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7.4. Disorders of bones and joints of metabolic and inflammatory etiology.

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Metabolic polyarthritis, deforming arthrosis, osteoarthrosis, arthralgias, psoriatic arthropathy, shoulder-blade periarthritis, bursitis, posttraumatic arthrosoarthritis, osteochondrosis of the spine column, etc.

MIL-therapy is performed after X-ray and other diagnostic investigations as monotherapy or in combination with diet, phitotherapy, medicamentous therapy, massage, curative physical culture.

The terminal (better two simultaneously) is applied with a light compression of soft tissues on lateral joint surfaces in the projection of joint aperture (the extremity is in a half-bent position) to the painful places revealed during palpation (joint sacs, ligaments, places of attachment of tendons to bones) (Fig. 9).Joints on the hand are irradiated from the dorsal and palmar surfaces, joints on the feet - from the dorsal and plantar surfaces (impulse frequency 50 Hz, exposure 1 min, LED radiation power 30 mWt). The cubital, wrist and ankle joints flexor and extensor surfaces are irradiated ; the humeral, knee and coxofemoral joints are irradiated on the front, back and lateral surfaces (impulse frequency is 80 Hz, LED radiation power is 50 mWt, exposure is 1-2 min on each zone). The spinal column is irradiated contactly on paravertebral zones bearing in mind the data obtained after X-ray investigation (impulse frequency is 50 Hz, exposure is 1-2 min on each zone, LED radiation power is 60 mWt, duration of the procedure is not more than 10 min).The course of treatment consists of 10-12 daily procedures. In case of necessity MIL-therapy is repeated in 2-3 weeks. Every year patients may have 3-4 courses of MIL-therapy.

Fig. 9 Zones of MIL-irradiation in joint diseases
Rheumatoid arthritis

This disease is caused by “hyper production” of auto-antibodies to different types of collagen. Impairments in the connective tissue synthesis is the main sign of the disease. Pathologic process becomes chronic. Most common complaints are: morning constraint, arthritis of 3 and more joints, symmetrical arthritis, rheumatoid nodules, presence of the rheumatoid factor.

Anti-inflammatory drugs are the basis of the treatment: derivatives of pirazolone, indolvinegar acid, propion acid, phenilvinegar acid, oxicams, derivatives of chinazolones, corticosteroids, immune depressants-cytostatics, alpha-aminochinoline drugs. In majority of patients the activity of the process correlates with the presence of sulfurpositive rheumatoid factor (RF-1 180+-95, by Speranski).

If phagocytic activity is significantly decreased, it is recommended to administer extracorporal MIL-therapy after hemosorption (1-2 procedures) or after the course of treatment with immune modulators. Tendency to increased macrophageal activity is the optimal period for MIL-therapy administration, but if such tendency is not observed after the first procedures, then the patient must continue his anti-inflammatory and immune modulator therapy as well as have additional hemosorptions (up to 5). As a rule, it is enough for normalising basic phagocytosis parameters. Taking into consideration the common LT effect, a physician should use one of the two MIL-therapy schemes.

1. An optimal scheme: 1-4 hemosoprbtions 1-2 times a week (depending on the process activity); between these procedures extracorporal MIL-irradiation of 250 ml blood (impulse frequency 80 Hz, LED radiation power 60-70 mWt, exposure 5 min) is performed. There are 8-12 sessions in the course.

2. Extracorporal radiation of blood may be replaced by MIL-therapy consisting of 8 - 12 sessions every day (5 Hz, LED radiation power 50 mWt) subcutaneously, the stable method (Fig. 10) on the cubital vascular bundles (zones 1) for 2 min on each bundle and on the adrenal glands projection (zones 2) - for 1 min. Then the diseased joints are irradiated ( one session lasts up to 10 min). On the day of hemosorption no MIL-therapy is performed.

Fig. 10 Zones for MIL-irradiation in rheumatoid arthritis
Calcaneal spurs

The first course of MIL-therapy (Fig.11) consists of 10 daily procedures. Irradiation is applied to zone 1 - a calcaneal spur projection on the plantar surface of the foot; then on the site of Achilles tendon attachment to the heel bone (zone 2), and starting from the 4th procedure to zone 3 on the internal or external heel surfaces (patients often show this painful point by themselves or a physician may find it by palpation). Impulse frequency is 50 Hz, LED radiation power is 80 mWt, exposure to one zone is 2 min.

After 2 weeks the treatment is repeated (10 daily procedures for a course), but with frequency 80 Hz. In case of necessity the third course of MIL-therapy with frequency of 600 Hz and LED radiation power about 90 mWt is performed two weeks after the second course. If a patient demonstrates resistant to MIL-therapy, it may be repeated under the same scheme in 6 months.

Fig. 11 Zones for MIL-irradiation in calcaneal spurs