DEAR DR. GOTT: I am a 74-year-old male with severe RLS and have been taking Mirapex and gabapentin, which do an acceptable job of controlling the symptoms. Since I’d prefer not to take medication, I am wondering about pulsed infrared light therapy. A chiropractor claims that my problem might be caused by small fiber neuropathy and that PILT has proven 90% effective in treating such problems. It’s an expensive treatment not covered by insurance and I’m having trouble finding any evidence that it can work. Can you offer any insight?
DEAR READER: As a reference for those unfamiliar with restless legs syndrome (RLS), it is a disorder characterized by an almost uncontrollable urge to move the feet and legs that commonly occurs during periods of inactivity. It can disrupt sleep for hours at a time and impair daytime activities. Symptoms are lessened by movement. The disorder and its causes are not fully understood but control is generally handled initially with dopaminergic medications; however, medication typically only reduces symptoms, it does not eliminate them. On the downside, these same drugs can cause nausea, dizziness and dyspepsia but are a small trade off to the devastation of RLS that will leave a person walking for literally hours at a time at all hours of the night in an attempt to reduce symptoms.
One alternative method of control is NIR (near-infrared light) for patients with neuropathy to increase sensation while decreasing pain. Infrared light is a form of medical treatment that can be administered in a medical setting or at home through the use of LED pads. The process uses a laser to stimulate blood circulated in a targeted area of the body for the purpose of increasing peripheral sensations, primarily for patients diagnosed with diabetic neuropathy. It has also been reported for use in people with RLS, osteoarthritis, fibromyalgia, carpal tunnel syndrome, chronic headaches, seasonal affective disorder, diabetic ulcers, tennis elbow and more.
Following 30 minutes of treatment three times a week for four weeks, patients in one study reported some progress with their neuropathy but a definite change for the better with their RLS. It was that revealing finding that prompted an investigation of the effectiveness of NIR for symptoms of RLS. A randomized, controlled study was approved by the Brigham Young University in Provo, Utah, the final results of which have not yet been published, involving a woman with classic symptoms of RLS who responded to a newspaper advertisement and was recruited after she met the necessary criteria. She was a 69-year-old Caucasian, reported as being reasonably active. She walked each day, did occasional yoga, and felt her general health was good – except for her RLS. She also reported being depressed and was prescribed Prozac for almost 25 years without making the connection between the RLS symptoms and fatigue that linked to her disrupted sleep pattern. Prescription medication for relief of her symptoms was ineffective.
For the purposes of the study, the patient received treatment for 30 minutes three times a week for four weeks. The restless legs syndrome rating scale was used to track changes in her symptoms. Initially she scored a 27 on a 0-40 point scale, indicating her case was severe. By week two of her therapy, she was almost symptom free, indicated by a score of 2 on the same rating scale. By the fourth week, the patient was symptom free, however symptoms gradually returned, beginning three weeks following completion of her treatment. The conclusion was that infrared light MAY be a feasible method of treatment for RLS sufferers.
Another study published by the National Institutes of Health reported on the effectiveness of an 8-week course for reversing long-standing neuropathy in patients with diabetes. Twenty-two patients participated. The therapy was administered to one foot only, chosen at random. The second foot did not receive therapy. The patients underwent a total of 24 treatments, three times a week for eight weeks, that took 30 minutes per treatment. The overall results were positive. However, the study dealt with diabetes only, not RLS.
One system known as Healthlight Infrared Therapy has FDA clearance for reducing or alleviating pain and inflammation associated with diabetic peripheral neuropathy. Patients with this and other conditions have had temporary-to-permanent relief from symptoms. No follow-up information is available from after treatment; however, as information is released, I will provide an update to my readers.
So, my answer to you is that if possible, you wait a bit longer before making a decision. There’s no point in it if the symptoms recur once treatment is discontinued.
