Photobiomodulation with cluster does not present superior results to placebo in young people with chronic non-specific lumbar pain
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Universidade Estadual do Oeste do Paraná, Cascavel, Brazil
Gladson Ricardo Flor Bertolini   

Universidade Estadual do Oeste do Paraná, Rua Universitária, 2069, 85819110, Cascavel, Brazil
J Pre Clin Clin Res. 2020;14(4):107–110
Introduction and objective:
Since the characteristic of chronic non-specific lumbar dysfunction presents a high prevalence and morbidity, and that there are still conflicting results with the use of photobiomodulation, the aim of this study was to analyze the effect of photobiomodulation application in patients with chronic non-specific lombalgy.

Material and methods:
A quantitative, experimental, randomized study composed of 21 volunteers randomly separated into two groups: 1) the intervention group (IG), who were given an application of photobiomodulation (LED (617nm ±10%, 1,500 mW) and low-level laser therapy (830nm, 150 mW, beam area 12.57mm), combined energy of 8.4 J per area for one minute in four different locations: in regions of greatest pain referred to palpation, on a bilateral basis, area of the applicator – 23,8 cm2). 2) the control group (CG), in which the device remained switched-off during therapy. All subjects were evaluated by McGill and Roland Morris questionnaires before and at the end of 6 interventions (3 weeks).

For both McGill and Roland Morris total pain rates, there was no inter-group interaction or interaction between evaluation and group (p>0.05). In the comparison between evaluations (before and after), there was a significant difference (p<0.001).

The use of photobiomodulation in these parameters in young patients with chronic non-specific lombalgy, was not more effective than the placebo for the relief of painful symptoms. Nor did it promote a decrease in the repercussion of lombalgy in the performance of daily activities.

