Monochromatic infrared photo energy (MIRE)

Cardiopulmonary physical therapy, infrared light, integumentary physical therapy, light therapy, MIRE, monochromatic infrared photo energy, musculoskeletal physical therapy, neurological physical therapy, occupational therapy, phototherapy, physical therapy, PT.

Anodyne therapy is a type of light therapy that is used to help relieve the symptoms of pain, stiffness, muscle spasms, and circulation irregularities. This form of treatment is usually given in addition to physical therapy. It works by relieving pain and/or increasing circulation in the area where the patient is experiencing pain. Anodyne therapy is marketed and sold by Spectropad Systems, which manufactures the device that administers the therapy. The scientific term for Anodyne therapy is monochromatic infrared photo energy (MIRE). MIRE is the type of energy that is used in this form of therapy.

Light therapy, also known as phototherapy, is the use of a specialized machine to emit only a specific wavelength of the light spectrum via lasers, LEDs, fluorescent lamps, dichroic lamps, or very bright, full-spectrum light, for a prescribed amount of time. Each wavelength in the light spectrum is said to possess specific qualities. Generally, the affected body part is exposed in light therapy. Advocates claim that each wavelength may coincide with beneficial symptom relief of a particular medical condition. Light therapy machines are able to offer more of a particularly useful wavelength than would be available by exposure to direct sunlight.

According to the American Physical Therapy Association, the goal of physical therapy or physiotherapy is to improve mobility, restore function, reduce pain, and prevent further injury by using a variety of methods, including exercises, stretches, traction, electrical stimulation, and massage. Physical therapy (PT) is commonly used for musculoskeletal injuries, joint pain or disorders, low back pain, cerebral palsy, and rehabilitation after injury or surgery, including heart surgery or mastectomy. Various types of physical therapy address specific problems. Musculoskeletal physical therapy uses massage and joint movement to increase strength, motor control, and flexibility. Cardiopulmonary physical therapy treats lung and heart conditions, such as cerebral palsy, asthma, and post-heart attack rehabilitation, by clearing the lungs of mucus, ventilating the lungs to ease breathing, or exercising to increase a patient's ability to move. Neurological physical therapy works to restore balance, coordination, and motor function through repeated exercises for patients with spinal injury, Parkinson's disease, Alzheimer's disease, and other brain and nerve disorders. Integumentary physical therapy uses wound cleaning, scar prevention, and scar reduction to help patients with wounds, burns, and other skin-related problems.

Anodyne therapy comes from the word anodyne, meaning a medical treatment that soothes or relieves pain. Anodyne therapy was first used in 1994.

All forms of Anodyne therapy use infrared light. Pads that emit the light are applied to the surface of the skin. At times, Anodyne therapy will resolve symptoms in one or only a few sessions. For other individuals, however, ongoing Anodyne therapy may be necessary to experience relief from symptoms. Anodyne therapy may help a patient cope with the symptoms of their medical condition because the pain relief and increased circulation provided by the near infrared light may aid in improving a patient's balance, range of motion, endurance, strength, and flexibility.

Eleven clinical trials have been conducted to evaluate the efficacy of Anodyne therapy for several different medical conditions. Though the results of these studies appear promising, larger studies need to be conducted before a firm conclusion can be drawn.

As a relatively inexpensive treatment, Anodyne therapy is gaining popularity in the United States. Some health insurances reimburse patients for near MIRE. Anodyne therapy is now being investigated for a number of uses, including diabetic neuropathy (deterioration of the spinal cord and its nerves due to diabetes).

A 2006 article by Harkless et al. reviewed the medical records of 2,239 patients who experienced neuropathic (nerve-related) pain and/or loss of sensation in the foot. The authors of the study concluded that the treatment significantly reduced pain and improved sensation in most patients, though a statistical analysis was not provided.

A 2004 study by Leonard et al. evaluated monochromatic near-infrared treatment for symptomatic relief in patients with diabetic peripheral neuropathy. Measures of treatment success included improved balance, reduced pain, and the restoration of sensation. Patients showed a statistically significant improvement in restoration of sensation, foot sensitivity, and pain. However, not all measured parameters showed statistically significant results.

This information has been edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Anodyne Therapy Systems

Burke TJ. 5 Questions--and answers--about MIRE treatment. Adv Skin Wound Care. 2003 Dec;16(7):369-71.

DeLellis SL, Carnegie DH, Burke TJ. Improved sensitivity in patients with peripheral neuropathy: effects of monochromatic infrared photo energy. J Am Podiatr Med Assoc. 2005 Mar-Apr;95(2):143-7.

