The promise of blue light therapy for headaches and pain relief

Onebout 20% of adults in the US—More than 50 million people — suffer from chronic pain. Although the causes are many, including arthritis, cancer, musculoskeletal disorders, migraines, fibromyalgia, etc., the solutions are limited.

Over-the-counter pain relievers are often less effective. Physical therapy, Massageand Acupuncture sometimes helps — but not always. Prescription opioids can provide short-term pain relief, but at a cost. At least three million Americans are currently addicted to drugs.

Researchers are now exploring another potential alternative that is safe, affordable, with little or no side effects, and without the risk of addiction: blue light exposure. Although science is young and research is inconclusive, in recent years studies have found that exposing people to light through the green wavelength — by how to have them sit in a dark room lit by green LED strips or by having them wear green glasses — can reduce both pain severity and frequency of migraine attacks , fibromyalgia and chronic musculoskeletal pain. It may also reduce anxiety and fear associated with chronic pain.

In a study presented on October 23 at annual meeting of the American Society of Anesthesiologists in New Orleans, Dr. Padma Gulur, associate chair of anesthesiology at Duke University, reported on an experiment she conducted in which 34 fibromyalgia patients assigned to wear colored glasses of different shades, four hours at a time. days in two weeks. Ten of the patients wore blue lenses, 12 wore clear lenses, and another 12 wore green lenses. At the end of the study period, people who wore green glasses were four times more vulnerable than those in either of the other two groups who reported a reduction in their pain anxiety, as well as a decrease in pain anxiety. their dependence on opioids.

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Gulur used commercially available glasses for research and tested each with a spectrometer to determine the exact wavelength of blue light each pair produced. She also tested each person’s glasses at the end of the study to confirm which people had which wavelengths. “What impressed us most was that at the end of the study, the patients were so satisfied with the results, they didn’t want to return the green glasses,” she said.

Although small, Gulur’s study is not the only one of its kind. At the University of Arizona, Dr. Mohab Ibrahim, professor of anesthesiology, neurosurgery and pharmacology; with Laurent Martin, associate professor of anaesthesiology; and other colleagues have published half a dozen papers over the past four years demonstrating the power of blue light for pain relief. In one, published in 2020 in the magazine Headache (meaning “headache”), investigators recruited 29 people with migraines and exposed them to a green LED light for one to two hours – which the university provided for people to install in their homes – every day for 10 weeks in a different dark room. The treatment reduced the number of headache days by 70 percent in people with episodic migraines compared with their initial headache frequency, and by nearly 60 percent in people with chronic, more frequent migraines. . (The group exposed to the white LED showed no change.) In another paper, published the following year. in the magazine AnalgesicIbrahim recruited 21 fibromyalgia patients, administered the same therapy, and found that eight out of 10 people reported their pain when they were exposed to white light dropped below 5 points when they were exposed. with green.

“There are nerve pathways that start in the eye and can trace back to certain brain regions,” says Ibrahim, who is also medical director of the Holistic Pain and Addiction Center at Banner University Medical Center. . “Some of these regions are heavily involved in pain regulation.” Through a mechanism that is not fully understood, the green light appears to interrupt this connection, providing pain relief without the need for medication, or at least not much.

“This is a simple approach,” says Ibrahim. “There is still some skepticism, and rightfully so. When you make an extraordinary claim, you must have extraordinary evidence. But the more research and research is funded, the closer we are to reaching the critical mass of evidence that shows that, OK, something is really happening here. “

Break the cycle

For Jennifer Dinardo, 64, a Tucson retiree who formerly worked in the hospitality industry, the trouble started when she was 18 and went skateboarding after she described, drinking more wine than pasta sauce. which she did that evening. She spilled a wound and fell face down on the pavement, breaking her nose and breaking a bone in her neck. The pain was acute, and while she was being treated, doctors responded promptly with pills.

“He said, ‘Here, take these. These things will make you feel better,” she recalls.

They did — for a while. But that one bad night led to complications including fibromyalgia and migraines headache, and ended up having surgery to fuse the two discs in her neck. Her pain turned chronic and she took strong painkillers for many years.

“I tried everything,” said Dinardo. “Massage therapy, stretching exercises, Tai Chi. And many times, I came back with the prescription in hand. “

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Finally, in 2020, she showed up at the Holistic Pain and Addiction Center just as Ibrahim was starting one of her trials with blue light therapy. “He said, ‘Are you interested in this research?’ ‘, she recalled. “I said, ‘I’ll do anything.'”

