Peripheral neuropathy in patients with diabetes is one of the primary causes of morbidity and lower-extremity amputations. Many supplemental therapies have been created to address sensory dysfunction among this population.
Monochromatic infrared energy therapy (MIRE) employs pulsed light of an 880nm wavelength delivered via pads containing 60 super luminous gallium aluminum arsenide diodes to increase sensation in feet. According to reports, it has proven successful.
Reduces Pain
Peripheral diabetic neuropathy is an ever-increasing threat that leads to foot ulcers and lower extremity amputations, with many adjunct treatments introduced to help improve sensation in these patients, such as monochromatic infrared energy (MIRE) therapy. MIRE therapy has generated conflicting results within scientific literature due to faulty research methodologies used during its studies; more recent research conducted with stronger approaches has demonstrated MIRE is effective in restoring protective sensation in people suffering from diabetic neuropathy.
Photobiomodulation (PBM) therapy works because it activates a process known as photobiomodulation. PBM has been shown to increase body production of nitric oxide and cause it to release within the bloodstream; vasodilation causes local vasodilation that leads to increased blood flow into the area being treated, providing essential nutrients necessary for nerve health.
Under stress, nerves send signals that cause muscles to tighten up, leading to pain. A rubber band wrapped around your foot cuts off oxygen flow to that area causing pain; when removed it quickly goes away because nerves now receive what they require to function optimally – similar to how MIRE treatment helps decrease pain by increasing oxygen flow to nerves.
MIRE works to alleviate pain by encouraging ion exchange. Ion exchange occurs when positive ions like calcium enter your body from painful areas surrounding you, increasing cell activity in those cells while simultaneously reducing nerve excitability and pain perception. Furthermore, this process also promotes fibroblastic activation – cells which help heal damaged tissue quickly.
This research used a commercial MIRE device produced by Bioremedi Therapeutic Systems called the HealthLight System that has received FDA 510(k) clearance as a heat therapy device and lists SMI SpectroPad as its predicate device. This unit comprises of an electrical power base with eight therapy pads each containing 60 gallium aluminum arsenide diodes for heating therapy purposes.
Increases Circulation
Monochromatic infrared energy increases blood flow to an area being treated, increasing circulation which in turn decreases inflammation, swelling and promotes cellular growth while simultaneously increasing nitric oxide release for decreased pain, improved function and quality of life. Therapy utilizes pads containing an array of 60 superluminous gallium-aluminum-arsenide diodes emitting monochromatic infrared energy at 890nm which are placed over skin surface treatments which last 30-45 minutes each session.
Anodyne Therapy is FDA-cleared and provides monochromatic near-infrared energy at near-infrared wavelengths which penetrate up to five cm below the skin’s surface. When exposed to tissue, MIRE photo-dissociates nitric oxide molecules from endothelial cells and hemoglobin molecules within red blood cells (RBCs), leading to local vasodilation and increased circulation resulting in reduction of neuropathic pain by decreasing accumulations of metabolites associated with neuropathies associated with neuropathies.
Clifft et al. conducted a recent study that compared active MIRE to placebo MIRE treatment in diabetic peripheral neuropathy patients aged 78 with loss of protective sensation in their feet and an elevated fall risk score (greater than 10). Their conclusion: neither MIRE treatment was superior than its counterpart for restoring foot sensation among these diabetic patients.
However, the study did not fully account for several potential contributing factors to differences between results for active and sham groups – such as placebo effects, natural history of disease progression or poorly designed research methodologies – which could account for them. Future studies using more robust methodologies will be required to accurately gauge MIRE’s effectiveness.
MIRE is a safe, non-invasive and drugless technology designed to complement physical therapy treatment programs to improve balance and function in people living with diabetes or neuropathies. Medicare and private insurers typically cover its cost under your physician’s prescription; speak to your therapist about including MIRE home treatment system into a comprehensive program of physical therapy treatments that may increase quality of life and independence.
Reduces Inflammation
Infrared energy is absorbed by living tissues through their water and organic molecules, where it converts to electrical energy that alters rotational states of intracellular molecules, initiating biochemical pathways that support cell metabolism.
IR light has been proven to effectively reduce inflammation in many conditions such as gingivitis, oral mucositis, wound healing, carpal tunnel syndrome and arthritis [3]. Furthermore, it’s used for pain relief by decreasing pro-inflammatory cytokines levels for osteoarthritis patients as well as decreasing pain levels associated with stiffness and swelling for those living with fibromyalgia patients [4-6].
Near infrared (NIR) photobiomodulation has recently gained prominence due to recent advances in photobiology and bioenergetics. When administered transcranially, NIR light stimulates activities of cytochrome C oxidase and superoxide dismutase in the brain while increasing blood flow, cognitive functions, and providing sedation effects in animals.
NIR radiation is non-toxic and poses no known side effects on cells or tissues. Its therapeutic benefits have been credited with increasing respiration rates, stimulating protein synthesis and suppressing cell growth. Furthermore, NIR can induce the production of nitric oxide which opens capillary pores to increase blood circulation.
Monochromatic infrared energy therapy offers an exciting potential solution to treat diabetic neuropathy patients’ foot sensation, balance and fall status. Thirty-eight patients aged 78 years participated in this study; all had no protective sensation in their lower extremities documented using Semmes Weinstein monofilaments and Tinetti scores showed an increased risk of falling; all received comprehensive therapy intervention including 12 sessions of MIRE plus supervised physical therapy as part of a comprehensive therapy package.
MIRE was delivered using the Anodyne Model 120-4 Infrared Therapy System from Medassist of Tampa, FL. This device features a base power unit and four flexible therapy pads containing 60 superluminous gallium-aluminum-arsenide diodes emitting monochromatic infrared energy at 890nm wavelengths. When activated, two active treatment units delivered an average energy output of 1.95joules per cm2, while two sham units provided no energy at all.
Improves Sleep
Studies have demonstrated the efficacy of infrared (IR) therapy on improving sleep and relieving pain, especially when combined with therapies such as massage. Furthermore, an LED monochromatic infrared light device has also shown great promise for alleviating neuropathy symptoms like pain, tingling and balance problems experienced by diabetics.
Though widely utilized, little is understood about how different wavelengths of infrared energy work to promote healing and treat disease. Most research to date is based on anecdotal reports or uncontrolled studies which may not account for placebo effects and natural history, possibly clouding findings.
Human skin acts as an impediment to infrared energy penetration. Studies have demonstrated that pulsed NIR (near infrared) laser energy penetrates more deeply than continuous emission at equal power output settings, due to higher peak concentrations of energy during pulses compared with continuous emission.
Studies conducted on NIR therapy have demonstrated its benefits in people living with neuropathy, including improved feet sensation and balance. Unfortunately, however, these studies were poorly designed with inconsistent and sometimes contradictory findings.
Leonard et al conducted a study that showed small improvements in feet sensation and balance for patients with mild to moderate peripheral neuropathy; while Clifft and Lavery, et al showed no changes. This may be related to severity of symptoms or method of measuring foot sensation.
NIR wavelengths have the capability of penetrating deep into brain tissue cells’ mitochondria, potentially increasing energy production while increasing blood flow to improve mental acuity and mental acuity.
Infrared saunas, lamps and fabrics emitting near infrared or NIR are widely utilized as pain relievers due to their heat properties; however, other forms of infrared that do not emit thermal waves such as FIR, mid infrared and LEDs (light emitting diodes) have also become popular as non thermal healing options (15). Their benefits are being studied and investigated further to promote overall health and wellness.
