Background: Low intensity laser therapy (LILT) has been tried successfully for the treatment of pain of different
etiologies, including postoperative pain. We tried to assess its efficacy in chronic postmastectomy pain, which has a complex nature and a probable functional component.
Methods: Forty female patients were allocated into two equal groups. All have completed adjuvant therapy following
Patey's mastectomy for operable breast cancer. We compared the effect of LILT with that of diclofenac sodium 50 mg twice daily. Present pain intensity scale (ppi) assessed pain subjectively, while the drop of diurnal serum cortisol level did it objectively .A goniometer was used to quantify changes in the range of movement at the shoulder joint following treatment.
Results: All patients completed the trial, and were compatible in terms of age, type of surgery and adjuvant therapy
received. The same surgeon did all operations and the average postoperative period before submission was 4 months. Results of treatment with LILT (n=20) were compared with those of diclofenac sodium (n=20) as follows: pain reduction (ppi mean values) from 72.00% to 21.25% and from 75.00% to 59.00% respectively. Mean diurnal plasma cortisol level (ug/dl) dropped from 22.71 to 15.82 and from 21.26 to 18.26 respectively. Improvement in the range of movement at the shoulder joint (mean values in degrees) flexion: from 20.25 to 71.00 versus 23.25 to 33.50, abduction: from 18.00 to 81.00 versus 20.25 to 36.70, horizontal adduction: from 42.90 to 115.00 versus 38.15 to 72.75. p<0.05 in all tested parameters.
Conclusion: LILT significantly reduces postmastectomy pain subjectively & objectively, and significantly improves the
range of movements at the shoulder joint. The degree of improvement is statistically significant.