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Your Daily Posterous Spaces Update October 23rd, 2011 Ultrasound,

Shock Wave Not Effective for Low Back Pain --Doctors

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Ultrasound, Shock Wave Not Effective for Low Back Pain Last Updated: October

21, 2011.

*Available evidence shows that different treatments of acute low back

pain give similar results*

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------------------------------

*Related*

*The available evidence does not support the effectiveness of ultrasound or

shock wave for treating low back pain, according to a review published in

the October issue of The Spine Journal.*

FRIDAY, Oct. 21 (HealthDay News) -- The available evidence does not support

the effectiveness of ultrasound or shock wave for treating low back pain

(LBP), according to a review published in the October issue of *The Spine

Journal*.

Jesús Seco, M.D., Ph.D., from the University of León in Ponferrada, Spain,

and colleagues reviewed available literature to July 2009 to assess the

evidence for efficacy, effectiveness, cost-effectiveness, and safety of

ultrasound and a shock wave device in treating LBP. A total of 13 randomized

controlled trials (RCTs) comparing vibrotherapy with placebo or with other

treatments for LBP were identified, of which four complied with the

inclusion criteria and included 252 patients. Additional data were obtained

from authors of original studies and the risk of bias of each study was

assessed using Cochrane Back Review Group criteria.

The investigators found that ultrasound, traction, and low-power laser gave

similar results for acute patients with LBP and leg pain due to disc

herniation. Ultrasound was less effective than spinal manipulation in

chronic LBP patients without leg pain. In these patients, a shock wave

device and transcutaneous electrical nerve stimulation produced similar

results. Of the three RCTs on ultrasound, two had a high risk of bias. Only

one study compared ultrasound versus a sham procedure, but results were

unreliable due to inappropriate sham procedure, low sample size, and no

adjustment for potential confounders.

" The available trials do not demonstrate the efficacy or effectiveness of

ultrasound and shock wave for treating LBP, whether acute or chronic, with

or without leg pain, " the authors write.

Abstract<http://www.thespinejournalonline.com/article/S1529-9430%2811%2900126-4/\

abstract>

Full Text (subscription or payment may be

required)<http://www.thespinejournalonline.com/article/S1529-9430%2811%2900126-4\

/fulltext>

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Does Anodyne Light Therapy Improve Peripheral Neuropathy in

Diabetes?<http://ptmanagerblog.com/does-anodyne-light-therapy-improve-peripheral\

>

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Does Anodyne Light Therapy Improve Peripheral Neuropathy in Diabetes? A

double-blind, sham-controlled, randomized trial to evaluate monochromatic

infrared photoenergy

1. Lawrence A.

Lavery<http://care.diabetesjournals.org/search?author1=Lawrence+A.+Lavery & sortsp\

ec=date & submit=Submit>,

DPM, MPH,

2. P.

Murdoch<http://care.diabetesjournals.org/search?author1=+P.+Murdoch & sorts\

pec=date & submit=Submit>,

MD,

3. Jayme

<http://care.diabetesjournals.org/search?author1=Jayme+ & sortspec\

=date & submit=Submit>,

MD and

4. C.

Lavery<http://care.diabetesjournals.org/search?author1=+C.+Lavery & sortspec=\

date & submit=Submit>,

MD

+ <http://care.diabetesjournals.org/content/31/2/316.full#> Author

Affiliations

1. From the Department of Surgery, Texas A & M University Health and

Science Center College of Medicine, and White Hospital, Temple, Texas

1. Address correspondence and reprint requests to Lawrence A. Lavery, 703

Highland Spring Ln., town, TX 78633. E-mail:

lklavery@...<http://care.diabetesjournals.org/content/31/2/316.full/mailto\

:lklavery>

Next Section<http://care.diabetesjournals.org/content/31/2/316.full#sec-1>

Abstract

*OBJECTIVE*—The purpose of this study was to determine the efficacy of

anodyne monochromatic infrared photo energy (MIRE) in-home treatments over a

90-day period to improve peripheral sensation and self-reported quality of

life in individuals with diabetes.

