Chronic pain has been described as the “undead cancer”. According to statistics, there are currently 1.5 billion chronic pain patients worldwide, and at least 100 million in China. How to overcome this stubborn disease has become an urgent problem in the world of medicine. Recently, German medical experts have tried for the first time to replace the original lighting in the consultation room with blue lights for the treatment of chronic pain. What is the treatment principle of this light therapy? What kind of effect can be obtained? With these questions, the reporter interviewed the experts.
A German pain clinic to use a specific blue bright light
According to the Daily Telegraph, the German pain specialist Thomas? Professor Thomas Tolle and his research team have recently launched a medical trial, using a special lighting system placed on the ceiling to assist in the treatment of chronic pain patients. This is the first international use of continuous bright light therapy for the treatment of chronic pain.
Tolle, a psychologist and neurologist, is president of the German Pain Society. Society and works at the Center for Pain Medicine at the Technical University of Munich. Starting in August this year, he will treat 100 pain patients with light therapy over a period of 18 months. Patients come to the pain center every day for four weeks for their regular treatment, which involves being exposed to light that is many times brighter than what they would normally experience in a regular clinic.
The light level in a normal office is usually between 500 and 800 lx (lux, unit of light intensity), but the pain center at the Technical University of Munich, in cooperation with the lighting company OSRAM, designed the light level in the medical environment to 3000 to 4000 lx. Moreover, the technicians made slight adjustments to the spectrum as required, so that it contains more blue light, but does not make the eyes feel uncomfortable. The entire ceiling light gives the impression as if the head is a clear blue summer sky.
Tolle believes that controlled light can stimulate a patient’s mood, sleep patterns and activity status and reduce the patient’s pain, which can affect the quality of life. It’s too early to draw conclusions, but the signs are good so far,” he says. Pain patients who have undergone this therapy have reported feeling more uplifted and confident.” He hopes that light therapy will become a powerful weapon in the fight against chronic pain.
Second, chronic pain often goes hand in hand with depression and insomnia
The director of the pain department told reporters that chronic pain is defined medically as pain that persists or recurs for more than a month. Its etiology and performance of the condition are complex, but whether it is muscle strain, lumbar disc herniation, post-traumatic scarring or pain triggered by viral infection, all are unpleasant emotional reactions of the brain caused by damage to the sensory nervous system.
The British National Health Service (NHS) research shows that 30% of chronic pain patients are accompanied by depression, 30% of patients are accompanied by anxiety, and 60% of patients have sleep disorders. Lu Zhenhe introduced the information from abroad that 63 percent of chronic pain patients are accompanied by depression, and in her clinical experience, she does often come into contact with chronic pain patients suffering from depression. “When the pain attack, people can not sleep well and can not go to work, and family members are often difficult to understand, thinking it is ‘mental illness’. The disapproval of people around you, combined with the physical pain, can cause a lot of stimulation to the cerebral cortex, causing anxiety and depression. And once one has anxiety and depression, one is more likely to magnify the pain.” That’s why good sleep is so important in the treatment of pain. One of the bottom lines that Lu Zhenhe’s pain department abides by is that it must ensure that patients can sleep well at night without physical pain. “If a patient can’t sleep well at night, then they can’t do minimally invasive treatment. Minimally invasive is a traumatic stimulus. Only if they are mentally stable can they receive new stimuli and have an accurate response to treatment and a better outcome.”
And there is a strong correlation between sleep and depression. Biologist Andreas Votisjak, who works for OSRAM Corp. Votisjak explains, “Research shows that if we don’t get restorative sleep, we are more likely to be depressed and have enhanced pain.” The director of psychiatry and director of the Sleep Center also pointed out that 98% of depressed patients have insomnia, “Insomnia itself is one of the symptoms of depression, and others are depressed because of long-term chronic insomnia, so curing insomnia can improve depression.”
Third, light therapy lends to improve depression and sleep to relieve pain
For the new study of Tolle, the British NHS Trust’s pain consultant Tom? Smith pointed out that chronic pain is a complex multifactorial disease, often intertwined with depression, anxiety, insomnia, etc., the interplay of these symptoms will aggravate the patient’s pain, and Tolle’s light therapy is actually a “borrowing method”, mainly through the treatment of depression and sleep disorders to relieve chronic pain.
