The application of point-type linear polarized light pain treatment instrument in pain diseases of middle-aged and elderly people Point-type linear polarized light pain treatment instrument, also known as “super laser pain treatment instrument”, trade name “Super lizer” (SL), is a low-energy light therapy equipment, combined with the advantages of infrared and laser treatment instrument, in the treatment of pain outpatient trauma, edema, arthralgia and neuralgia with remarkable results. It is a low-energy light therapy device that combines the advantages of infrared light and laser therapy, and is effective in the treatment of traumatic edema, arthralgia and neuralgia in pain clinics. It is also suitable for patients of all ages due to its non-invasive, painless, safe, and non-adverse reaction properties, and is an additional option when other pain treatments are ineffective. We collected the data of cases who received SL treatment in the pain clinic of the Department of Anesthesiology, East China Hospital of Fudan University between June 2013 and June 2015, and summarized and reported as follows. 1, DATA AND METHODS 1.1 Clinical data There were 40 cases who received SL treatment in the Pain Clinic of the Department of Anesthesiology, East China Hospital of Fudan University between June 2013 and June 2015, aged 50-85 years old; there were 17 male cases and 23 female cases. All patients did not have pacemakers, had no bleeding disorders, and had no tumor or allergy history. Among them, there were 3 cases of acute wrist sprain and contusion, 3 cases of acute post-traumatic knee edema, 2 cases of achalasia, 5 cases of chronic lumbar strain; 10 cases of lumbar disc herniation or lumbar spinal stenosis (confirmed by CT or MRI) resulting in sciatica, 3 cases of degenerative knee osteoarthritis, 2 cases of postoperative knee swelling, 2 cases of periarthritis, 7 cases of periarthritis, 2 cases of postoperative lower abdominal pain, and 1 case of diabetic foot gangrene. 1.2 Pain score According to the patients’ complaints, according to the visual analog scoring method (VAS) assessment, no pain: 0 points, 0 cases; 3-54 points for mild pain, 16 cases; moderate pain 5-7 points, 24 cases; severe pain for 78 points or more, 0 cases; the score of patients who visited the clinic 3-8 points. 1.3 Treatment methods All patients were treated once a week, patients with lumbar disc herniation or lumbar spinal stenosis resulting in sciatica, and patients with frozen shoulder were treated with 3 to -4 times as a course of treatment, and the rest received more than one treatment according to the evaluation criteria. 1.3.1 Simple SL treatment: the point-type linear polarized light pain therapy instrument super-lizer HA-550 developed by Tokyo Medical Research Co. According to the condition , the B-type probe was selected for irradiation of the pressure point of the pain site, irradiation of the relevant acupoints according to the meridian theory of traditional Chinese medicine, irradiation of the projection of the joint cavity, irradiation of the projection of the nerve root; and the SG-type probe was selected for irradiation of the stellate ganglion; The irradiation power is 100%, and the on:off ratio is 1:1; continuous irradiation with C-type probe is used for localized pain. 1.3.2 Nerve block assisted SL treatment: patients with lumbar disc herniation or lumbar spinal stenosis resulting in sciatica and some patients with frozen shoulder adopt this treatment method. Nerve block is 2% lidocaine 50mg* + Depo-Proxon 1mL* + Mecobalamin 1 ampoule + 0.9% saline total 20mL mixture, for pain point injection, ring jump point injection or L3 transverse process injection, paravertebral injection, pay attention to avoid blood vessels, in the myofascial sub-tendon membrane injection. 1.4 Efficacy assessment According to the patients’ self-perception assessment, patients with lumbar and leg pain and frozen shoulder were treated for one course of treatment, and the rest of the patients did not need to be re-examined if their pain symptoms disappeared after one or two treatments. Some patients were called back to know the effect of diagnosis and treatment. 2, Results Treatment effect evaluation criteria: according to the VAS score. Acute wrist contusion, acute knee injury and postoperative knee swelling and pain patients after 1 treatment, edema significantly subsided, pain reduced to less than 5 points, wrist (knee) joint mobility increased significantly; follow-up treatment for 1 time to improve and consolidate the efficacy of the treatment, and no 3rd follow-up treatment. Heel pain patients 2 cases are treated for the first time after the apparent effect, the second consolidation of the efficacy, without the need for a third treatment. Patients with chronic lumbar muscle strain complained of reduced pain in the lumbar area and increased lumbar mobility when they left the clinic after the 1st treatment for about 10 min. 1 case did not have a follow-up after the 1st treatment; 2 cases had a VAS score of 4 or less at the time of the 2nd treatment, and did not have a follow-up after the 2nd treatment; and 2 cases underwent 3 treatments, and the results were better than the previous one. Degenerative knee osteoarthritis caused knee pain in 3 cases, after the 1st treatment, the pain had been reduced when walking out of the clinic; all of them received 3 treatments, of which the pain in 1 case was reduced compared with that before the treatment, and the pain in 2 cases disappeared. Patients with lumbar disc herniation or lumbar spinal stenosis resulting in sciatica and frozen shoulder were treated with 4 sessions, with nerve block as the main treatment, supplemented by SL treatment. It was supplemented with stellate ganglion irradiation as needed. 