Relieve Osteoarthritis with Photobiomodulation Therapy
What is Osteoarthritis?
Osteoarthritis (OA) is a type of arthritis. It’s the most common joint disorder and associated with the aging population.
Osteoarthritis is also called degenerative joint disease (DJD). No matter what it’s called, the disease affects the cartilage of the joints, eating away at the cartilage. When the cartilage is broken down, bones within the joint start to rub together.
Since the purpose of cartilage is to protect the ends of the bones and absorb the shock of movement, this makes it difficult for the joint to work properly as it should and leads to joint destruction.
The joints that are usually most affected by OA are the hip, hands, fingertips, spine, and knees.
Symptoms of Osteoarthritis
OA is a progressive disorder and leads to functional decline and loss in the quality of life. Some of the symptoms that are seen include any of the following;
- inflammation in the joint
- pain in the joint
- disability and limitations in stooping, bending or kneeling, and pushing or pulling large objects
- joint instability
- muscle weakness
- bone spurs
- joint deformity
One of the diagnostic criteria of osteoarthritis is that the affected joint tends to hurt more after a night of sleep due to the lack of movement in bed. When the patient starts moving around, the pain is alleviated somewhat once movement starts.
Risks of Osteoarthritis
Those who have OA commonly suffer from depression or anxiety, social isolation and loneliness. It’s no wonder this happens – when your every movement is filled with pain, it is definitely a challenging situation.
Osteoarthritis also raises the cost of health care. And some studies have shown that patients with OA are at greater risk of dying from all causes, especially cardiovascular diseases, when compared with the general population. The risk of death is closely associated with disability level. 
How Prevalent is Osteoarthritis?
OA is very common. If you check around with 10 of your friends over the age of 50, you’ll most likely find that at least 3 to 4 of them have a joint or more affected by the disease.
The actual incidence of osteoarthritis is quite interesting because it depends on who created the statistic and how the statistic was calculated.
There are three ways this could be calculated:
1. Counting the patients who self-report that they have OA.
In this method, researchers have to take the patient’s word for it and assume the patient is not lying.
2. Symptomatic OA.
In this method, doctors usually report that so many patients have the symptoms of OA and each one is counted.
3. X-ray findings.
In this method, doctors are actually seeing the changes in the bones and joints on x-rays. It’s the most accurate method of counting who has arthritis and who doesn’t.
In the studies to see exactly how many people have OA, if the statistic is based on self-reported and symptomatic OA definitions, the numbers are similar. But when x-rays are used for diagnosis, the numbers of those who have OA are a lot higher.
One World Health Organization study reported the following incidence of OA found in different countries. The measurement they used was pain and stiffness in joints that did not go away after movement on the chart below. This would be considered the symptomatic OA method.
Since the percentages in the study don’t translate well to actual numbers of people plagued with osteoarthritis, the following numbers will help you better understand the prevalence of it:
• In 2017, there were >300 million cases of hip and knee OA worldwide.
• About 32.5 million adults in the U.S. have osteoarthritis.
• The incidence of knee OA is highest in those between 55 and 64 years old.
• In those younger than age 45, OA is more common among men. Above age 45, OA is more common in women.
• More than half of those with symptoms of OA in the knee are younger than age 65.
• 78% of those with OA are non-Hispanic whites. That’s 25.35 million people.
In one study on osteoarthritis of the knee, when x-rays were used to diagnose the arthritis, the statistics ranged from 7.1% in Croatia to 70.8% of the population in Japan. However, when they looked at symptoms, the lowest estimate was 5.4% in Italy and it was 24.2% in Korea. See the difference?
But according to doctors in Portugal who reviewed 72 different research papers on osteoarthritis, if x-rays were used to define OA, then the incidence was a lot higher in women, men and in all age groups. If they just considered symptoms, women had a higher prevalence.
Cause of Osteoarthritis
OA results from a combination of factors. The most prominent one is increasing age and obesity. If someone is older AND they are obese, then, the chance that he/she has OA is quite high.
OA may result from an old injury to a joint that simply did not heal. The injury could have been a dislocation to a joint, fracture, torn cartilage, or ligament injuries.
Osteoarthritis may also occur because of an underlying biomechanical problem such as hip dysplasia, scoliosis, flat feet, poor posture, and genetic disorders that affect the joints.
Treatment of Osteoarthritis
Medications for osteoarthritis are aimed at trying to relieve the symptoms. At present, there are no drugs that have been created that modify the disease. They will not slow or stop the disease progression. The drugs most commonly used are paracetamol, NSAIDS and sometimes opiates. Each of these medications has side effects.
Other treatments include the following:
• physical exercise
• losing weight
• supportive braces and walking sticks
• surgery to replace the joint, although artificial joints only last for about 10 years
In recent years, some studies have shown an influence of diet on the prevalence and/or symptoms of OA. For example, a Mediterranean diet has been shown to be associated with a lower prevalence of osteoarthritis.
