Power-up your ability to speed healing and reduce inflammation by adding an advanced laser clinic to your practice
Laser and light therapy can increase your overall success with relaxing tight and stiff muscles and connective tissues, and so you know, some chiropractic adjustments work better if the muscles and connective tissue allow the corrections to remain. Turning to a safe, productive way of loosening that tissue gives you an advantage and more treatment options when you add an advanced laser clinic to your offerings.
Many of the recent advancements in laser therapy application and equipment make this an affordable and effective tool for helping people reduce their pain and gain mobility.
Hot vs. cold
Research shows all types of pain can be helped by low-level lasers. This includes pain in the joints of fingers, hands, elbows, shoulder, neck, back, hips, knees, ankles, and even in some organs, such as the lymph nodes.
A healthy body communicates from cell to cell by generating its own chemical and infrared light communication called biophotons. The biophotons carry information that affects DNA and the production of healthy new cells. Some evidence points to a lack of biophoton activity in a sick cell as being a cause of illness and inflammation.
The Norwegian Health Technology Report states that low-level laser therapy is twice as effective as NSAIDS for controlling osteoarthritis type pain. In addition, it appears to interrupt pain by bombarding electrons into inflamed and injured cells, encouraging cellular repair and triggering the release of endorphins.
Cold laser therapy is also known as Low-Level Laser Therapy (LLLT), Low-Power Laser Therapy (LPLT), and Photobiomodulation Therapy (PBMT).
Through the diode of the module, red or near-infrared light targets a specific area. The cells in the light’s path absorb the energy, encouraging healing. The different wavelengths cause different cells to react in various ways. Some data suggests this treatment stimulates chemical changes and releases hormones, such as endorphins, to reduce pain. It can also inhibit prostaglandin and other neurochemical production.
Where more is not necessarily better
However, focusing on one wavelength or using more power does not achieve better results. Like most of chiropractic work, it’s all about precision and the right force. For example, lasers in acupuncture, called acupoint lasers, operate at a peak efficiency of 2-4 joules of energy and concentrate to a small point no larger than a pencil eraser.
There are a few times where laser therapy is contraindicated. You should use extreme caution and check for pregnancy and the risk of cancer before using laser therapy. And although there has been some research showing lasers can be used throughout the body, you should proceed with caution near the thyroid and brain. The use of laser therapy shows promise on children and teenagers, but this is another area in which you should tread carefully. And, of course, lasers are not to be used on or near the eyes.
Currently, there is not enough research to show an advanced laser clinic can help diseases such as diabetes, blood coagulation issues and epilepsy. There is some indication that laser therapy has the potential to be harmful (and some that show it could help), but not enough information is known at this time. Most areas of disease and injury have not been studied extensively.
Wavelength and laser usage in the chiropractic setting
In general, a laser’s ability to successfully treat a wide variety of conditions is mostly based on output power at an appropriate wavelength with some contribution added from pulsing. Your experience and control of the laser give it practical use and direction. By varying the output, wavelength and pulses, you can adjust the healing times and outcomes.
Different wavelengths work on different areas and tissues. Depending on the desired outcome, you may use any of these wavelengths:
800-860nm — Based primarily on the research and publications of Michael Hamblin, PhD, the preferred wavelength of 800-860nm works for the nervous system and vascular issues. It combines maximum penetration depth and maximum photochemical reaction. However, for the maximum interaction with the mitochondria, 810nm appears to be the optimum wavelength.
600-660nm — This is best for lymphatic tissues, acupoint therapy, and working in shallow areas. This wavelength range is used when more complex problems have diverse source points. It is thought to be absorbed by the blood and the energy travels to different problem areas. It’s the most commonly used wavelength range in cosmetic lasers.
905-980nm — Wavelength 980nm is the preferred option for pain control, and 905nm is preferred where safety is the highest priority. At this point, it appears that all the wavelengths are appropriate for treating structural or cellular damage. Wavelength 910nm is the standard right now for all super pulsing lasers, and class 4 systems tend to use 980nm.
Laser power
Power is generally a lesser consideration, yet the biggest debate. Some believe more power provides greater results, while others think that lower power and greater precision and pulsing yield faster healing.
