There is substantial clinical evidence published in peer reviewed medical journals that "cold" Low Level laser Therapy (LLLT) can stimulate repair of tissue, reduce inflammation and relieve pain in musculoskeletal disorders.

The main areas with good evidence are: 

• Soft Tissue Injuries

• Joint conditions

• Back and Neck Pain

• Spinal Cord Injury
• Brian Injury & Trauma
• paralysis in stroke
• paralysis in head injury
• multiple sclerosis
• pseudo bulbar palsy & cerebral palsy in babies
  
• children spinal cord injury
  
• peripheral facial paralysis (Bell's palsy)coma

WHAT IS IT?

Laser and LED beams of light can stimulate the cells in the body that repair tissue, reduce inflammation and transmit pain.

HOW LLLT / COLD LASER THERAPY WORKS

Light can stimulate or inhibit cellular function according to it’s intensity and the time applied.

Lasers and LED's produce intense beams of light at specific wavelengths. When the right wavelength at the right intensity is used at the correct anatomical location for the right amount of time you can stimulate repair, resolve inflammation and reduce pain.  

One of the primary mechanisms is the effect of light on cytochrome coxidase and the consequently the unbinding of nitric oxide and release of ATP leading to improved cellular function. For anti-inflammatory effects we have found a measurable reduction in PGE2, TNF Alpha and IL-6 in the synovia surrounding damaged tendons and for analgesia high intensity lasers over nerve supply can inhibit fast axonal flow.

In addition, high intensity single point lasers can release trigger points and treat acupuncture points instead of needles.

Below are a selection of cold laser therapy treatment photos.

If you have any questions about laser therapy, please feel free to contact me visit my website www.medaku.com

Two devices are used in the LASER treatment program:

• a red-beam laser pen (5 mW, ITO laser pen) and
• a microamps TENS device (MicroStim 100).

The 5 mW red-beam laser pen and the microamps TENS device are both used to stimulate wrist and hand acupuncture points.

Consumer warnings

For the Laser Pen:

• Do not stare into the laser beam source, it would harm the retina. The laser lecture
  pointer is clearly labeled – “Do not stare into the laser beam.”
• Do not use the laser beam on pregnant women.

For the Microamps TENS Device:

• Do not use on persons with a pacemaker.
• Do not use on pregnant women.

Before beginning the treatment, the Doctor washes his/her hands, and wipes all areas on the hand to be treated, with alcohol. It is important that there is no perspiration or hand lotion present on the skin, because these would block the laser beam and microamps TENS stimulation of the acupuncture points. A substance with yellow color such as iodine, would also block the stimulation effects of the laser light.

Step 1.

The tip of the laser pen is physically placed onto the skin at the median nerve area on the wrist crease at the base of the palm (acupuncture point, Pericardium 7) for 21 minutes (6.3 joules or 32.1 joules per cm2). The laser pen is held in a 90 degree position, so that the laser beam is entering the acupuncture point at a perpendicular angle for maximum penetration. The “continuous wave” laser beam is used, not the “pulsating” laser beam. The actual depth of tissue penetration with a red-beam laser is believed to be only 0.8 mm (direct energy), and 11-15 mm (indirect energy) (Seitz & Kleinkort, 1986). Thus, the red-beam laser is ideally suited for stimulation of shallow acupuncture points located on the hand.

Step 2.

The primary electrode for the MicroStim 100 TENS device is taped onto the same area which was treated in Step 1 – e.g., the palm side of the wrist crease at the median nerve (acupuncture point, Pericardium 7). The primary electrode used with the MicroStim 100 TENS device is the metallic, circular-shaped electrode with four tiny LED red lights which are embedded into it; it is about the size of a fifty-cent coin. This primary electrode should be pre-moistened with some clear conducting gel before it is taped into place. Or, a clear, double-sided, self-sticking electrode patch may be used over the primary electrode. The grounding pad electrode is then pre-moistened with a few drops of water, and taped onto the back of the wrist area (acupuncture point, Triple Warmer 4).