2 patients with lumbar spinal stenosis had no obvious effect after 1 course of treatment; the rest of the patients had either pain or relief and a VAS score of 3 or less. The 2 patients with lower abdominal pain had a history of lower abdominal surgery, prolonged postoperative abdominal pain, insomnia, and negative emotions, with a duration of more than 2 years. After 1 course of treatment, the pain was reduced or even disappeared, sleep improved, and mood was pleasant. Postherpetic neuralgia was ineffective in 2 cases. Diabetic foot gangrene 1 case is invalid. 3.Discussion In recent years, laser therapy as a “painless therapy” by the clinical general concern, in addition to pain treatment, there is a wide range of indications. In 1988, Tokyo Medical Research Co., Ltd. developed the first “point-type linear polarized light pain treatment instrument” based on the principle of green treatment, symptomatic and fundamental treatment. The instrument to iodine lamp as a light source, with fiber optic material transmission linear polarized broad spectrum near infrared, in the 600 ~ 1600nm human body transmission window range, the output power of up to 2 200mv of light waves, the effective effect of the depth of the body’s tissues up to 125px or more. Based on the principle that the therapeutic effect of a light therapy device depends on the amount of energy of the light reaching the depth of human tissue and the treatment method, SL can effectively treat a variety of diseases. SL take the directionality of laser and point linear polarized light characteristics, to avoid the laser wavelength single, low therapeutic efficacy of the defects; take the ordinary infrared wavelength bandwidth, the advantages of a good thermal effect, to avoid the ordinary infrared scattering, absorption, the defects of the absence of polarized light, so the SL both ordinary infrared light and laser therapeutic instrument with the advantages of the body’s environment can be effectively adjusted to stabilize the regulation of the vegetative nervous system, the endocrine and immune functions. The mechanism of SL includes: inhibiting nerve excitation, relaxing muscles; dilating blood vessels, improving blood flow, promoting the absorption of inflammatory exudates; promoting the production of active substances; regulating the vegetative nervous system; accelerating the metabolism and cleaning of pathogenic and pain-causing substances; promoting the production of collagen; promoting the circulation of the lymphatic system; regulating the stability of the internal environment of the body; selective blockade of the nerves that conduct pain; promoting the absorption of inflammatory exudates, inhibiting inflammatory reactions and so on. reaction, etc. SL has a wide range of clinical effects due to its mechanism of action, such as raising the temperature of the lesion to promote neovascularization and improve blood flow; promoting protein synthesis; increasing enzyme activity; increasing collagen synthesis; immunomodulation (activation and inhibition); and bactericidal (anti-inflammatory) effects. SL because of the above mechanism of action and clinical effects can be effective in the treatment of a variety of diseases, but also because of the safety, painless, non-traumatic, non-invasive, non-adverse reactions less widely accepted by patients, but also because of the operation of the simple, controllable and widely used in the clinical use of the SL since it is known as a pain therapy device, the main purpose of use is still in the treatment of pain. This group is a post-traumatic wrist, knee edema patients, after one treatment, edema significantly subsided, because of edema caused by the swelling and pain symptoms are also relieved, and even disappeared, joint mobility increased, patient satisfaction is high. The same postoperative edema patients, after each treatment, edema reduced significantly, and accordingly blood circulation can be improved. It is envisioned that if orthopedic patients undergoing limb joint surgery can routinely receive SL treatment after surgery, it should effectively reduce and shorten the degree and duration of postoperative localized edema, which will help with postoperative joint functional exercise, and will it therefore also reduce the incidence of postoperative joint stiffness? In our group, two patients with heel pain came with lameness and pain in the landing of the affected heel. After 10 min of continuous irradiation with the SLC-type probe, the affected heel was able to land on the ground and walk out of the clinic. Patient satisfaction was high. The purpose of the second visit was to consolidate the therapeutic effect. The causes of lumbar pain include sprain, lumbar muscle strain, lumbar disc herniation and lumbar spinal stenosis, etc. Sprain and lumbar muscle strain are mostly caused by local aseptic inflammation, which stimulates the nerve endings