Harkless LB, DeLellis S, Carnegie DH, Burke TJ. Improved foot sensitivity and pain reduction in patients with peripheral neuropathy after treatment with monochromatic infrared photo energy--MIRE. J Diabetes Complications. 2006 Mar-Apr;20(2):81-7.

Leonard DR, Farooqi MH, Myers S. Restoration of sensation, reduced pain, and improved balance in subjects with diabetic peripheral neuropathy: a double-blind, randomized, placebo-controlled study with monochromatic near-infrared treatment. Diabetes Care. 2004 Jan;27(1):168-72.

Powell MW, Carnegie DH, Burke TJ. Reversal of diabetic peripheral neuropathy with phototherapy (MIRE) decreases falls and the fear of falling and improves activities of daily living in seniors. Age Ageing. 2006 Jan;35(1):11-6.

U.S. Centers for Disease Control and Prevention (CDC).

Anodyne therapy is intended for individuals who participate in a regular physical therapy or occupational therapy program because it augments the more conventional treatment. Usually, the person who performs Anodyne therapy does not also provide physical therapy. However, certification is not necessary to perform the therapy.

Patients generally learn about Anodyne therapy if a healthcare provider believes that the treatment may aid in the improvement or management of symptoms. However, individuals may also investigate providers of this service at the Anodyne therapy web page. The manufacturer of the Anodyne therapy devices stresses that a treatment plan should only be given by a certified healthcare practitioner, such as a physical therapist, nurse, or doctor.

Before the first Anodyne treatment, the healthcare provider interviews the patient. The patient tells the provider about the onset and duration of symptoms and personal goals for recovery. The provider and patient also discuss the intensity of pain, as well as the patient's physical or occupational therapy. The provider then creates a treatment plan, which details the expectations of the frequency and duration of Anodyne therapy that may help the patient; generally, patients who choose this modality also participate in regular physical or occupational therapy.

Generally, the practitioner recommends that a patient receives three 30 minute sessions of Anodyne therapy per week for at least four weeks.

Most Anodyne therapy sessions last 30 to 45 minutes. In the office of a healthcare provider, the treatment is delivered by eight rectangular pads that are part of the Professional System.

During treatment in an office, the patient generally sits still while the practitioner applies some or all of the eight available pads. Some individuals experience a feeling of warmth during the treatment. However, some patients may feel a tingling sensation or a small amount of discomfort. These symptoms generally disappear after a few minutes of the treatment. However, the patient should always communicate their comfort level with the practitioner so that the treatment may be adjusted if necessary.

If this modality is appropriate, most people experience relief between the first and sixth treatment. It is possible for some patients to experience relief from symptoms after the first treatment of Anodyne therapy. However, some patients may need to attend up to 12 treatments before pain improves and circulation increases. Ultimately, most healthcare practitioners believe that if a patient does not experience relief within 12 treatments, then near infrared therapy may not help the particular patient. However, some patients, such as those with chronic pain disorders, may require ongoing treatment.

Patients may receive Anodyne therapy a maximum of three times daily. In these instances, the intensity of infrared light delivered to the patient's skin and the length of each session may decrease.

Most individuals receive Anodyne therapy at a healthcare provider's office. However, some individuals may receive this type of treatment at home. Some home healthcare providers give Anodyne therapy; in addition, the manufacturer of these machine sells devices designed for at home use by patients.

Anodyne therapy is available through several different machine models. The Model 480 is designed for use by physical therapists and doctors. The light is delivered at a wavelength of 890 nanometers, and has a 60 infrared diodes per therapy array. The pulsed energy is delivered at 292 times per second. The energy output is adjustable up to 780mw per therapy array. The system is available in four or eight pads. The Model 120 is designed for patient and nurse use. It is identical to the Model 480, except that it features a preset energy setting at 600mw per therapy array to prevent inadvertent burning. Home systems come with a soft shoe, which fits on the foot or may be held to apply to other areas. The Spectropad System Anodyne therapy product has received clearance from the U.S. Food and Drug Administration (FDA) for temporarily increasing blood circulation as well as reducing stiffness, muscle spasm, and pain.

Practitioners claim that Anodyne therapy is most effective when used at the same time as physical or occupational therapy. In addition to attending all appointments for this modality, patients are encouraged to also attend all other therapy sessions. The frequency of treatment is thought to be an important factor in a successful outcome. Patients are also encouraged to perform all assigned physical therapy exercises to maximize the benefit of treatment.