Arguably, the two most important aspects regarding laser phototherapy for pain management are those of effect mechanism (to determine the most appropriate application) and of dosing parameters. Herein is summarised the outcomes of more than 15 years of the author's research to date, to clarify some of these factors. Initial investigations demonstrated that the central descending inhibitory (endogenous opioid) system was involved in the effect mechanism of phototherapy and that doses below 5J/cm2 in the wavelengths tested, had the best effects in a chronic pain clinical model. Subsequent research using a non-invasive clinical model in lateral epicondylalgia has established that the descending inhibitory system is not the sole likely origin of the treatment response; or, if it is, it plays this role selectively for only some combinations of wavelength, dose and power output. Repeated low doses of laser (at some wavelengths) are sufficient to stimulate physiological responses and reduce pain in subjects with lateral epicondylalgia. It is clear further information is required for dosing and dose threshold factors of laser phototherapy for clinical pain management.
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机译：可以说，关于疼痛管理激光光疗法的两个最重要方面是效应机制（确定最合适的应用）和给药参数。这里总结了提交人的研究的15年以上的迄今为止的结果，以澄清一些这些因素。初步调查证明中央下降抑制（内源性阿片类药物）系统参与光疗的效果机制，并且在经过测试的波长中低于5J / cm 2的剂量对慢性疼痛临床模型具有最佳效果。随后使用横向上髁痛的非侵入性临床模型的研究已经确定下降抑制系统不是唯一的治疗反应的起源;或者，如果是，它仅为波长，剂量和功率输出的某些组合选择性地发挥此作用。重复低剂量的激光（在某些波长）足以刺激生理反应，并减少侧面髁痛的受试者的疼痛。对于临床疼痛管理激光光疗的剂量和剂量阈值因素，需要清楚的进一步信息。
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