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Patient withdrawal symptoms unblinded the study
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This study will examine the effect of LASER photobiomodulation therapy on pain and opioid pain medication weaning on patients who are undergoing opioid pain medication weaning.
The primary objective of this study is to determine if treatment with LASER photobiomodulation therapy reduces pain and facilitates opioid pain medication (OPM) reduction (weaning). The subject group includes patients with chronic pain who are undergoing OPM weaning and are candidates for LASER photobiomodulation therapy. This is a prospective interventional study using a double-blind 4-period crossover design to assess the efficacy of HIGH POWER LASER photobiomodulation therapy compared to sham (LOW POWER LASER) therapy in reducing pain and improving compliance with OPM weaning.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| ABAB | Other | Treatment, either LASER (arm A) or LOW LEVEL LASER (arm B) will be provided 3 (not less than 2) days a week for three weeks at which time crossover into the alternate arm occurs (BABA to ABAB or ABAB to BABA). ABAB initial period is active treatment - LASER. Active Treatment: LASER light is delivered to the skin and deeper tissues affected by pain using either a wand or glass roller ball. Ten to 25 Watts of LASER energy is delivered to the painful regions for 8 to 16 minutes depending on the size of the area treated and other factors such as skin pigmentation. |
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| BABA | Other | Treatment, either LASER (arm A) or LOW LEVEL LASER (arm B) will be provided 3 (not less than 2) days a week for three weeks at which time crossover into the alternate arm occurs (BABA to ABAB or ABAB to BABA). BABA initial period is sham treatment - LOW LEVEL LASER. LOW LEVEL LASER "treatment": Low level LASER is provided in a similar fashion using LASER power levels (1 Watt) that produce warmth only at superficial skin levels. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| LightForce EXPi | Device | LASER photobiomodulation therapy of 15-25 watts of coherent infrared light to affected area for 10 minutes using wand-type probe. |
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| Measure | Description | Time Frame |
|---|---|---|
| Compliance with Medical Opioid Use Reduction Protocol | Prescriptions for pain medications will be provided each week. Each successive prescription will have a decreasing quantity of tablets consistent with an agreed upon taper rate. Taper rates will be roughly based upon the recommendations of the CDC (10% per week). Subjects will have the option of postponing the taper by one week as often as every other week. If a subject was to exercise every option available to them to delay taper, then the weaning process would take twice as long and the rate of taper would be cut in half. The study will compare the number of missed medication tapers, and the taper rates of patients in the HIGH POWER LASER treatment periods to those in the LOW LEVEL LASER THERAPY treatment periods. | 12 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Self-reported measure of Pain. | Participants will complete the Visual Analogue Scale for Pain (Wong Baker FACES pain rating scale), taken at baseline, weekly thereafter, and immediately after the last treatment. | 12 weeks |
| Self-reported measure of Quality of Life. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Jerome C Stenehjem, Md | Sharp HealthCare | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Sharp Alison DeRose Rehabilitation Center | San Diego | California | 92123 | United States |
There is no intent to share data and no plan formulated at this time.
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| ID | Term |
|---|---|
| D059350 | Chronic Pain |
| ID | Term |
|---|---|
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D028022 | Low-Level Light Therapy |
| D053685 | Laser Therapy |
| ID | Term |
|---|---|
| D013812 | Therapeutics |
| D010789 | Phototherapy |
| D055011 | Ablation Techniques |
| D013514 | Surgical Procedures, Operative |
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This is a prospective interventional study using a double-blind 4-period crossover design to assess the efficacy of LASER Photobiomodulation therapy compared to sham (LOW POWER LASER) therapy in reducing pain and improving compliance with OPM weaning. LASER photobiomodulation treatments or sham treatments will be provided three times a week using standardized protocols. Crossover will occur every 3 weeks with weekly data collection occurring at the end of each week allowing for washout and to minimize the carryover effects of active treatment. Data collection will consist of LASER and sham treatments, prescribed pain medication dosage and quantity, subjective pain questionnaires, and urine samples. Cognitive and memory screening will occur every 3 weeks at the end of each period prior to crossover.
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Sham therapy will consist of treatment using an identically appearing device that delivers low level LASER POWER to simulate LASER treatment.
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Participants will complete the 36-Item Short Form Health Survey (SF36) at baseline and at study completion. |
| 12 weeks |
| Self-reported measure of Depression. | Participants will complete the 17-item Hamilton Depression Rating Scale (HAM-D) at baseline and at study completion. | 12 weeks |
| Self-reported measure of Anxiety. | Participants will complete the 40-item State-Trait Anxiety Inventory (STAI) at baseline and at study completion. | 12 weeks |
| Self-reported measure of Sleep Quality. | Participants will complete the Pittsburgh Sleep Quality Index (PSQI) at baseline and at study completion. | 12 weeks |
| Urine screening | Weekly urine screening will be conducted to assess deviations from treatment (use of non prescribed medications or substances). | 12 weeks |