Pain, mood problems, and sleep disorders often intersect, and improving one can improve the other. Foreign studies have found that treating chronic pain with antidepressants can be very effective, suggesting that there are common pathophysiological mechanisms for depression and pain. And these are the basis for the use of light therapy for chronic pain by German medical experts. Treatment of depression with light therapy is already a relatively mature method in Europe and North America.
In May, a new study from Harvard Medical School showed that bright light therapy can improve sleep, cognition, mood, and brain function in people who have had a mild traumatic brain injury (TBI). The study was conducted in 18 adults with TBI and sleep disorders. Researchers found that consistent light therapy in the morning for six weeks resulted in a significant reduction in subjective daytime sleepiness, which improved the quality of sleep at night.
Bright light therapy can improve depression and sleep disorders because bright light regulates circadian biorhythms and resets the body’s disrupted internal biological clock.
Circadian rhythms regulate the body’s natural cycles, affecting appetite, sleep and mood, which are largely controlled by light. Changing the circadian time rhythm through light therapy, extending the duration of light exposure and inhibiting melatonin secretion can significantly reduce early awakening and improve a person’s sleep quality and depression.
Blue light therapy is only performed during the day, so why was blue light specifically used in this German trial instead of other light? Light in the blue-green spectrum range has the strongest effect on the circadian system, with blue light having a stronger suppression of melatonin and the greatest effect on the daily rhythms of the organism. Some studies have shown that blue light has twice the inhibitory effect on melatonin than green light. When blue light is used in the treatment of patients with depression, anxiety and even Alzheimer’s disease, blue light is able to increase the amount of daytime activity and the amount of time the patient sleeps at night. Researchers at the University of Montreal’s Sleep and Biological Rhythm Research Centre found in their experiments that blue light had a stronger effect in terms of increased body temperature, increased heart rate and reduced drowsiness, and that the body’s response to blue light increased dramatically whenever the lights were on, whether at night or during the day.
Accordingly, it can be inferred that blue light therapy should be limited to the daytime, if the retina is stimulated with strong blue light at night, it is difficult for people to sleep peacefully. Pan Ji Yang said that at night, people who are prone to insomnia should lower the light in the room, too much bright light will interfere with the normal circadian rhythm of people. This year, a study in New York showed that in the evening before bed let volunteers use the iPad for two hours, the results of their melatonin levels were suppressed by 23%, so that their sleep was affected.
Tolle said in an interview with British journalists: “Stimulating the retina with bright light can naturally regulate sleep. We are looking for an association between extra light, better mood and reduced pain.”
This light therapy as mental regulation is mechanistically the same as hypnotherapy, environmental therapy and music therapy, which are commonly used in psychiatry to relax patients and provide a good adjustment to abnormal foci of excitement in the cerebral cortex. “This is a good therapy that can reduce or replace some drugs, but it can only be an adjunct therapy, not a miracle cure for all diseases. The cause of the sensory nerve damage must be found and removed to cure the pain.”
Light therapy is still not popular in China. When this reporter checked online for information about light therapy, he found no reports of domestic doctors using the therapy to treat depression, insomnia, and chronic pain. What is the popularity of light therapy, which has become increasingly popular abroad, in China?
Light therapy is rarely used in the treatment of depression in domestic hospitals, and is currently used only sporadically by some researchers to complete research projects. This is mainly due to the lack of attention to the relationship between seasonal affective disorder and climate in domestic psychiatric clinics. In addition, among China’s 1.3 billion population, 150-200 million people suffer from anxiety, depression, bipolar disorder and other psychiatric disorders, but there are only about 20,000 psychiatrists in China, and they mainly work in specialized hospitals, whose main clients are patients with severe mental disorders, and in general hospitals, which are too busy just to use medication for depression and insomnia disorders, hospitals have neither the space nor the funding and manpower to conduct light therapy trials.
It is estimated that in about 4-5 years, if the fees are reasonable, more psychiatric medical staff will pay attention to this therapy. He envisages that the following model will be more likely to be promoted: a light therapy room will be formed jointly by several departments of the hospital, such as the psychology department, the pain department and the sleep center, so that inpatients of each department can receive light therapy as an adjunctive treatment at regular intervals and then be charged according to the rates approved by the Price Bureau.
Light therapy (lighttherapy), also known as light therapy, light therapy, is a method of using sunlight or artificial light (infrared, ultraviolet, visible light, laser) to prevent disease and promote the body’s recovery.