Mohab Ibrahim, MD, PhD, is the Assistant Professor of Anesthesiology and Pharmacology, Director of the Chronic Pain Clinic and Director of the Pain Fellowship at the University of Arizona, explains how green light therapy is helping those suffering headaches and migraines.
Interview conducted by Ivanhoe Broadcast News in May 2017.
Where did the original concept of looking at green light for pain come from?
Dr. Ibrahim: I have a brother his name is William. He lives in San Diego and he gets headaches occasionally. And I call him every now and then and check on him and a couple times I called him and I just ask him how are you feeling. He said, oh I have a headache. Being the pain physician that I am I told him, well why don’t you just take some Tylenol or ibuprofen or something. And he said, he keeps telling me; no I really don’t like medication. If I just go and sit between my trees, he has a lot of trees at his house; he tells me that he feels better. He did that a couple times and I didn’t think much about it actually until one day I got a headache myself. I just so happened to have no ibuprofen at home or no Tylenol. So I decided I’m just going to drive to the pharmacy and get something for my headache. On my way to the pharmacy I drove by a park and I thought, well I wonder if that will work for me as well. So I just took a little detour, I went to the park and I sat among the trees. Ten or fifteen minutes later my headache actually started to improve. I thought, well maybe just being in a quiet place away from stress, away from noise helped my headache just go away. Then I thought I actually sit in a lot of quiet areas that don’t necessarily help my headache. I thought maybe it’s something in the park, maybe it’s the trees. Maybe it’s chemical being released by the trees or it could be the color of the trees. It’s somewhat difficult to test all the chemicals that are being released by an endless number of trees in a park. I thought how much easier hypothesis to test is to see what effect colors have on us. That’s how the green light project got started.
And the green light of course is easier produced than trees.
Dr. Ibrahim: Yes, absolutely.
How have you been testing this?
Dr. Ibrahim: Initially we tested the green light on rats. We exposed rats to a certain frequency of light spectrum. We tried to test different intensities to see which works best for the rats. One of the ways to test whether it’s working or not is we shine a focused beam of light on the rats. Light by itself will create warmth or heat. When the rat is bothered enough by that source of light he just walks away and that terminates the light. So we measured the baseline, we see how long it takes the rat to move away from the light at its natural environment. Then we exposed them to light, to the green light, and then we see how long it takes them to move away from that light stimulus. So the rats are free moving whenever they feel bothered they just walk away from the source. And that’s when we noticed that green light changed their baseline and rats were not bothered by that stimulus.
They could stand the green light much longer than the regular light?
Dr. Ibrahim: Yes, what the green light did is basically give them the ability to tolerate this heat source. It acted as an analgesic almost.
Then you started testing it on people and what did you see?
Dr. Ibrahim: That’s true. When we saw this encouraging reproducible and very robust effect on rats, the side effects associated with green light are very minimal so it’s safe, it’s available, and it’s cheap. The thought came to us well why don’t we try it on humans. We obtained approval from the university and we started recruiting people with migraine and fibromyalgia for a clinical trial. We randomized the people initially they did not know the effect of color. So one group of people got just white light which is the control and a group of people got the green light. The people who were enrolled in the white light they really didn’t see much effect and some of them actually withdrew from the study just because they didn’t notice any difference. The people that were in the green light they reported somewhere an average of forty to fifty percent pain reduction, and that was for fibromyalgia and migraine. Of course it’s a very early study, but the preliminary data are very encouraging. Suffice to say the people in the green group they actually refused to return the green light and they want to keep it, so we let them keep it.
Did they notice immediately in fifteen, twenty minutes any relief or did it take a little bit?
Dr. Ibrahim: It varied. We don’t have enough statistical power to actually come up with a range but what we’ve seen from this small group we have the earliest responder was about maybe two to three days after we started the light therapy and the other end of the spectrum was about maybe two weeks or so.
Was it a certain number of hours a day or how does that work?
Dr. Ibrahim: The protocol that we provided people is to be exposed to green light somewhere between one to two hours a day for ten weeks.
How many people have come to the study so far?
Dr. Ibrahim: The control I think we have had five, the green light I think we have around eight or nine.
And now the study expands or where are we?
Dr. Ibrahim: We are hoping to expand the study. We applied for grants from the Department of Defense and the National Institute of Health. Once we get funded hopefully then we can enroll more people and actually have enough statistical power to be able to make a more solid conclusion.
At this point are you still testing people or are you kind of waiting for grants to come in?
Dr. Ibrahim: We’re still enrolling people. I still have few light strands left and I want to make this therapy available to as many people as possible.
It seems so simple.
Dr. Ibrahim: That’s the beauty of it. That’s the intriguing part of it as well. It’s such a simple thing that we notice every day. Dr. Conner mentioned earlier when people go on a hike or when they go and walk in the forest or just walking in a park there is something about the color green that really helps people. It could be psychological, it could be biological we’re still looking in to it. It could be a combination of both. We really don’t know the mechanism just yet; we have some indications as to how or why it works. We still have to do some work to really get to the bottom of it. Regardless of the mechanism, the outcome is what really matters and people are both feeling better and their pain is getting better. That’s the ultimate outcome. How we get to that point that is for us to look in to. It’s very good timing, as the opioid epidemic unfortunately has reached dangerous levels. Opioids are a complicated story, just like any other medication there is the good and there is the bad. When opioids are used appropriately they can serve a great function. However when they are used for a purpose they are not intended to it can result in a lot of consequences. Unfortunately we are seeing these consequences now. Now the green light therapy is not intended to replace another pain therapy. What we’re hoping for that it will augment it. I don’t think it would be possible to completely get rid of opioids. At least we’re hoping to decrease in the amount of opioids that we’re using or other pain medications. That’s what we do at the pain clinic; we try to find every possible alternative to get patients off of opioids while maintaining good pain control.
What haven’t I asked you that you think we should include in this story?
Dr. Ibrahim: I would like to just share with whoever is watching that this is still an early therapy, we’re still trying to find out the best parameters. We don’t necessarily know if it’s better to be exposed and hour every day or two hours every other day, this is something we will have to look in to. We know that it works but to maximize the benefit we still need more time. I strongly suggest that people at least discuss with their own physicians before they plan on changing any medications their own because the green light therapy is not intended to replace any medication. It’s intended to augment what we have currently and hopefully limit all the pain medication people are using.
END OF INTERVIEW
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Mohab Ibrahim
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