Integrating laser therapy into your practice

By tailoring laser therapy protocols to individual patient needs, you can enhance outcomes, expand treatment options and position your practice at the forefront of integrative health.

In my experience, lecturing to doctors on laser therapy and chiropractic for almost a decade all over the world, one of the most common things I see with doctors is the “paralysis of analysis.” Far too often, they are excited about this new technology, but then feel lost when it comes to implementation, even if they have attended really good training seminars. Additionally, they have a limited understanding of what actually happens in the body when a laser is applied, if there is any difference with different wavelengths (colors) or powers (watts/class) or if an LED red light from Amazon has any difference worth the cost vs. a true laser. I know I was in that mode 21 years ago and it was frustrating. The information can be overwhelming, contradictory and lead to confusion on the doctor’s part, resulting in underutilization of laser therapy in a number of practices.

This article attempts to cut through the noise and misinformation and give you some common protocols to think about if you are considering integrating laser therapy into your chiropractic practice.

The benefits of laser therapy and chiropractic

Almost every patient who comes into my office gets a combination of laser therapy and chiropractic. Why? Because the combination along with lifestyle modifications provides a huge support to the entire body on a quantum level that goes far beyond just pain relief. They come in for pain and they stay for enhancement of their brain and body. Why wouldn’t you want to provide the best treatment plan for every patient who walks through your door?

Although some patients think of chiropractic as a treatment for just pain; in reality, it is far more powerful and has global effects beyond the adjustment. The same is true for laser therapy; especially high photon energy/high-frequency lasers.

The laser world has two basic distinctions: 1. non-thermally cleared visible devices and 2. thermally cleared infrared devices. It is important to note the mechanism of action in the body is different for each; one follows quantum laws and reactions, while the other is Newtonian/classical.

Non-thermally cleared visible devices

Non-thermal devices range from violet to green to red and have lower wattages because they have very high energy and frequency. Increasing wattage does not improve outcomes with these high-energy wavelengths, as shown in the research.¹ Increased power actually caused damage, not better results, when we ramped up violet to only 100mw with a collimated laser (a collimated beam remains focused and uniform even at a distance, which increases its efficacy).

Safety and efficacy testing for these wavelengths have shown that less power is better when the energy and frequency are high, such as for wavelengths shorter than 750nm in the visible spectrum.²

Low wattage with high energy/frequency were used to get FDA clearances for chronic neck and shoulder pain,³ chronic low back pain,⁴ chronic heel pain and plantar fasciitis⁵ and even full-body postoperative pain and inflammation.⁶ Benefits were shown to last and even get better 12 months post-treatment.⁷ Great results were shown for children with autism, and that study is being reviewed by the FDA for a potential new clearance.⁸

These devices have 22 FDA clearances based on double- and quadruple-blind studies. They impact the body through quantum level interactions with electrons that trigger photochemical and photo signaling reactions requiring an energy only present when wavelengths are shorter than 750nm. These photons have energies ranging from 3.1 electron volts for violet, to 2.4 eV for green and 1.9 eV for red. The minimum voltage to trigger an electron jump is 1.7 eV.

These reactions allow for unique application methods through the bloodstream and cellular communication networks that do not rely on direct or deep penetration. These are also known as “abscopal” or global effects.

Thermally cleared infrared devices

Infrared devices use low-energy/low-frequency wavelengths that work primarily through Newtonian/classical physics reactions, meaning those that are photothermal and photomechanical in nature. There are fewer FDA clearances, and almost all are exclusively for thermal reactions to decrease pain.

They use high wattages because of the low energy of their photons and different mechanism of action. This also makes their method of application different, as they require direct application and deep penetration to be effective. Their electron volts are too low to trigger electron jumps as even an 830nm laser has an eV of only 1.5, which is below the 1.7 eV threshold.

Triggered response

The high energy/frequency wavelengths trigger “quantum” reactions in the body that do not occur with the high power/low electron volt/low-frequency Class 4 infrared lasers that trigger “Newtonian” or classical physics reactions.

High-energy lasers trigger excitation of electrons in the ETC in the mitochondria at complex 4 and also at complexes 1, 2 and 3, which require specific wavelengths/energies for electron jumps. They also cause electron jumps in pi resonant clouds around the microtubules.

Microtubules used to be thought of as just cellular scaffolding, but research suggests these are actually where the seats of memory and even consciousness occur.^9,10

As high-energy/high-frequency lasers interact with these free electrons, they trigger the production of biophotons that transmit information instantly throughout the body through this network of microtubules. They will trigger them to release not only more biophotons but also for a longer time, which is called producing “super-radiance” and “delayed luminescence.” Coherent light in neurons and microtubules has been suggested to have the ability to not only communicate but also trigger repair.