Resonating Low-Level Laser — A resonating low-level laser operates under 5mW of either a single or multiple wavelength diode laser. Resonating lasers have the best results for muscles, glands and organs.
Stimulating Low-Level Laser — A stimulating low-level laser can be a single wavelength or a multiple diode instrument that operates from 5-1,000mW, most often under 500mW. Stimulating low-level lasers are best for nerves, bones, joints, tendons, cartilage, ligaments, and acupoint therapy. It’s recommended to first treat pain associated with tight muscles or the bone or joint with a resonating low-level laser.
1,000mW+ — Lasers over 1,000mW are classified differently and not recommended for chiropractic, physical therapy or acupuncture, except with specialized training and conditions.
Pulsing vs. continuous
Some lasers provide one continuous wavelength and power setting. Others vary the settings. Continuous wave (CW) light provides higher dosages quickly.
However, many believe pulsing provides better results and at lower dosages. Pulsing changes the wavelength and/or the power. In many models, you can switch between these options and choose the variability of pulses.
It’s suspected, with no proof in either direction, that cells may become used to continuous-wave lasers, and the pulsing helps prevent desensitization to the laser therapy. However, a single study shows pulsing may be more beneficial.1
Best in class
Once you decide on the settings for the laser, they’ll often be sold via classes. Here is some of the information you’ll see:
Class 1, 2 & 1m — Best in safety, they often provide super-pulsing technology and have higher peak power level.
Class 3 — Multiclass, most of which offer pulsing and CW output, both broad and pinpoint treatments in one laser.
Class 4 — With the highest power, these provide high dosages for quick treatment times.
Pricing
The costs of these lasers vary considerably. Some simple at-home units can retail for several hundred dollars. They are usually class 1, single wavelength, low-powered units. There are dozens of these available.
Professionally, you can expect to spend $3-7,000 for a good class 3 unit that allows variability in power, wavelength and pulsing ability for your advanced laser clinic. Several manufacturers offer various models, so be sure to compare your prices and the options available.
Choosing a laser for PT and rehab
How you want to use your laser will dictate what you choose from your laser. For example, chiropractors may get the best use from a general, variable wavelength laser.
Joint pain associated with tight muscles responds better to a multi-diode, low power, constant output laser. Most report it works better with the soft tissues. Harder, more structural aspects, such as bones, ligaments, cartilage, joints and nerves, respond better to higher power, pulsating lasers.
Inflammation and the pain associated with it responds well to laser therapy. Although the wavelength and power vary depending on the type of inflammation, many conditions see improvement, including carpal tunnel, rheumatoid arthritis, atopic dermatitis, nephrology, multiple sclerosis and asthma.
Laser therapy may be beneficial for scar tissue, both skin and internal scarring. Some studies show it can reduce the appearance of scar tissue, but it was unknown if the actual scar tissue decreased, or if the associated tightness of the surrounding tissues was affected. Anecdotal evidence says it is.
Multiple studies show light therapy helps relax tight muscles and provides some pain relief. The level of relaxation and pain relief depends on the origin of pain, cause of muscle tightness, and other follow-up therapies.
The popularity of advanced laser clinics
Laser treatment is gaining wide acceptance in the natural and holistic fields of medicine. It’s safe when used properly and is non-invasive. People appreciate the pain relief and release of tension that advanced laser clinics bring in such a short time. Practitioners who use this tool to expand their range of options for therapy find it’s an invaluable addition to their practice and a popular, sought-after offering.
When it comes to rehabilitation and PT, there are many options to pick from which makes lasers a viable source of continued benefits and treatment.
ANTHONY CRIFASE, DC, CNS, DACBN, is double board-certified in clinical nutrition and maintains an active chiropractic practice in Denver, Co. With experience in multiple different industries and as a seasoned chiropractor who understands the ins and outs of functional medicine, chiropractic and practice management, he is on a mission to help other practitioners maximize their time, revenue and systems. Learn more at drcrifase.com.
REFERENCES
- Hashmi JT1, Huang YY, Sharma SK, Kurup DB, De Taboada L, Carroll JD, Hamblin MR. – Lasers Surg Med. 2010 Aug;42(6):450-66. doi: 1002/lsm.20950.
