Chronic Pain Treatment Whith Auricular Laserpuncture

This study analyzed the effectiveness of treatment protocols A and B for chronic pain in the shoulder, knee, or lumbar spine regions in older adults. Protocol A involved the application of low-power red laser therapy to auriculotherapy acupoints. Protocol B involved the application of mustard seeds. To assess the qualitative aspect of the study, the McGill Pain Questionnaire and the Visual Analog Scale were used to evaluate chronic pain, while the SF-36 instrument assessed the participants' quality of life before and after the treatment protocol. For the quantitative evaluation, thermographic imaging and the Ryodoraku System were used. All proposed tools were applied before the first treatment session, before the fifth session, and at the end of the tenth session.

Risks and Benefits

During the study, participants were subject to risks related to physical and psychological discomfort due to the proposed therapeutic protocol. All procedures were performed individually in an appropriate and private room to ensure the participants' comfort and privacy. Each participant was provided with protective goggles, which were worn throughout the laser application period. These goggles were sanitized before each session, and the laser device tip was covered with PVC film, which was replaced after each session.

Although rare, stimulation of the auricular pavilion could cause transient side effects such as local pain, fatigue, dizziness, nausea, and headaches. The use of the laser could generate slight discomfort, such as mild warming, but this effect was temporary and had no serious consequences. If a participant experienced any of these symptoms or any other physical discomfort, the protocol was immediately interrupted, and the participant remained under observation by the researcher until they felt better. The use of mustard seeds could cause mild pain at the application site, but this typically subsided over time. Participants were informed that if a seed fell off prematurely, it would not affect the treatment, and they should continue stimulating the remaining seeds three times a day and remove them one day before the next session.

Psychological discomfort could also arise when participants answered the questionnaires. The questionnaires were administered in a private setting with only the participant and the researcher present. If the participant felt uncomfortable, they could request to withdraw from the study.

To minimize the risk of exposure of participants' personal data, the researcher committed to storing all collected data in password-protected digital files accessible only to the research team. Each participant was assigned an individual identification code to prevent any possibility of unauthorized access or identification.

Whenever the participant wished, the principal researcher provided clarifications regarding the procedures to establish trust. Participants were informed that they could withdraw from the study at any time without affecting the continuity of their treatment.

As a benefit of this study, the results were expected to help establish a non-invasive, easy-to-apply, and ergonomically comfortable treatment protocol for chronic pain in older adults, thereby improving their quality of life.

Clinical Protocol

The participants were received individually in a private room with only the researcher present. They were instructed to sit comfortably in a chair. The McGill Pain Questionnaire, the SF-36 questionnaire, and the Visual Analog Scale for Pain were then administered to assess pain intensity and its impact on the participants' quality of life.

After completing the questionnaires, while still seated, the researcher evaluated the participants using the Ryodoraku System for bioenergetic meridian measurement. This assessment was conducted through 24 reactive points, known as electro-permeable skin points, located on the upper and lower limbs at the acupoints P9, PC7, C7, ID5, TA4, IG5, BP3, F3, R4, B65, VB40, and E42. The Ryodoraku System is a portable electronic device equipped with two wand-shaped electrodes. One wand was held by the participant, while the researcher manipulated the other, placing it in direct contact with the acupoints. The device was connected via USB to a computer with pre-installed software, generating graphs that compared the participants' meridian conditions and possible energy imbalances with a standard balanced energy pattern.

Next, thermographic images of the area where the participant experienced chronic pain were taken using a thermal imaging camera. During this process, participants stood upright on an insulated rubber surface. The analyzed region was free of clothing. Images were captured from a distance of 50 cm from the target area to ensure proper framing, against a black background to avoid infrared radiation reflection. Participants were instructed to avoid alcohol, physical exercise, bathing, and stimulant intake (such as caffeine) for at least two hours before the examination.

The evaluation tools for research data collection were applied before the first session, before the fifth session, and after the tenth session.

Treatment Protocol

For participants in Group A (GA), a portable Recover® laser device (MM Optics) was used. The device was operated with red laser light at a wavelength of 660 nm, an output power of 100 mW, a beam area of 0.03 cm², and continuous emission. An energy of 4 J was delivered to each auricular point over 40 seconds per point. All participants sat in a comfortable position and wore protective goggles provided by the researcher, who also wore protective goggles during laser application.

For participants in Group B, mustard seeds were applied with micropore tape to the same auriculotherapy acupoints used in Group A. Each participant underwent ten sessions, twice a week, over five weeks of treatment.

For participants with shoulder or knee pain, the auriculotherapy acupoints were treated on the ear corresponding to the side of the reported pain. For participants with low back pain, the right ear was treated. These points were previously cleaned with gauze soaked in 70% alcohol. Additionally, the laser device tip was wrapped in PVC film, which was replaced for each participant.