The biophotons contain “qubits” of data that is “coherent and laser-like,” so the high-energy lasers enhance and amplify this cellular communication network and data processing.¹¹ If you add specific adjusting, you should be able to see the power of that combo! I believe this is why we have seen such profound results with brain applications and performance enhancement.

This is in addition to being able to impact complexes 1, 2, 3 and 4 with the higher energy. Disruptions in the ETC at these locations are common in different illnesses, pain, neurodegenerative conditions and even in autism. Many medications produce significant disruptions in the mitochondria, as do many common foods. Current research is looking for therapeutic approaches to support mitochondrial function¹² and laser is one method.

So, when you apply a high-energy/high-frequency laser, you can trigger not only enhanced, coherent, laser-like communication throughout the body, you also help produce more ATP by supporting all aspects of the ETC in the mitochondria.¹³

This is on top of triggering a dampening of inflammatory cytokines, modulation of immune responses like T reg cells and Th1 and 2, stimulation of stem cells, VEGF, NO and down regulation of prostaglandins and Cox 1 and 2 to a level superior to that of opioids and NSAIDS.¹⁴

So now that you have a basic understanding of what happens on a quantum level when you apply a laser on a patient, you should be able to think about protocols. I have not had to advertise in more than a decade because once patients come in to recover from an injury, they stick around to enhance performance and prevent brain decline.

Basic protocols

Here are a few basic protocols to help you get started when using high energy/frequency visible lasers. These protocols may not apply to low-energy/high-wattage devices since they have different electron voltages, wavelengths and frequencies that trigger different reactions and may even be contraindicated.

Please review your state board regulations and the FDA clearances of your device before undertaking any of these protocols.

Acute pain protocols

For recent injuries in a relatively healthy individual, I will usually place a laser in a stand or use my scanning laser on the area of involvement on pulse frequencies of 8/25/42/125. High energy non-thermal lasers can be applied unattended and work best if you have the patient do active movements at the same time.

For example, while the laser is applied, if it is a shoulder I will have them do range-of-motion (ROM) exercises in the range that does not increase their pain while laser is applied over the painful area and up into the nerve roots in the neck. Typical treatment time will range from five to 10 minutes.

You can also stack soft tissue treatment at the same time, such as shockwave, PEMF or myofascial release. The same type of protocol can be used for any other joint.

Sample protocol

• Place the laser over the affected area running parallel to the nerves
• Have the patient do ROM exercises in the pain-free range
• Settings of 8/25/42/125 hz for pulse frequency
• 5-10 minutes of passive treatment
• Can stack with other modalities
• Finish with adjustment

Chronic pain protocol

Similar to the acute protocol with the exception being, I will use longer time for severe, chronic pain or for patients in overall poor health.

I will also use a slightly different pulse frequency of 8/25/42/279 hz¹⁵ and a time frame that ranges from 10-20 minutes. I charge more for the longer session. The rest of the protocol remains the same, and if the patient is dark-skinned or has tattoos, there is no concern if you are using a non-thermal Class 2 visible laser.

Brain support protocol

This will depend on what your patient can tolerate. Some can tolerate a longer session, while others may only be able to handle high energy for as little as 30 seconds.

You will have to make sure the patient lets you know if they feel anxious, jittery, amped up or uncomfortable in any way, while the laser is applied. The laser I use has an FDA clearance for use on the head, so you also have to make sure you are using your laser appropriately and safely.

For pulse frequencies, I like to use 1/10/40/60 hz. I will often apply these directly over the carotid arteries so they can pick up the energy and deliver it to the regions I activate during the treatment. Laser energy can get picked up by free floating mitochondria and will also propagate through the microtubules.

Sample protocol

• Apply laser therapy either transcranially or over carotid arteries or both if a scanning laser is used.
• Pulse settings of 1/10/40/60 hz
• Time will vary from 30 seconds to 20 minutes depending on tolerance. My average treatment in office ranges from 7-10 minutes.
• Whatever they are bad at, have them do while they are lasered. Bad balance: Do balance exercises. Bad speech: Do tongue twisters or Duolingo app. Bad reading or eye tracking: Do eye exercises. Apply the laser therapy and have them do the activity at the same time for best results.

Final thoughts on laser therapy

Be sure your patient is also getting adjusted, exercising and eating a healthy diet for the best results. There is no cookie cutter for laser therapy, but these three basic protocols can jump-start your patients into better results without being very complicated.