The MicroStim 100 TENS device is turned on, and adjusted so that the patient does not feel any “tingling” sensation at all. For example, the intensity knob is turned up until a “tingling” sensation is felt at either electrode site, then the intensity is turned down, until there is no “tingling” sensation at all. This will be the ideal setting for treatment with microamps TENS for that patient, on that day. The ideal setting is usually around 200 to 500 microamps (around 2 to 4 or so, on the knob).

A high-frequency pulse rate of 292 Hz (F4) is used for two minutes, then the pulse rate is turned down to a low-frequency pulse rate of 0.3 Hz (F1), which is used for 18 minutes. A more detailed explanation of exactly how to use the MicroStim 100 TENS for this treatment protocol is provided in a booklet from the American Association of Acupuncture and Oriental Medicine.

Step 3.

While the TENS device is in place at the wrist, the red-beam laser is applied to other acupuncture points on the affected hand, 3 minutes per acupuncture point (1 joule or 4.6 joules per cm2).  The acupuncture points are as follows: Lung 11, Large Intestine 1, Pericardium 9, Triple Warmer 1, Heart 9, Small Intestine 1, Distal BaXie points in the webs between the fingers, Large Intestine 4, Pericardium 8, Heart 8, Lung 9 or 10, and Heart 7. Some patients prefer to work with two laser pens at the same time, so that two acupuncture points may be treated at the same time, thus reducing the duration of one treatment session.

Each treatment lasts about 45 minutes. Each device produces no feeling whatsoever, no heat, no cold, no pain.

Additional acupuncture points may be treated on the forearm or up to the shoulder area (according to the distribution of possible radiating pain) and the posterior neck, paraspinal region (cervical vertebrae C5 to T1). However, these deeper acupuncture points need to be treated with infrared laser or acupuncture needles. It is extremely important to be trained by a licensed acupuncturist in the location of all acupuncture points. For example, an acupuncture paper published in 1990 observed complete pain relief in 24 of 36 cases with CTS (82%) success rate, following a series of needle acupuncture treatments (Chen, 1990).

Frequently Asked Questions

1. Is it OK to continue to take non-steroidal anti-inflammatory medications (ibuprofen) while doing the Laser Acupuncture and Microamps TENS treatments?

• Yes, but you may not need to them after a few weeks. Ibuprofen does not interfere with these treatments. My anecdotal experience with patients taking cortisone, however, suggests that patients using this drug while undergoing acupuncture treatments will have a slower response to acupuncture or laser acupuncture. Additional medications which I have observed to be incompatible with good response are some anti-seizure medications (phenobarbital or tegretol), and some tranquilizers (valium) and anti-depressants; or cases who have had Bo-Tox injection into the joint area for control of spasms. Patients should always consult with their physician before making any changes in their medications.

2. Do I have to treat a minimum of every other day?

• Yes. The minimum schedule for these Laser Acupuncture and Microamps TENS treatments is once every 48 hours, especially during the first two weeks. There was one additional patient (age 72) who was treated under the controlled research conditions at the hospital, but during the series of real treatments, his wife became ill, and he was only treated once or twice a week (the regular schedule is 3 times per week). This patient had only minimal change in his Melzack pain score (score of 24 Pre-real treatments, and score of 19, Post-real treatments).

How do Laser Acupuncture and Microamps TENS work?

The effects of low-energy laser biostimulation on the cellular level have been reviewed by Basford (1989). The mechanism of exactly how this treatment program with red-beam laser and microamps TENS stimulation works is unknown. However, some possibilities include:

• The red-beam laser is thought to have an anti-inflammatory effect (Mester, Toth, Mester, 1982), and may temporarily increase serotonin levels to promote pain relief (Walker, 1983).
• In addition, the red-beam laser and the microamps TENS device may increase ATP levels (adenosine triphosphate) at the cellular level in the wrist and hand where they are used (Passarella et al., 1984; Passarella, 1988; Cheng et al., 1982). An increase in ATP levels would improve cellular respiration locally, in the wrist and hand area, and help the injured area to return to normal.