Two supplements - glucosamine and chondroitin sulfate have been shown to delay the progression of knee OA. Nutrients, vitamins, antioxidants and other natural components have also been shown to be effective for arthritis.
One common herb used against OA is turmeric, with its constituent ingredient curcumin. Curcumin’s action is anti-inflammatory, and the decrease in inflammation is a distinct benefit for patients with arthritis. Taking the herb improves pain, physical function, and quality of life, plus the patients end up decreasing their use of analgesics. This means they suffer less from side effects that usually result from these drugs.
Photobiomodulation for Osteoarthritis
There’s a new treatment that is starting to gain a lot of popularity for OA called photobiomodulation. Breaking this word down into three parts, you have the words photo, bio, and modulation. In photobiomodulation, light changes life.
Photobiomodulation already happens naturally in our bodies. Sunlight on the skin is an example of photobiomodulation. The photons of sunlight activate vitamin D receptors in the skin so that vitamin D is produced. Vitamin D then goes on to activate hundreds of reactions in the body. Those who are deficient in vitamin D are missing the activation of all these reactions – and this accounts for the different diseases that may appear when there is a vitamin D deficiency.
Another example of light-induced photochemical reactions in our body is vision. Our retinas contain photosensitive cells called photoreceptors that absorb light. Electrical signals are then transmitted to the brain that make it possible for us to see everything around us.
What is Photobiomodulation Therapy?
The use of light for treating medical conditions dates back probably to the beginning of time but in 1903 a Nobel Prize in Medicine was awarded to Dr. Niels Finsen. He treated lupus using an arc lamp.
Then in 1960, the ruby red laser was invented and laser biostimulation was discovered in 1967 by Endre Mester, a Hungarian scientist. He was researching low level laser light effects in mice to see if the light would cause cancer. It didn’t cause cancer at all. In fact, what the light did was regenerate tissue and grew hair. Mester did additional studies on laser treatment for wound healing in diabetics with ulcers.
Since then, over 4000 experiments have been performed and over 500 clinical studies have proven how light may be used for many conditions – from arthritis to back pain, neck pain, shoulder pain, fibromyalgia, and neuropathy.
Photobiomodulation (PBM) or photobiomodulation therapy (PBMT) is the scientific use of light to affect the biological cells in the body and make changes that improve health. Other terms have been used for this process such as biostimulation, low intensity laser light, low level laser therapy (LLLT), cold laser, cool laser, and low power laser therapy.
There are different types of devices that may be chosen for photobiomodulation. The practitioner may use a tool that is pressed up against the skin and move it around the entire area for about five minutes. Another tool is an actual laser that is moved on the surface of the skin. The laser is held on the skin for 30 seconds and then another point of pain is chosen for the next 30 seconds.
Another way photobiomodulation may be done is transcranial. In this method, light is shined on the head and penetrates the brain. The light may be created via a headband of small red lights all together, a brain ‘cap’ that is worn which looks like a helmet, or a series of connected pieces placed at strategic parts of the head..
The photons from the light penetrate the skin and start a complex chain of events in the mitochondria. During the process, an enzyme known as cytochrome c oxidase is activated, which creates energy called ATP. It speeds up metabolism of the cells and inflammation is decreased.
Calcium ion channels are also affected from PBM. 
Benefits of Photobiomodulation
Giving you more energy and less inflammation are only two of the benefits of PBM.
Here’s a short list of some of those benefits that have been reported:
• Stimulates the healing of wounds
• Stimulates regeneration of tissues
• Improves cognition
• Increases nitric oxide, which increases gene expression to make more antioxidants to control free radicals
• Blood circulation and lymphatic flow circulation is improved
• Cells prevented from dying
• Nerve protection
• Oxygenates cells and tissues
• Increases antioxidants
• Increases range of motion in joints
• Decreases pain and inflammation
How Photobiomodulation Therapy Helps Relieve Osteoarthritis
Over 230 studies have been reported in PubMed on the topic of how PBM therapy works in osteoarthritis.
In one dog elbow arthritis study, dogs received PBM or placebo therapy on both elbows for six weeks. The dogs that received the PBM had a greater improvement in lameness, greater reduction in pain score, and lower need for NSAID medication. 
In one study of knee osteoarthritis of 100 volunteers aged 40 to 80 years old, the addition of PBM was equal to what was achieved by those in the exercise group. Pain was decreased, the ability to sit and stand was improved and fatigue levels were enhanced. The participants had three sessions a week for 8 weeks.
PBMT has been successfully proven as an effective intervention for neck pain patients and reduces pain and disability caused by low back pain as well. Many conditions related to neck and back pain have an underlying arthritis component to them.
Light is a very powerful tool in medicine and has the power to heal the disease.
Photobiomodulation offers cost-effective advantages over drug therapy for a quicker, more positive response to treatment and has no side effects. Using PBM in arthritis can bring success, based on the doctor’s ability to seek the optimal solution, choose the best technology, and select the mode of action to target what needs to be done. However, more and more home devices are being created for ease of therapy and may one day become light therapy we all need and use daily.
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