By Kathy Simpson
Who hasn’t had a pain in the neck?
Most people have, and if they haven’t already, they more than likely will at some point (or more) in their lives. According to a report of the Bone and Joint Decade 2000-2010 Task Force, about 72 percent of adults could experience neck pain in any given year, and for some of those folks, the pain limits their ability to work, socialize, and participate in normal activities of day-to-day life.1
Cervical manipulation is a first line of treatment for neck pain. Add low level laser therapy (LLLT) to the mix and the results are better than either treatment alone.2 A growing number of DCs use LLLT in their practice, yet it remains relatively underutilized as a treatment modality.
The cold treatment
Lasers, or light amplification by stimulated emission of radiation, are therapeutic devices that heal with light. High powered lasers have a thermal effect; they destroy tissue and are used during surgical procedures. Low level lasers are “cold,” which means they have little to no thermal effects but allow light energy to penetrate deeply into the body’s tissues. These are the devices that have application in the chiropractor’s office. Their effect is to increase circulation and help restore cellular function, reducing pain, inflammation, edema, and enhancing the body’s own ability to heal.
Studies have shown that LLLT can be beneficial for musculoskeletal conditions associated with neck pain, especially for patients whose pain is chronic and not due to a serious pathology.4 LLLT may also provide immediate relief for acute neck pain. But its application goes much further—to helping manage the pain associated with conditions such as neuralgia, carpal tunnel syndrome, fibromyalgia, tendonitis, osteoarthritis, and rheumatoid arthritis.3
As a treatment, LLLT is non-invasive, painless, and has no recovery time. It has been deemed safe by the FDA with little known side effects,5 so it may be a modality worth bringing into your practice.
Choosing an LLLT device
There are many FDA-approved LLLT devices on the market. Some key considerations when evaluating a device include:
- Wavelength. The wavelength controls the depth of the laser’s penetration. Lower wavelengths (600nm range) are absorbed more quickly into the skin and are a better choice for wound healing. Longer wavelengths (800 to 980nm) penetrate more deeply to reach deeper injuries.
- Pulsed, continuous or sweeping waves. Pulsing and sweeping waves allow for higher power levels while still being safe. Continuous waves saturate the damaged tissues more quickly. Higher-end systems offer both continuous and pulsed wave output.
- Wattage. A laser with more power can make for shorter, more effective treatments.
Before making a purchase, experiment with devices from three or four manufacturers. Get a demonstration from the sales representative, making sure you understand in depth the different settings and their use. Offer treatments to consenting patients at no charge and make your purchase decision based on actual results.
1Hogg-Johnson S, et al. “The Burden and Determinants of Neck Pain in the General Population.” SPINE. 2008:33(4S);S39-S51.
2Abrahamse H, Hay C, Saayman L. “Chiropractic manipulative therapy and low-level laser therapy in the management of cervical facet dysfunction: a randomized controlled study.” J Manipulative Physiol Ther. 2011:34(3);153-163.
3Gross A, et al. “Low Level Laser Therapy (LLLT) for Neck Pain: A Systematic Review and Meta-Regression.” Open Orthop J. 2013:7;396-419.
4Bjordal J, Chow R, Johnson M, Lopes-Martins R. “Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials.” The Lancet. 2009:374(9705)1897-1908.
5American Chiropractic Association. “Low-Level Laser Therapy.” ACAToday.org. http://www.acatoday.org/content_css.cfm?CID=4721. Accessed December 2014.