Bright Light Improves Function, Pain in Fibromyalgia
There’s new way for fibromyalgia sufferers to improve function and ease pain sensitivity.
According to a recent pilot study, bright light treatment is an effective complimentary treatment which shifts sleep patterns in a a way that helps relieve fibromyalgia symptoms by improving function and reducing pain.
Helen J. Burgess, PhD, director, Biological Rhythms Research Laboratory and professor, Department of Behavioral Sciences, Rush University Medical Center in Chicago, Illinois, presented the study in Boston at the 31st Annual Meeting of the Associated Professional Sleep Societies.
Testing Light Box Therapy for Fibromyalgia
Dr Burgess and her colleagues tested the effect of bright-light treatment on function and pain sensitivity in 10 women meeting 2010 criteria for fibromyalgia from the American College of Rheumatology.
The women slept at home, keeping their usual sleep schedule for 1 week, followed by an overnight session in the sleep lab.
During the overnight session, the researchers assessed baseline function (Fibromyalgia Impact Questionnaire [FIQ]), pain sensitivity (heat threshold and tolerance), and circadian timing (dim-light melatonin onset).
The following morning, the women were randomly assigned to 6 days of a self-administered home either morning or evening light treatment, using a light box 1 hour per day.
Afterward, function, pain sensitivity, and circadian timing were reassessed.
The women with fibromyalgia used light boxes for 1 hour each day.
On average, the women completed 84% of the scheduled light treatments. No side effects were reported.
Both morning and evening light treatments led to improvements in function and pain sensitivity, but only morning light treatment led to a clinically meaningful improvement in function (>14% reduction in FIQ) and heat pain threshold (P < .05).
Morning light box treatments improved function by 14% and decreased pain threshold by 5%.
Results Equal to Cognitive Behavioral Therapy
Dr Burgess noted that the improvement was about equal to that seen after cognitive-behavioral therapy and about half of that seen after weeks of intense exercise therapy.
The study also found that phase advances in circadian timing were associated with a significant increase in pain tolerance.
Morning light box treatment improved fibromyalgia pain tolerance by 67%.
Clinically Significant Implications
The study authors concluded that:
“Morning bright light treatment should be further explored as a potentially feasible, acceptable and effective adjunctive [add-on] treatment for fibromyalgia.
The improvement in function was similar to that seen after psychotherapy, and about half of the improvement seen after months of exercise training.”
Improvements using a light box were similar to that seen after psychotherapy, and half of the improvement gained from months of exercise training.
A “Noteworthy” Study
Shelby Harris, PsyD, director, Behavioral Sleep Medicine, Sleep-Wake Disorders Center, Montefiore Health System, New York City, says this is a “very noteworthy and novel study since, in terms of helping sleep and fibromyalgia, the researched sleep treatments in this population — that we currently have on hand — are cognitive-behavior therapy for insomnia and medication interventions.”
“This study utilized a simple, quick method (light therapy) to help patients shift sleep patterns in a way that appears to help their fibromyalgia symptoms,” says Dr Harris.
“Patients with fibromyalgia typically suffer from difficulties falling asleep and staying asleep,” she said, “and this study noted that early-morning light exposure helped to advance their sleep timing, helping them to fall asleep earlier.”
“It is very possible that earlier sleep times, with less tossing and turning in bed throughout the night, can lead to more alertness in the morning, pain tolerance, helping to decrease pain and increase overall functioning. However, this was a small study and one that needs more research behind it,” added Dr Harris.
She also noted that some patients are “not ideal candidates for light boxes due to eye problems, and it would be interesting to see whether similar results would be found using natural outdoor light. This is worth studying further because a simple technique may make a big impact on the lives of those with chronic pain problems. More research is needed in this area,” said Dr Harris.
Kevin Fleming, MD, medical director of the Fibromyalgia and Chronic Fatigue Clinic at Mayo Clinic in Rochester, Minnesota, also thinks the study is noteworthy.
“Although a small study (just 10 patients) and only 1 week long, it is very suggestive of being useful because it fits with at least one physiology issue known to contribute to FM [fibromyalgia] — bad sleep. Light therapy may address that portion,” he said.
“Impaired sleep is known to be common in FM and likely contributes to pain (sleep deprivation makes people have widespread discomfort like FM),” Dr Fleming explained. “Why this is so is unclear; what sleep does for our muscles and brain is uncertain. But lacking good sleep contributes to pain, so it is reasonable to focus on sleep in treating FM.”
“The sleep clock (circadian rhythm) is set at least in part by your exposure to bright light, such as sunlight. Exposure to bright light or light therapy can remedy that part of the sleep disorder,” he noted.
Light Therapy Also Effective For Depression
Morning light treatment has already been shown to reduce depression, which can lead to diminished pain and improvement in people’s ability to cope and function with pain.
