COMBINED INFRARED LASER AND LED THERAPY FOR POSTMASTECTOMY PAIN AND DISCOMFORT: A CASE REPORT

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Mastectomies can sometimes be associated with prolonged pain and discomfort. Low reactive-level laser therapy (LLLT) at 830 nm has been reported as effective in pain attenuation. A new generation of quasimonochromatic light emitting diodes at a nominal 830 nm has offered the clinician an alternative IR phototherapy source for the hands-off treatment of large areas. The combination of the LED therapy over a large area combined with punctal application of laser therapy is an interesting concept. The present study evaluated this combination phototherapy in a patient with comparatively long-term postmastectomy pain. A 44-year-old female had suffered from postmastectomy pain and discomfort for over 3 months, despite taking a nonsteroidal anti-inflammatory drug at high doses. A GaAlAs diode laser (60 mW, CW, 20 sec and 60 J/cm² per point) in punctal application was combined with an LED array (830 nm ± 5 nm, 20 min/irradiation, CW, 60 J/cm²) in the dermatomal approach. Three consecutive daily sessions were given at the above parameters. The Hospital Anxiety and Depression Scale (HADS) was administered one day before and one day after the treatment regimen. Range of movement (ROM) and pain relief scores were recorded. The pre- and posttreatment HADS scores for depression and anxiety were 14 and 9, and 4 and 4, respectively. Pain and discomfort decreased somewhat after the first session, and more rapidly with the subsequent 2 sessions. At 24 hours after the third session, the patient was completely pain free with a full ROM. After an 8-week follow-up, ROM was still good, but mild discomfort was noted around the right breast, and a single ‘top-up’ session with the LED array alone was required, which was effective. The combination of punctal laser and area LED therapy at 830 nm over three consecutive daily sessions improved postmastectomy pain and restored full ROM in this one patient, with good latency which was extended with a single ‘top-up’ IR LED session. Further controlled studies with larger patient populations and longer follow-ups are warranted.