For the next 70 days, Dinardo will spend two hours a day in a room in her home lit only by blue LEDs, reading and listening to music to pass the time. After 30 days, her chronic pain began to subside. Not long after, she quit all pain medication and hasn’t taken any since starting treatment two years ago. She keeps the LEDs on, and although she doesn’t use them every day anymore, she turns them on whenever a neck pain, headache, or fibromyalgia flares up.

“You can feel the difference,” she says. “It’s really great.”

How does blue light relieve pain?

Scientists still don’t know exactly why blue light seems to help painful conditions like fibromyalgia and headaches, but they have some ideas. Gulur believes the answer may lie in blue light’s ability to activate melanopsin, a light-sensitive neurotransmitter found in the eye responsible for regulating pupil dilation and contraction. Melanopsin also interacts with the pericortical gray matter, a structure in the upper brain stem that is responsible for pain processing. She speculates that melanopsin might activate an inhibitory pathway that doesn’t process pain, but instead turns it off. And it’s not just any old blue light that will do the trick, she found, but also its specific frequencies.

A product Ibrahim is developing with Luxxon Therapeutics that builds LEDs directly into the frames ((Luxxon Therapeutics))

A product Ibrahim is developing with Luxxon Therapeutics that builds LEDs directly into the frames

(Luxxon Therapy)

“You would think that would be the peak of the green wavelength — absolute green — that would be most effective,” she said. “But what we found for chronic pain is that lower wavelengths and higher wavelengths – towards the ends of the green spectrum – seem to be helping patients. ” That limits people’s options to try this therapy for themselves, as simply buying any green glasses available in the store does not guarantee the proper wavelength, which can only be tested with spectrograph.

For now, this is just theory. But Gulur is now developing a new study in which the brains of pain patients wearing green glasses will be scanned with functional magnetic resonance imaging (fMRI) to see if the inhibitory pathway is indeed exist or not.

Ibrahim and his colleagues are looking at other brain regions involved in pain processing, particularly the ventral tegmental area (RVM), which is also located in the brain stem. A specific type of brain cell, known as GABA afferent neurons, produces a protein called c-Fos that, in turn, activates the RVM, completing a neural circuit that leads to pain. In animal studies, mice exposed to blue light produced less c-Fos, reduced the activity of GABA afferent neurons, and disrupted pain pathways.

“We evaluated the number of GABA atopic cells that were expressing c-Fos, and we found that blue light was reducing their production,” says Ibrahim. “In general, light reduces the activity of cells, which, if stimulated, cause pain.”

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In other studies, Ibrahim looked at the anterior end of the inhibitory pathway — cells in the eye that respond to blue light and pain relief. In a 2022 studypublished year Clinical medical insights: Case reports, he found that blue light had a pain-relieving effect even in a color-blind patient who also had a chronic headache. That research seems to suggest that nothing more placebo effect in the workplace, in which the person desires pain relief and so on. But Ibrahim said otherwise. The two main types of cells in the eye that process light and color are called cones and rods, with their characteristic shapes, and it’s the cones that cause color blindness. But there is also a third type, called retinal ganglion cells, that are photosensitive in nature, and these cells are not affected in colorblind people. Ibrahim believes that these cells may be the ones responsible for pain relief.

“It’s one of our hypotheses, that the effects of blue light travel at least partially through these photoreceptors,” he said. Gulur grew older with this idea, pointing out that those same cells also contain melanopsin, which in her models plays a central role in pain relief.

More studies in humans are needed. And even its advocates don’t believe that blue light therapy will completely replace other forms of pain treatment — including pharmacological forms. “Will it ever replace traditional medicine?” Ibrahim said. “I do not think so. That is not the purpose. The goal is to reduce dependence on drugs immediately because, practically speaking, it’s all about tools. “

However, blue light treatment has become a commercial trend. Many manufacturers sell green LED lighting systems online and market them for pain relief, although there is no guarantee that the green wavelengths used in the products will be effective.

To try to create something like it, Ibrahim and Luxxon Therapeutics are combining glasses and the LED approach: building blue LEDs directly into the frame of a pair of glasses so that they shine in the user’s eyes in the glasses. treatment session.

Ibrahim says: “Blue light exposure tests a lot of therapy boxes. “First safety, then efficiency, then price, then compliance,” he said. It is the last thing — the patient’s adherence or commitment to treatment — that may be the most telling. “Patients with chronic pain will do almost anything to get rid of the pain,” says Ibrahim.

Dinardo agrees. “Just sitting in that green lighted room,” she said, “was a change for me — and it was a blessing.”

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