Kirk Gair, DC, has been using high-energy, non-thermal lasers since 2004 and teaching doctors internationally and researching lasers since 2017. His peer-reviewed research on green and violet lasers led to the first FDA clearance for a combination laser of those wavelengths for chronic neck and shoulder pain. He has worked with professional athletes, celebrities, Olympic gold medalists and world record holders; he has also been featured in Kharrazian Institute for Functional Medicine and in Izabella Wentz’s New York Times best-selling book, “Hashimoto’s Protocol.” He has a private practice near Los Angeles, California, and a highly interactive and free Facebook group (facebook.com/groups/drgairlasertherapy). This article was written on behalf of Erchonia.

References

1. Sammons T, et al. Assessing the impact of high photon energy wavelengths on the treatment of chronic neck and shoulder pain. Evid Based Complement Alternat Med. 2023;2023:6672019. https://pubmed.ncbi.nlm.nih.gov/37829623/ . Accessed October 16, 2025.
2. Moskvin SV, Khadartsev AA. Methods of effective low-level laser therapy in the treatment of patients with bronchial asthma (literature review). Biomedicine (Taipei). 2020;10(1):1-20. https://pubmed.ncbi.nlm.nih.gov/33854908/. Accessed October 16, 2025.
3. Silverman RG, et al. Effects of a single treatment with two nonthermal laser wavelengths on chronic neck and shoulder pain. Med Devices (Auckl). 2019;12:319-325. https://pubmed.ncbi.nlm.nih.gov/31564998/. Accessed October 16, 2025.
4. Berry TS, et al. A randomized, double-blind, sham-controlled study evaluating the effectiveness of a low-level laser device for treating lower back pain. Emedical Research. 2020;2:100005. Erchonia.com. Accessed October 16, 2025.
5. Macias DM, et al. Low-level laser therapy at 635nm for treatment of chronic plantar fasciitis: A placebo-controlled, randomized study. J Foot Ankle Surg. 2015;54(5):768-772. https://pubmed.ncbi.nlm.nih.gov/25769363/. Accessed October 16, 2025.

6. FDA Clears Low-Level Laser Device for ‘Whole Body’ Pain. July 2019. [News]. https://www.erchonia.com/news/fda-clears-low-level-laser-device-for-whole-body-pain/ . Accessed October 16, 2025.

7. Berry TS, et al. Low-level laser therapy for treating low back pain: 12-month follow-up. Journal of Pain and Relief. 2019;9:1. Erchonia.com. Accessed October 16, 2025.

8. Leisman G, et al. Effects of low-level laser therapy in autism spectrum disorder. Adv Exp Med Biol. 2018;1116:111-130. https://pubmed.ncbi.nlm.nih.gov/29956199/. Accessed October 16, 2025.

9. Hameroff SR. The brain is both neurocomputer and quantum computer. Cogn Sci. 2007;31(6):1035-1045. https://pubmed.ncbi.nlm.nih.gov/21635328/ . Accessed October 16, 2025.

10. Hameroff SR. Quantum mathematical cognition requires quantum brain biology: The “Orch OR” theory. Behav Brain Sci. 2013;36(3):287-290. https://pubmed.ncbi.nlm.nih.gov/23673035/ . Accessed October 16, 2025.

11. Moro C, et al. The code of light: Do neurons generate light to communicate and repair? Neural Regen Res. 2022;17(6):1251-1252. https://pubmed.ncbi.nlm.nih.gov/34782559/. Accessed October 16, 2025.

12. Diaz-Vegas A, et al. Is mitochondrial dysfunction a common root of noncommunicable chronic diseases? Endocr Rev. 2020;41(3):bnaa005. https://pubmed.ncbi.nlm.nih.gov/32179913/. Accessed October 16, 2025.

13. Passarella S, et al. Increase of proton electrochemical potential and ATP synthesis in rat liver mitochondria irradiated in vitro by helium-neon laser. FEBS Lett.1984;175(1):95-99. https://pubmed.ncbi.nlm.nih.gov/6479342/. Accessed October 16, 2025.

14. Januskewski, et al. Efficacy of 635nm red low-level laser on nociceptive musculoskeletal pain compared to NSAIDS, opioids and other light sources orthopedics and rheumatology. Ortho and Rheum. 2020;17(2). https://www.researchgate.net. Accessed October 16, 2025.

15. Hashmi JT, et al. Effect of pulsing in low-level light therapy. Lasers Surg Med. 2010;42(6):450-466. https://pubmed.ncbi.nlm.nih.gov/20662021/. Accessed October 16, 2025.