Healing light Using lasers to heal sports injuries

Light heals — at least laser light. Cold laser therapy, either in the form of Class III or IV lasers, as defined by the Food and Drug Administration, are used to improve therapeutic outcomes in musculoskeletal problems.

The use of lasers is growing among chiropractors, so Chiropractic Economics decided to explore their use in sports chiropractic. We asked several laser manufacturers/distributors for their insights. Included in this round table were:

• Yorick Wijting, PT, director of clinical education, Chattanooga Group, www.chattgroup.com, yorick_wijting@chattgroup.com;

Why should chiropractors who specialize in sports chiropractic incorporate lasers into sports treatment?

Wijting: Laser therapy has significant positive effects on superficial inflammatory conditions and pain, both chronic and acute. Physicians active in sports medicine frequently treat conditions that fall into these categories.

Ellingson: The FDA cleared infrared therapy, and the price of light therapy has decreased, so many more chiropractors are using this modality in their practices. It is not intended to replace traditional electrotherapy and ultrasound units.

Rather, it is simply another instrument that is effective and simple to use. With an estimated 3,500 studies covering a broad range of pain and soft-tissue conditions, light therapy has proven to be an effective treatment for a number of different conditions.

Smith: Laser therapy is the best energetic modality available to medical professionals and lay people.

Smith: Class IV-A lasers can damage tissue; however, they take pain away, but [it] comes back.

Ellingson: In many cases, laser devices require the use of safety goggles by both patient and clinician, to avoid possible tissue damage to the eyes. Many manufacturers are switching to super-luminous diodes (SLD) that eliminate the risk of eye injury and the need for eye protection.

Ellingson: We have seen many clinics market light therapy through patient brochures, monthly mailers, local newspapers, and magazines. The biggest marketing returns are always based upon patient results. If a clinic can draw patients in and begin treating them, word-of-mouth reports of the treatment results generate more patients than any traditional marketing methods.

Wijting: Market the fact that it is state-of-the-art technology. Treatment is rapid. And outcomes are good.

Smith: Either buy a marketing program or run basic promotions to treat frozen shoulders, CTS, pain, or to increase neck range of motion.

All three experts agree that a chiropractor or trained assistants working under the direction of the chiropractor can administer most treatments. However, Class IV-A requires special certification in most sates, according to Smith.

Wijting: Training should include a thorough understanding of indications, precautions, contraindications, and a basic understanding of operaton of the device and its safe use.

Smith: Any laser seminar provides training in techniques. However, I recommend not using any technique that doesn’t include some type of neurology.

Ellingson: Sales reps often offer training in the chiropractor’s office, to assure proper use of the device.

Ellingson: A few questions would be: What is the primary wavelength? How many independent treatments can be administered? Is the treatment dosage driven? What is the maximum power output? Does the device have other modalities along with light?

Wijting: What applicators are available with the laser unit? What wavelengths? Does it use cluster and/or single diodes? What output power does the device use? Are treatment protocols available?

Smith: How will the device benefit my patients? What kind of warranty does it have? Customer support? What kind of training is available? How do I bill patients?