Korean J Pain.  2021 Jun;34(3):250-261. 10.3344/kjp.2021.34.3.250.

Effects of photobiomodulation on different application points and different phases of complex regional pain syndrome type I in the experimental model

• Canever JB
• Barbosa RI
• Hendler KG
• Neves LMSd
• Kuriki HU
• Aguiar Júnior AS
• Registro Fonseca MdC
• Márcio Marcolino A

• KMID: 2517510
• DOI: http://doi.org/10.3344/kjp.2021.34.3.250

Abstract

Background
Complex regional pain syndrome type I (CRPS-I) consists of disorders caused by spontaneous pain or induced by some stimulus. The objective was to verify the effects of photobiomodulation (PBM) using 830 nm wavelength light at the affected paw and involved spinal cord segments during the warm or acute phase.
Methods
Fifty-six mice were randomized into seven groups. Group (G) 1 was the placebo group; G2 and G3 were treated with PBM on the paw in the warm and acute phase, respectively; G4 and G5 treated with PBM on involved spinal cord segments in the warm and acute phase, respectively; G6 and G7 treated with PBM on paw and involved spinal cord segments in the warm and acute phase, respectively. Edema degree, thermal and mechanical hyperalgesia, skin temperature, and functional quality of gait (Sciatic Static Index [SSI] and Sciatic Functional Index [SFI]) were evaluated.
Results
Edema was lower in G3 and G7, and these were the only groups to return to baseline values at the end of treatment. For thermal hyperalgesia only G3 and G5 returned to baseline values. Regarding mechanical hyperalgesia, the groups did not show significant differences. Thermography showed increased temperature in all groups on the seventh day. In SSI and SFI assessment, G3 and G7 showed lower values when compared to G1, respectively.
Conclusions
PBM irradiation in the acute phase and in the affected paw showed better results in reducing edema, thermal and mechanical hyperalgesia, and in improving gait quality, demonstrating efficacy in treatment of CRPS-I symptoms.

Keyword

Complex Regional Pain Syndromes; Edema; Hyperalgesia; Laser Therapy; Mice; Models; Animal; Pain; Pain Management; Reflex Sympathetic Dystrophy; Skin Temperature; Temperature; Thermography

Figure

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  Fig. 1 Representative photographs during tourniquet exposure (A), 2 after reperfusion (B) and 1 hour after tourniquet removal (C). Note in the second image the tissue hypoxia and in the third image, after tourniquet removal, hyperemia with apparent edema.

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  Fig. 2 Illustrative representation of the parameters used to calculate the Sciatic Static Index and Sciatic Functional Index. IT: intermediate finger opening, PL: footprint length, TS: full finger opening. Adapted from the article of Marcolino et al. (J Hand Microsurg 2013; 5: 49-53) [33].

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  Fig. 3 Average values of the edema variable between groups and evaluation days. Group (G) 1: control (placebo), G2: photobiomodulation (PBM) applied to the paw with complex regional pain syndrome type I (CRPS-I) from the warm phase, G3: PBM applied to the paw with CRPS-I from the acute phase, G4: PBM applied close to the area of the region between L4 and L5 from the warm phase, G5: PBM applied close to the area of the region between L4 and L5 from the acute phase, G6: PBM applied at two points: right paw and region between L4 and L5 from the warm phase, G7: PBM applied at two points: right paw and region between L4 and L5 from the acute phase. *P < 0.05.

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  Fig. 4 Average values referring to thermal hyperalgesia between groups and evaluations. Group (G) 1: control (placebo), G2: photobiomodulation (PBM) applied to the paw with complex regional pain syndrome type I (CRPS-I) from the warm phase, G3: PBM applied to the paw with CRPS-I from the acute phase, G4: PBM applied close to the area of the region between L4 and L5 from the warm phase, G5: PBM applied close to the area of the region between L4 and L5 from the acute phase, G6: PBM applied at two points: right paw and region between L4 and L5 from the warm phase, G7: PBM applied at two points: right paw and region between L4 and L5 from the acute phase. *P < 0.05.

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  Fig. 5 Average values of the mechanical hyperalgesia test (Von Frey) between groups and evaluations. Group (G) 1: control (placebo), G2: photobiomodulation (PBM) applied to the paw with complex regional pain syndrome type I (CRPS-I) from the warm phase, G3: PBM applied to the paw with CRPS-I from the acute phase, G4: PBM applied close to the area of the region between L4 and L5 from the warm phase, G5: PBM applied close to the area of the region between L4 and L5 from the acute phase, G6: PBM applied at two points: right paw and region between L4 and L5 from the warm phase, G7: PBM applied at two points: right paw and region between L4 and L5 from the acute phase.

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  Fig. 6 Average values of the thermographic evaluation between groups and evaluations. Group (G) 1: control (placebo), G2: photobiomodulation (PBM) applied to the paw with complex regional pain syndrome type I (CRPS-I) from the warm phase, G3: PBM applied to the paw with CRPS-I from the acute phase, G4: PBM applied close to the area of the region between L4 and L5 from the warm phase, G5: PBM applied close to the area of the region between L4 and L5 from the acute phase, G6: PBM applied at two points: right paw and region between L4 and L5 from the warm phase, G7: PBM applied at two points: right paw and region between L4 and L5 from the acute phase. *P < 0.05.

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  Fig. 7 Average values of Sciatic Functional Index (SFI) between groups and between evaluations. Group (G) 1: control (placebo), G2: photobiomodulation (PBM) applied to the paw with complex regional pain syndrome type I (CRPS-I) from the warm phase, G3: PBM applied to the paw with CRPS-I from the acute phase, G4: PBM applied close to the area of the region between L4 and L5 from the warm phase, G5: PBM applied close to the area of the region between L4 and L5 from the acute phase, G6: PBM applied at two points: right paw and region between L4 and L5 from the warm phase, G7: PBM applied at two points: right paw and region between L4 and L5 from the acute phase. *P < 0.05.

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  Fig. 8 Average values of Sciatic Static Index (SSI) between groups and between evaluations. Group (G) 1: control (placebo), G2: photobiomodulation (PBM) applied to the paw with complex regional pain syndrome type I (CRPS-I) from the warm phase, G3: PBM applied to the paw with CRPS-I from the acute phase, G4: PBM applied close to the area of the region between L4 and L5 from the warm phase, G5: PBM applied close to the area of the region between L4 and L5 from the acute phase, G6: PBM applied at two points: right paw and region between L4 and L5 from the warm phase, G7: PBM applied at two points: right paw and region between L4 and L5 from the acute phase. *P < 0.05.

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