Bohnenberger Escanes I, Cordeiro Baierle I, Thaise de Assis, Neves M, Jupir Forner Flores L, Ricardo Flor Bertolini G. Photobiomodulation with Cluster does not present superior results to placebo in young people with chronic non-specific lumbar pain. J Pre-Clin Clin Res. 2020; 14(4): 107–110. doi: 10. 264 4 4/jpccr/130262
Almeida DC, Kraychete DC. Low back pain – a diagnostic approach. Rev Dor. 2017;18(2):173–7.
Çinar-Medeni Ö, Elbasan B, Duzgun I. Low back pain prevalence in healthcare professionals and identification of factors affecting low back pain. J Back Musculoskelet Rehabil. 2017;30(3):451–9.
Pires RAM, Dumas FVL. Lombalgia: revisão de conceitos e métodos de tratamentos. Univ Ciências da Saúde. 2009 Jul 23;6(2):159–68.
Vlaeyen JWS, Maher CG, Wiech K, Zundert J Van, Meloto CB, Diatchenko L, et al. Low back pain. Nat Rev Dis Prim. 2018;4(1):52.
Helfenstein Junior M, Goldenfum MA, Siena C. Occupational low back pain. Rev Assoc Med Bras. 2010;56(5):583–9.
Lizier DT, Perez MV, Sakata RK. Exercícios para tratamento de lombalgia inespecífica. Rev Bras Anestesiol. 2012;62(6):838–46.
Maher C, Underwood M, Buchbinder R. Non-specific low back pain. Lancet. 2017;389(10070):736–47.
Kamel DM, Abdel NA, Tantawy SA. Efficacy of lumbar mobilization on postpartum low back pain in Egyptian females: A randomized control trial. J Back Musculoskelet Rehabil. 2016;29(1):55–63.
Coulter ID, Crawford C, Hurwitz EL, Vernon H, Khorsan R, Suttorp Booth M, et al. Manipulation and mobilization for treating chronic low back pain: a systematic review and meta-analysis. Spine J. 2018;18(5):866–79.
Endamlı D, Bayramlar K, Turhan B. Investigation of fascial treatment effectiveness on pain, flexibility, functional level, and kinesiophobia in patients with chronic low back pain. Physiother Q. 2019;27(3):1–5.
Tantawy SA, Kamel DM, Abdelbasset WK, Nambi G. A randomized controlled trial investigating the impact of interferential therapy on pain, range of motion and quality of life in patients with chronic non-specific low back pain. Arch Balk Med Union. 2020;55(1):47–54.
Rubira APFDA, Rubira MC, Rubira LDA, Comachio J, Magalhães MO, Marques AP. Comparison of the effects of low-level laser and pulsed and continuous ultrasound on pain and physical disability in chronic non-specific low back pain: A randomized controlled clinical trial. Adv Rheumatol. 2019;59(1):57.
Huang Z, Ma J, Chen J, Shen B, Pei F, Kraus VB. The effectiveness of low-level laser therapy for nonspecific chronic low back pain: a systematic review and meta-analysis. Arthritis Res Ther. 2015;17:360.
Ferraresi C, Huang Y-Y, Hamblin MR. Photobiomodulation in human muscle tissue: an advantage in sports performance? J Biophotonics. 2016;9(11–12):1273–99.
Siqueira CPCM, Toginho Filho DDO, Lima FM de, Silva FP, Durante H, Dias IFL, et al. Efeitos biológicos da luz: aplicação de terapia de baixa potência empregando LEDs (Light Emitting Diode) na cicatrização da úlcera venosa: relato de caso. Semin Ciências Biológicas e da Saúde. 2009;30(1):37.
Tsai SR, Hamblin MR. Biological effects and medical applications of infrared radiation. J Photochem Photobiol B Biol. 2017;170:197–207.
Ezzati K, Fekrazad R, Raoufi Z. The effects of photobiomodulation therapy on post-surgical pain. J Lasers Med Sci. 2019;10(2):79–85.
Barez MM, Tajziehchi M, Heidari MH, Bushehri A, Moayer F, Mansouri N, et al. Stimulation effect of low level laser therapy on sciatic nerve regeneration in rat. J Lasers Med Sci. 2017;8(Suppl 1):S32–7.
Alves ACA, De Carvalho PDTC, Parente M, Xavier M, Frigo L, Aimbire F, et al. Low-level laser therapy in different stages of rheumatoid arthritis: A histological study. Lasers Med Sci. 2013;28(2):529–36.
Mansourian A, Pourshahidi S, Sadrzadeh-Afshar M-S, Ebrahimi H. A comparative study of low-level laser therapy and transcutaneous electrical nerve stimulation as an adjunct to pharmaceutical therapy for myofascial pain dysfunction syndrome: a randomized clinical trial. Front Dent. 2019 Dec 24;16(4):256–64.
Santos CM dos, Rocha RB da, Hazime FA, Cardoso VS. A systematic review and meta-analysis of the effects of low-level laser therapy in the treatment of diabetic foot ulcers. Int J Low Extrem Wounds [Internet]. 2020 May 12;153473462091443. Available from:
Cheung WKW, Wu IXY, Sit RWS, Ho RST, Wong CHL, Wong SYS, et al. Low-level laser therapy for carpal tunnel syndrome: systematic review and network meta-analysis. Physiotherapy [Internet]. 2020 Mar;106:24–35. Available from:
Campos GRS, de Moura KMB, Barbosa AM, Zamuner LF, Nadur-Andrade N, Dale CS, et al. Light emitting diode (LED) therapy reduces local pathological changes induced by Bothrops asper snake venom. Toxicon. 2018;152:95–102.
Al-Quisi AF, Al-Anee AM, AL-jumaily HA, Bahr EF, Finjan DA. Efficacy of the LED red light therapy in the treatment of temporomandibular disorders: double blind randomized controlled trial. Pain Res Treat [Internet]. 2019 May 7;2019:8578703. Available from:
Gabel CP, Petrie SR, Mischoulon D, Hamblin MR, Yeung A, Sangermano L, et al. A case control series for the effect of photobiomodulation in patients with low back pain and concurrent depression. Laser Ther. 2018;27(3):167–73.
Taradaj J, Rajfur K, Shay B, Rajfur J, Ptaszkowski K, Walewicz K, et al. Photobiomodulation using high-or low-level laser irradiations in patients with lumbar disc degenerative changes: disappointing outcomes and remarks. Clin Interv Aging. 2018;13:1445–55.
Tantawy SA, Abdelbasset WK, Kamel DM, Alrawaili SM, Alsubaie SF. Laser photobiomodulation is more effective than ultrasound therapy in patients with chronic nonspecific low back pain: a comparative study. Lasers Med Sci. 2019;34(4):793–800.
Melzack R. The McGill pain questionnaire. From description to measurment. Anesthesiology. 2005;103(1):199–202.
Sardá Júnior JJ, Nicholas MK, Pimenta CA de M, Asghari A, Thieme AL. Validation of the Roland Morris Disability Questionnaire for general pain. Rev Dor. 2010;11(1):28–36.
Falavigna A, Teles AR, De Braga GL, Barazzetti DO, Lazzaretti L, Tregnago AC. Instrumentos de avaliação clínica e funcional em cirurgia da coluna vertebral. Coluna/Columna. 2011;10(1):62–7.
Hedges L V. Effect sizes in cluster-randomized designs. J Educ Behav Stat. 2007;32(4):341–70.
Sullivan GM, Feinn R. Using effect size—or why the P value is not enough. J Grad Med Educ. 2012;4(3):279–82.
Silva JA da, Ribeiro-Filho NP. A dor como um problema psicofísico. Rev Dor. 2011;12(2):138–51.
Požgain I, Požgain Z, Degmečić D. Placebo and nocebo effect: A mini-review. Psychiatr Danub. 2014;26(2):100–7.
Brody H. Meaning and an overview of the placebo effect. Perspect Biol Med. 2018;61(3):353–60.
Damien J, Colloca L, Bellei-Rodriguez C-É, Marchand S. Pain modulation: from conditioned pain modulation to placebo and nocebo effects in experimental and clinical pain. Int Rev Neurobiol. 2018;139:255–96.
Meroni R, Piscitelli D, Ravasio C, Vanti C, Bertozzi L, De Vito G, et al. Evidence for managing chronic low back pain in primary care: a review of recommendations from high-quality clinical practice guidelines. Disabil Rehabil. 2019;0(0):Epub ahead of print.
Glazov G, Yelland M, Emery J. Low-level laser therapy for chronic non-specific low back pain: a meta-analysis of randomised controlled trials. Acupunct Med. 2016 Oct 12;34(5):328–41.