Should you add laser therapy to your service menu?

Therapeutic lasers have been shown to have a wide variety of benefits, including reducing pain and inflammation, helping speed wound healing, and reducing the appearance of scars.¹

Researchers think that therapeutic lasers help speed the healing process by stimulating cells’ own natural healing properties.

Chiropractors may find that investing in a therapeutic laser system will not only expand the scope of their practices, but will also allow them to treat more types of patients than ever before. Ultimately, it may add to the DC’s bottom line.¹ However, there are specific protocols that must be followed by both patient and DC in order to avoid injury not only to the skin, but also to the eyes.

Laser classes

The U.S. Food and Drug Administration (FDA), which oversees the manufacture and use of therapeutic lasers, has divided lasers into four different classes, based on their power or energy output, as well as the wavelength of the emitted radiation:²

• Class I: Considered non-hazardous. Hazard increases if viewed with optical aids, including magnifiers, binoculars, or telescopes. Examples include laser printers and CD/DVD players.
• Class II, IIa: Hazard increases when viewed directly for long periods of time. Hazard increases if viewed with optical aids. Examples include bar-code scanners.
• Class IIIa: Depending on power and beam area, can be momentarily hazardous when directly viewed or when staring directly at the beam with an unaided eye. Risk of injury increases when viewed with optical aids. Examples include laser pointers.
• Class IIIb: Immediate skin hazard from direct beam, and immediate eye hazard when viewed directly. Examples include laser light-show projectors.
• Class IV: Immediate skin hazard and eye hazard from exposure to either the direct or reflected beam. May also present a fire hazard. Examples include medical lasers.

Therapeutic protocols

Contraindications: According to the New York Chiropractic College, there are several contraindications for using laser therapy on patients, including pregnancy or any suspicious or cancerous lesions. The laser should not be used over or into the eyes, nor should it be used over the thyroid gland. Patients who have taken any steroids within the previous week should also not undergo laser treatment. Patients should wear protective goggles when undergoing laser treatment in order to avoid any possibility of eye injury.³

Acute conditions: Daily treatments can be administered for the first week. Treatment sessions can then be reduced to two to three times a week until improvement after one to three weeks. The laser should be set to deliver 10 joules of energy on the continuous setting.³

Chronic conditions: Treatments can be given for two to three times per week until improvement. It can take anywhere from six to 25 sessions for patients to notice any improvement. The recommended initial setting is 10 joules on continuous setting, which can be reduced by 2 joules for the following visit if the patient experiences pain.³

References

¹ Beychok T. “Therapeutic applications for lasers.” ChiroEco.com. https://www.chiroeco.com/news/chiro-article.php?id=14573&catid=1480&title=therapeutic-applications-for-lasers. Published October 2013. Accessed April 2015.

² U.S. Food and Drug Administration. “Laser products and instruments.” U.S. Department of Health and Human Services. http://www.fda.gov/radiation-emittingproducts/radiationemittingproductsandprocedures/homebusinessandentertainment/laserproductsandinstruments/default.htm. Updated February 2015. Accessed April 2015.

³ New York Chiropractic College. “Therapeutic cold laser.” NYCC.edu. http://www.nycc.edu/webdocs/ic/IQA/IQAFiles/Protocols/Chapter4/TherapeuticColdLaser4_5.pdf. Updated April 2005. Accessed April 2015.