LLLT: Discover the Most Researched and Validated Modality of Modern Time: recording and transcript

Rick: Hello, and welcome to the Tuesday webinar series, Chiropractic Economics Webinar for doctors of Chiropractic. I’m Rick Vach, Editor In Chief at “Chiropractic Economics.” Today’s webinar, Low Level Laser Therapy: Discover the Most Researched and Validated Modality of Modern Time is sponsored by Erchonia. And as always, our program is being recorded and will be archived at Chiropractic Economics website, www.chiroeco.com/webinar for one year. Our expert is onboard here today to speak with you, and when this presentation is complete we will follow with a Q&A period. You will be muted and we will answer your questions at the end. You could submit questions throughout the presentation by clicking on the appropriate icon on the right side of your screen. Our presenter today is Dr. Jerome Rerucha. He is a practicing clinician, co-owner of Crossfit Eatonton with his wife, Jennette, and a speaker teaching integration of advanced clinical treatment applications and competitive strength and conditioning principles. Prior to clinical practice, he was a full-time strength coach. He competed in powerlifting for 14 years and won a Lifetime Drug-Free World Title and The Best Lifter Award in 1999. Rerucha has been involved with numerous Division 1 strength programs. Dr. Rerucha, thank you for taking the time to participate in our webinar and for sharing your expertise with Low Level Laser Therapy, and helping our audience to get a better understanding of the physiological benefits and treatment benefits in chiropractic practice. Before we get started, Dr. Rerucha, please, give us a brief background on yourself and your work with Erchonia.

Dr. Rerucha: I graduated from Life University in the first class of 2000. Shortly after that, I started teaching seminars within the chiropractic profession. And over the course of that time I’ve had the pleasure of meeting thousands of different chiropractors and learning from them as much as I was able to teach them principles of laser therapy and how it fits into all different types of applications into our practices. I’ve used it extensively throughout my own practice. We have functional medicine we do, obviously we adjust every single person, so, we have a very typical family based practice as well, we do a lot of nutrition. And lasers fit into all different phases of it. We’re also involved in the public within the competitive world, not just strength but a variety of applications in all athletics at all levels, whether it’s youth levels, recreational levels. And obviously chiropractic fits in all age groups, all conditions, but also in the prevention of health and performance. So, lasers fit right in to that and I’m going to take the 19 years of common questions people have asked me and condense t down into this next 30 minutes here. And give people a really good broad based feel, but so you leave with a real concrete understanding of the physiological benefits of true Low Level Laser Therapy and how it can apply into your specific style practice. So, thank you, Rick. Thank you, Chiro Economics and welcome everybody on this webinar. Now, when we’re talking about low level…

Rick: Thank you, Dr. Rerucha.

Dr. Rerucha: Absolutely. While we’re talking about Low Level Laser Therapy, just from one company alone, you have a lot of different options out there, everything we’re going to be talking about in this webinar is accurate throughout the entire laser industry. However, it is going to be more specific to the red laser beam as you will see when we go through it, but the principles apply through all of light therapy, and we’ll make those specifics as we go. And when we get to the hands on unit we’re primarily going to be talking about the PL-Touch unit. But I want you to know the broad based information that we’re going over is going to be very universal, for you to help understand how we’re making that claim of the most researched modality of modern time. So, as we look at just as recently if we to PubMed on April 18th of 2019. And if we just search Low Level Laser Therapy, being very specific with Low Level Laser Therapy. And you will see over 6700 research papers that are currently published on the safety, the efficacy, the effectiveness of true Low Level Laser Therapy. Another thing that I find fascinating is on many searches that you may do off to the side that I’ve circled in red, you will see results by year. And each one of those bars represent one year of the amount of research that was done. And when we just look at what has happened in the last 20 years, just with Low Level Laser Therapy research. Now, lasers themselves have been around since the mid-1960s, and you can see how there wasn’t a lot of information about them before. And the reason being is there was the first FDA clearance was granted in 2002. And that was done by Erchonia with a true level 1A study. So, that was really landmark. Absolutely historic in terms of getting a non-pharmacological device, FDA cleared for chronic neck and shoulder pain.

