April 2009

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Introduction to Neuromechanical Instrument Adjusting: Impulse Adjusting Technique

What are you treating with lasers?

By Julie Duck

So you’ve purchased a laser – congratulations! You’ve entered the hi-tech zone, where aches, pains and injuries fade into distant memory at the speed of light. Now the power of laser is yours and your patients’ to behold. But before you run for your protective eye goggles, think about what you want to treat with the laser.

What do you enjoy treating?
We all have things we love to do (as well as those that we loathe). Most healthcare professionals have certain cases that they would treat day-in, day-out—dentists who love performing root canals; plastic surgeons who enjoy taking away a patient’s love handles; and DCs who enjoy treating sports injuries. What is it that you love treating? By using the laser to treat your choice cases, you marry niche with niche, carving out a name for yourself as “the DC who treats X or Y with that awesome laser.”

Whether you use your laser for certain patients, or a wide variety of cases, the proof is in the pudding, which puts a powerful ally in your pocket. Studies conducted on various types of conditions and injuries can help you further promote laser for certain patients in your practice:

• Back and neck pain – Where cortisone shots and epidurals fail, laser therapy has been a godsend for those who suffer back and neck pain. Additionally, laser therapy was shown as one of the three effective treatments available for whiplash-associated neck pain.¹

• Carpal tunnel syndrome – One study noted that when the usual treatment for CTS—splinting—was used with low-level laser therapy, that symptom severity, pain alleviation, and increased patient satisfaction were experienced.²

• Tendinopathies – Subjects in the laser group of one study on the effects of laser treatment in conjunction with standard treatment on chronic tendinosis of the Archilles in athletes, concluded that the subjects showed significantly less pain at the four, eight and 12 week marks, with pain reduced by almost 50-percent.³

• Shoulder injuries – Low-level laser therapy was shown to significantly reduce shoulder pain after two weeks, compared to sham laser and naproxen.4

Additionally, arthritis, myofascial trigger points, and an assortment of sprains, strains and repetitive stress injuries also respond well to laser therapy.

Strong… and stronger lasers

Widely used in chiropractic practices today,

The low-level laser is optimal for situations where the targeted area is close to the skin’s surface, as its penetration level is about 1.5-inch. And the evidence that low-level laser therapy helps patients heal is made clear once again in a recently published study5 of the most commonly used treatment procedures in chiropractic for myofascial pain syndrome and myofascial trigger points. In the study, it was concluded that low-level laser therapy had a strong effect on therapy outcomes, particularly when compared to other modalities such as ultrasound, interferential current, high-voltage galvanic stimulation, and electrical muscle stimulation.

It keeps getting better. The newer Class IV lasers offer more power, greater penetration and a wider treatment area than the Class III, which can help you achieve quicker results for your patients. Able to reach depths of up to 9 inches, the Class IV is good for going deep into the bodily tissues to heal problems with the muscles, nerves, bones and discs.

Steps ahead
Both Class III and Class IV lasers have the same goal–to encourage metabolic activity at the cellular level, which in turn speeds healing and gets your patient back on his or her feet much more quickly than using standard modalities. Whether you choose to use your laser on particular cases, or as an adjunct to adjusting and traditional treatment methods, you’re already light-years ahead of the technology game when it comes to chiropractic medicine.

Sources:

1. Bone and Joint Decade 2000-10 Task Force (Hurwitz et al., Spine. 2008 Feb 15;33(4 Suppl):S123-52.)

2. Umit Dincer, Engin Cakar, Mehmet Zeki Kiralp, Hilmi Kilac, Hasan Dursun. Photomedicine and Laser Surgery. February 2009, 27(1): 119-125. doi:10.1089/pho.2008.2211.

3. Am J Sports Med. 2008 May;36(5):881-7. Epub 2008 Feb 13.

4.  England S, Farrell A, Coppock J, et al. Low laser therapy of shoulder tendonitis. Scand J Rheumatol 1989;18:427–443.  [PubMed]

5. J Manipulative Physiol Ther. 2009 Jan;32(1):14-24.

Julie Duck is the former editor of Chiropractic Products and a healthcare writer with more than 16 years of experience. She can be reached by e-mail at juliechiro@cox.net.

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