Laser Treatment of Backpain and Enthesiopathy in Ankylosing Spondylarthritis

Ankylosing spondylarthritis is one of the diseases which cause chronic pain , not only during the day, but often more severe during the night and in some cases nearly intolerable in the very early morning. Depending on stage and extension pain is localized at back, at the tendons (as enthesiopathy) and in about 30 % at joints because of peripheral arthritis. Common treatment uses NSAIDs and daily physiotherapy. The outcome with this concept of management for most patients is fair. Still not solved problems include: 1. loss of range of motion 2. management of iridocyclitis 3. side-effects of NSAIDs and 4. in some cases ineffectiveness of pain releaving drugs. Two years ago we reported our study with therpy-resistant tendonitis which we treated with low-power-laser. The immediate effect (87 %) and the long-term-outcome (80 %) of these patients has been as convincingly that we performed another preliminary study on 16 patients (10 male/ 6 female) with enthesiopathies (8 x achillestendon, 5 x Periarthropathia coxae, 3 x plantar fasciitis) as manifestations of ankylosing spondylarthritis (12 x) or psoriasisarthritis (4 x). Treatment was performed with infirared-laser. 904 nm (IR CEB Space) or IR mixed with He-Ne 632.8 nm (M 3 UP Space), the energy-density varied between 600 and 960 Joule/m2, irradiations were daily up to 20 times as monotherapy.