A 2016 placebo-controlled clinical trial published in the Journal of the American Medical Association Psychiatry found that:
“Bright light treatment, both as monotherapy and in combination with fluoxetine, was efficacious and well tolerated in the treatment of adults with nonseasonal MDD [major depressive disorder].”
The research was the first first placebo-controlled trial that shows that light therapy is an effective treatment for depression that is not brought on by seasonal affective disorder.
“These results are very exciting because light box therapy is inexpensive, easy to access and use, and comes with few side effects,” said Dr. Raymond Lam, a UBC professor and psychiatrist at the Djavad Mowafaghian Centre for Brain Health, a partnership between UBC and Vancouver Coastal Health.
“Patients can easily use light therapy along with other treatments such as antidepressants and psychotherapy.”
Lam and his colleagues followed 122 patients and evaluated whether light therapy improved the mood of patients when it was used both with and without the commonly prescribed antidepressant fluoxetine [Prozac].
Light therapy involved 30 minutes of exposure to a light box soon after waking up every day for eight weeks.
Some study participants were given placebo pills and placebo devices instead of the real therapies. The researchers found that light therapy helped many patients and provided the most benefit to those who were also taking antidepressants.
Future Fibromyalgia Studies
Dr Fleming said light therapy for fibromyalgia is worth continued study.
“There’d be no way to do a randomized trial I can think of, but size could be increased and compared to usual FM care for 12 months,” he said.
But before those studies are completed, “it is really low risk for FM patients to trial [light therapy] in the morning,” he said.
Best Light Boxes For Fibromyalgia
Bright light therapy has gained significant traction in the home-use market, and as a result, there is a wide variety of models available.
These are the light boxes I recommend, based on research, message boards, and a wide variety of review sources:
TaoTronics Light Therapy Lamp
The TaoTronics Light Therapy Lamp features UV-free 10,000 lux of light. It features the same 6500K color temperature as natural sunlight, and offers 3 brightness settings.
Its tilting head measures 6.7 x 9.8 inches.
Gently press it’s touch control to turn the unit on/off, and slide it to set the timer from 10 to 60 minutes.
The TaoTronics has a compact silhouette and a foldable bracket, so it’s easy to store and carry, and its power cord measures approximately 57 inches.
A power adapter and user’s guide are also included in the box.
This lamp is covered by the TaoTronics Product and Labor Warranty for 12 months from the date of its original purchase. If manufacturing defects occur, please contact TaoTronics Support (firstname.lastname@example.org) to launch a warranty claim.
User reviews are very good for this model. One reviewer with fibromyalgia noticed a marked decrease in “fibro brain fog,” as well as a general boost in mood.
Another reviewer reported that this model “works well and provides a very uniform light spread.” She goes on to say that the Taotronics “looks a lot like you might see from an Amazon Kindle backlit device, but a whole lot more intense, with an interesting smoothness to the light.”
This same reviewer also noted that she has other products from this company, and has liked them all.
Chekue Bright Light Therapy Lamp
Offering 10,000 lux of UV-free light intensity, this model allows you to choose from white, warm white and warm yellow lights.
It features adaptable (vertical/horizontal) orientation. Its illumination surface measures 5 x 7.9 inches.
This model comes with a 2 year manufacturer’s warranty.
Purchasers say the Chekue Lamp provides great light intensity and setting choices.
Verilux HappyLight Touch
The Verilux HappyLight Touch is a very popular LED,UV-free, full spectrum light box.
The illuminated screen measures 5 x 8 inches, delivering the recommended 10,000 lux of light intensity.
It features 3 brightness levels, and daylight or warm light options.
The HappyLight Touch has a 6′ power cord, and comes with a 3 year warranty.
User reviews for the Verlilux HappyLight Touch are outstanding. Purchasers say this model is well made, and they appreciate the ability to choose from daylight and warm light settings.
Mibote Light Therapy Lamp
The Mibote Light Therapy Lamp delivers 10,000 UV-free lux of light intensity.
The 6.8 x 9″ panel can be set to 3 lighting modes: white, warm white and warm yellow.
The reviews for the Mibote are excellent, with purchasers reporting that the intense light has helped with mood and energy.
Northern Light Technology Boxelite
The Boxelite has the largest illuminated panel among my recommendations. At 12 x 14 inches, this model delivers 10,000 UV-free lux at a distance of up to 17 inches.
Reviews are very good for this model, with many purchasers reporting an improvement in energy and mood.
The box comes with the light box, 74″ power cord, a UV filter, metal stand, and stand screw.
The Boxelite comes with a 7 year unlimited warranty.
Hey! Blogging can be a lonely business … I’d love to hear your thoughts and tips on coping with fibromyalgia – drop me a comment below!
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