*RESEARCH DESIGN AND METHODS*—This was a double-blind, randomized,

sham-controlled clinical trail. We randomly assigned 69 individuals with

diabetes and a vibration perception threshold (VPT) between 20 and 45 V to

two treatment groups: active or sham treatment. Sixty patients (120 limbs)

completed the study. Anodyne units were used at home every day for 40 min

for 90 days. We evaluated nerve conduction velocities, VPT, Semmes-Weinstein

monofilaments (SWM) (4-, 10-, 26-, and 60-g monofilaments), the Michigan

Neuropathy Screening Instrument (MNSI), a 10-cm visual analog pain scale,

and a neuropathy-specific quality of life instrument. We used a nested

repeated-measures multiple ANOVA design. Two sites (great toe and fifth

metatarsal) were tested on both the left and right feet of each patient, so

two feet were nested within each patient and two sites were nested within

each foot. To analyze the ordinal SWM scores, we used a nonparametric

factorial analysis for longitudinal data.

*RESULTS*—There were no significant differences in measures for quality of

life, MNSI, VPT, SWM, or nerve conduction velocities in active or sham

treatment groups (*P* > 0.05).

*CONCLUSIONS*—Anodyne MIRE therapy was no more effective than sham therapy

in the treatment of sensory neuropathy in individuals with diabetes.

via

care.diabetesjournals.org<http://care.diabetesjournals.org/content/31/2/316.full\

>

The Effect of Monochromatic Infrared Energy on Sensation in Patients

With Diabetic Peripheral

Neuropathy<http://ptmanagerblog.com/the-effect-of-monochromatic-infrared-energy-\

o>

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The Effect of Monochromatic Infrared Energy on Sensation in Patients With

Diabetic Peripheral Neuropathy A double-blind, placebo-controlled study

1. Judy K.

Clifft<http://care.diabetesjournals.org/search?author1=Judy+K.+Clifft & sortspec=d\

ate & submit=Submit>,

PT, MS1 <http://care.diabetesjournals.org/content/28/12/2896.short#aff-1>,

2. J.

Kasser<http://care.diabetesjournals.org/search?author1=+J.+Kasser & sortspe\

c=date & submit=Submit>,

PT, PHD1<http://care.diabetesjournals.org/content/28/12/2896.short#aff-1>,

3. S.

Newton<http://care.diabetesjournals.org/search?author1=+S.+Newton & sortspe\

c=date & submit=Submit>,

PT, DPT, OCS,

CWS2<http://care.diabetesjournals.org/content/28/12/2896.short#aff-2>and

4. J.

Bush<http://care.diabetesjournals.org/search?author1=+J.+Bush & sortspec=dat\

e & submit=Submit>,

PHD3 <http://care.diabetesjournals.org/content/28/12/2896.short#aff-3>

+ <http://care.diabetesjournals.org/content/28/12/2896.short#> Author

Affiliations

1. 1Department of Physical Therapy, University of Tennessee Health

Science Center, Memphis, Tennessee

2. 2Pulaski Physical Therapy, Pulaski, Tennessee

3. 3Department of Preventative Medicine, University of Tennessee Health

Science Center, Memphis, Tennessee

1. Address correspondence and reprint requests to Judy Clifft, UTHSC

Department of Physical Therapy, 930 Madison Ave., Room 650, Memphis, TN

38163. E-mail:

jclifft@...<http://care.diabetesjournals.org/content/28/12/2896.short/mail\

to:jclifftutmem (DOT) edu>

Abstract

*OBJECTIVE*—The purpose of this study was to determine the effect of

monochromatic infrared energy (MIRE) on plantar sensation in subjects with

diabetic peripheral neuropathy.

*RESEARCH DESIGN AND METHODS*—In this randomized, double-blind,

placebo-controlled study, 39 subjects with diabetic peripheral neuropathy

completed the 8-week study. Subjects received 30 min of active or placebo

MIRE three times a week for 4 weeks. Plantar sensation was tested with

monofilaments at the beginning of the study (M1), following 4 weeks of

treatment (M2), and after an additional 4 weeks of nontreatment (M3). The

number of sites that could sense the 5.07 monofilament was totaled at M1,

M2, and M3. Data were analyzed using a special repeated-measures statistic

followed by a post hoc Tukey-Kramer test.

*RESULTS*—The average number of sites that patients could sense the 5.07

monofilament increased for both the active and placebo groups. There were

significant gains from M1 to M2 (*P* < 0.002), no significant gains from M2

to M3 (*P* = 0.234), and significant gains from M1 to M3 (*P* < 0.002) for

both the active and placebo groups. There were no significant differences

between active and placebo groups at any measurement.

*CONCLUSIONS*—Thirty minutes of active MIRE applied 3 days per week for 4

weeks was no more effective than placebo MIRE in increasing sensation in

subjects with diabetic peripheral neuropathy. Clinicians should be aware

that MIRE may not be an effective modality for improving sensory impairments

in patients with diabetic neuropathy.

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