and causes pain; whereas lumbar disc herniation and lumbar spinal stenosis are due to edema caused by nerve compression, and the effect of SL on anti-inflammation and edema can play the role of spasmodic and analgesic effects. It has been reported that there is no statistical difference in the efficacy of SL for the treatment of chronic soft tissue injury pain compared with nerve block therapy. Our group was limited to obsolete instruments and a limited number of patients, and a controlled study was not set up, but the effect of SL on the treatment of pain in chronic soft tissue injuries is clear, and compared with the possible adverse effects of hormones in the medication used in nerve block and the traumatic nature of the operation, SL wins with a high degree of safety. Bone, articular cartilage, muscles, tendon sheaths, ligaments, bursae, nerves, blood vessels, and even the skin are more frequently injured than acute injuries, and the popularization of the Internet in the 21st century and the creation of the “low head” generation have led to an increase in the number of patients suffering from chronic soft-tissue injuries and pain, and SL would be a very convenient, economical, and effective treatment method. It has been reported that, whereas in patients with lumbar disc herniation, SL combined with massage, acupuncture or nerve block can have a synergistic effect. Since the outpatient clinic can not meet the aseptic requirements of intravertebral nerve block, this group mostly adopts the pain point block, L3 transverse process block, ring-jump block and other methods combined with SL treatment, to achieve the same effect of intravertebral block, so that the combination of the safety, undoubtedly, is the pain outpatient business can be expected to open up the development of the guarantee. Frozen shoulder, also known as “50 shoulders”, has a high incidence rate among the elderly. For mild and moderate patients, after a standardized course of treatment, the effect of SL is not statistically different from that of nerve block. In the past, patients with moderate or severe frozen shoulder were treated with pain point + intracavitary injection in the shoulder joint. The joint cavity is a sterile environment, and intracavitary injection carries the risk of infection.The combination of SL and nerve block has a faster efficacy, less risk, and fewer adverse effects than monotherapy. Wang Qiuhua et al. reported that the incidence of gastrointestinal adverse reactions in patients with degenerative knee osteoarthritis who took NSAIDs for a long period of time was 35%. The infrared light of “super laser pain treatment instrument” which reaches the lesion on the one hand can promote the absorption of inflammatory fluid in the knee joint cavity and accelerate the metabolism of articular cartilage, which can promote the dissipation and absorption of synovitis in the knee joint and relieve the pain of the patients, and on the other hand, it has the function of accelerating the microcirculation of the knee joint locally and repairing the damaged knee joint cartilage and improving the function of the knee joint. knee joint function. Therefore, the therapeutic effect of this group of degenerative knee osteoarthritis patients with knee joint pain is ideal. In this group, there were 2 patients with lower abdominal pain, both of whom had a history of lower abdominal surgery, with prolonged postoperative abdominal pain, insomnia, and negative emotions. They were cured after SL treatment. , speculating that the etiology may be postoperative intestinal adhesions. With the great progress of minimally invasive surgery in recent years, the quality of perioperative survival is also an issue of concern. According to the mechanism of SL, SL will play a positive role in patients’ preoperative sleep, postoperative analgesia, and prevention of intestinal adhesion, which needs to be verified in future clinical practice. The treatment of postherpetic neuralgia with SL has been reported, but no efficacy was achieved in two cases in our group, and we are relatively inexperienced in this area. SL should be effective in the treatment of diabetic foot ulcers, but it is obviously ineffective in diabetic foot gangrene. In the process of using SL, if we want to achieve good therapeutic effect, Xiao Jianbin et al. suggest that (1) choosing a good irradiation point is a prerequisite to ensure the therapeutic effect; (2) choosing higher irradiation conditions is an important factor to ensure the therapeutic effect. In the 21st century, phototherapy instruments that are safe and have fewer adverse reactions may have a wide range of application prospects. The SL equipment used in our clinic is old and cannot reach the ideal working condition. Even so, we can still see the exact effect of SL treatment and its wide range of indications and applicability. SL is very suitable for pain clinics, and can effectively improve the quality of life for elderly patients; for patients who have experienced the ineffectiveness of various pain treatments, SL provides an additional option; in terms of treatment cost, SL has a high cost-effectiveness ratio, and is worth promoting to the grassroots. In conclusion, the point-type linear polarized light pain therapy device is worth further practice, research and promotion in clinical practice.