute and chronic pain in rats. Pain, 158(2), 347.

  5. Karu, T. I., Pyatibrat, L. V., & Kalendo, G. S. (2004). Photobiological modulation of cell attachment via cytochrome c oxidase. Photochemical & Photobiological Sciences, 3(2), 211-216.

  6. Lin, L., Li, J., Lin, J., Tang, S., & Li, Y. (2021). Effectiveness and safety of low-level laser therapy in diabetic peripheral neuropathy: a protocol for a systematic review and meta-analysis. Systematic Reviews, 10(1), 1-7.

  7. NobelPrize.org. Nobel Prize Outreach AB 2021. Thu. 18 Nov 2021. <https://www.nobelprize.org/prizes/medicine/1998/press-release/

  8. Robijns, J., Censabella, S., Bulens, P., Maes, A., & Mebis, J. (2017). The use of low-level light therapy in supportive care for patients with breast cancer: a review of the literature. Lasers in medical science, 32(1), 229-242.

  9. Shanb, A. A., Youssef, E. F., Al Baker, W. I., Al-Khamis, F. A., Hassan, A., & Jatoi, N. A. (2020). The efficacy of adding electromagnetic therapy or laser therapy to medications in patients with diabetic peripheral neuropathy. Journal of lasers in medical sciences, 11(1), 20.

  10. Singel, D. J., and Stamler, J. S. (2005). Chemical Physiology of Blood Flow Regulation by Red Blood Cells: Annual Review of Physiology, 67(1), 99–145. https://doi.org/10.1146/annurev.physiol.67.060603.090918

  11. Slipman, R. A. (2020). What is the effect of light therapy on depression and seasonal affective disorder?. Evidence-Based Practice, 23(7), 32-33.

  12. Smith, K. C. (2005). Laser (and LED) therapy is phototherapy. Photomedicine and Laser Therapy, 23(1), 78-80.


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