This study evaluates the effect of photobiomodulation (PBM) therapy using a MLS® class IV laser on chronic pain and fatigue in patients with hypermobile Ehlers-Danlos Syndrome (hEDS). hEDS is a hereditary connective tissue disorder characterized by joint hypermobility, chronic pain, and debilitating fatigue, for which therapeutic options remain limited.
Participants will receive 10 PBM sessions over 5 weeks (2 sessions per week), using red and near-infrared light (808 nm continuous + 905 nm pulsed) applied to painful areas identified at baseline. Pain (Visual Analogue Scale), multidimensional fatigue (MFI-20), and quality of life (EQ-5D-5L) will be assessed at baseline (T0), end of treatment (week 5), and follow-up (week 10).
This is a pilot observational study - the first to document the effect of MLS® laser PBM in hEDS. No additional procedures beyond routine care are required.
Age ≥ 18 years
Confirmed diagnosis of hypermobile Ehlers-Danlos Syndrome (hEDS) according to 2017 International Consortium criteria
Chronic pain ≥ 3 months, average VAS score ≥ 4/10 over the preceding week
Stable analgesic treatment for ≥ 4 weeks (if any)
Suspicious or malignant skin lesion on areas to be treated
Non-modifiable photosensitizing treatment
Pregnancy or breastfeeding
Photosensitive epilepsy
Adult patients with confirmed hypermobile Ehlers-Danlos Syndrome (hEDS), diagnosed according to the 2017 International Consortium criteria, presenting with chronic pain (≥ 3 months, VAS ≥ 4/10) and/or fatigue, followed in private outpatient practice at Centre Médical ISM, Boulogne-Billancourt, France. Patients are recruited consecutively among those already receiving photobiomodulation therapy as part of their routine care. No healthy volunteers are included.
Cohort
Prospective
Not listed
Change in chronic pain intensity
Change in pain intensity measured by the Visual Analogue Scale (VAS, 0-10), representing average pain over the preceding week. A decrease of ≥ 1.5 points is considered clinically meaningful.
Durability of pain relief
Change in pain intensity assessed by the Visual Analogue Scale (VAS, 0-10, where 0 = no pain and 10 = worst pain imaginable; lower scores indicate less pain), between end of treatment (Week 5) and follow-up (Week 10), to assess persistence of the analgesic effect after PBM cessation
Change in multidimensional fatigue
Change in fatigue assessed by the Multidimensional Fatigue Inventory (MFI-20), comprising 20 items across 5 subscales: General Fatigue, Physical Fatigue, Reduced Activity, Reduced Motivation, and Mental Fatigue. Total score ranges from 20 to 100.
Change in health-related quality of life
Change in quality of life assessed by the EQ-5D-5L questionnaire (5 dimensions: mobility, self-care, usual activities, pain/discomfort, anxiety/depression) and the EQ Visual Analogue Scale (EQ-VAS, 0-100).
Tolerability of PBM therapy
Frequency and nature of local adverse events (redness, discomfort, transient pain aggravation) recorded at each session by the investigator.
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