However, what that did to an entire industry that existed, it put a lot of eyeballs on it in terms of the validation. And we have learned so much even since then, even though these devices are incredibly safe and effective, lasers have taught us a lot about cell physiology. So, as we see that progression, I want you to kind of keep in mind that that same progression that we’ve seen in PubMed of how could that transfer into your existing practice, so you see that growth in success along with the great work that you already do. Now, even when you go into PubMed, if you did a further search such as Low Level Laser Therapy and pain, or Low Level Laser Therapy and stroke, or you just started gazing through the 6700 research papers in order, you will find it being used on hundreds and hundreds of different symptoms. Many of these symptoms are not even in our scope of practice as a chiropractor. And it’s important to understand this common denominator and really simplify this. Nobody has time to read 6700 research papers, it’s very complicated doing level 1A studies, and it’s very complicated to build a laser diode. But it’s really simple to apply these as practitioners and chiropractors do it better than any other practitioner out there. So, that’s my goal for you, to really understand these common denominators and truly how simple and effective these are to bring into our practices.

Now, the common denominator for the last 6700 researched studies and the common denominator for the next 6700 research studies, is everybody agrees Low Level Laser Therapy and light therapy in general affects the mitochondria. Now, every cell in your body has mitochondria, and that cell works dependent on the amount of energy the mitochondria make so that cell can do with that cell does. A bone cell needs energy to do what the bone cell does. The liver needs energy to do what the liver does, muscles, nerves, on and on and on. It’s not just symptom based, it’s tissue based and it’s the cells of the tissue involved. And that’s why there are so many papers on literally almost everything you can think of. Validating the use of Low Level Laser Therapy and it’s growing. So, every doctor and patient as well, they have different emotional buttons as I say of when they commit to care of why you would bring lasers into your office. So, some people are really going to be sold on the physiological facts. Some people really want to see that research. Some people really want to understand how simple the application is or a combination of all those. We’re going to discuss all of those different sections, and so, we help you understand best as possible what’s your priority.

When we refer to a study in 2009 from Harvard Medical School, it discusses that there’s large numbers of animal and human clinical studies that have demonstrated highly beneficial Low Level Laser Therapy effects on a variety of diseases, injuries, and has been widely used in both chronic and acute conditions. Low Level Laser Therapy enhances neovascularisation, promotes angiogenesis, and increased collagen synthesis to promote healing. So, as we’re going through this, hopefully you can just kind of visualize individual patients or what you actually see in your practice or how you’d like to grow and change your existing practice. Low Level Laser Therapy can also stimulate healing of deeper structures such as nerves, tendons, cartilage, bones, even internal organs. These are not superficial devices as you will learn as I explain how those things work. Even internal organs, Low Level Laser Therapy can reduce pain, inflammation, swelling caused by injuries, degenerative diseases, even autoimmune diseases.

Beneficial effects of Low Level Laser Therapy on repair processes after injury or ischemia in skeletal and heart muscles in multiple models in vivo and in vitro. Even after strokes, traumatic brain injury, spinal cord injuries. Now, there’s a lot of things we’ve discussed in just this few slides here. Again, some of these aren’t in our scope of practice. However, you start getting the idea of how universal these devices can be used, and not just for superficial effects. And that is talking Low Level Laser Therapy, not high-powered products that make exaggerated claims about more power penetrates deeper. As we’re gonna learn that’s not how these devices work. So, when we do talk about bringing this into our practice and some of the biggest needs that we as chiropractors have, the pain market. A lot of people are learning the benefits of Low Level Laser Therapy in the brain for the last 15 years and even more commonly applied now through the organ system. Everything PubMed has talked about it even being, sometimes we have patients that have come to us too late and they do need surgery. 

And there is PubMed studies that validate that and even Erchonia has a FDA clearance related to pre and post surgical benefits. So, there’s so many applications, toes to nose, acute or chronic, muscle, tendon, ligament. Even a great way to apply these into our offices is taking patients that are maintenance patients, we worked on them for years prior to getting the laser in our office. And taking the laser over chronic subluxations and seeing the common indicators that we use as chiropractic change. And this is no substitute for an adjustment, but as we understand the benefits of Low Level Laser Therapy. I always tell all my doctors, “Would you rather adjust somebody with 40% of the mitochondria working? Or would you rather adjust somebody with 65% of the mitochondria working? And that’s whether you’re looking at the subluxation, the nerve roots involved, the tissues of the muscles, joint capsule, or even the organs involved through the Merrick Chart visceral somatic reflexes and the safety pin cycle of the brain. So, the universal question that holds true for everything and it fits into exactly what we do and talk about as chiropractors no matter what specific techniques you do.

Now, lasers do not work by magic. I wanna make these very tangible to you including the validation that’s in PubMed. And we want to…again, give a synopsis of what holds true for every single article. Now, even a pessimist in PubMed will validate that using a laser similar to what we’ll talk, you’re pretty much going to expect just doing simple point-and-shoot applications, 30% increase in any tissue regeneration that has mitochondria. That would be a pretty, simple, universal accepted statement. Now, how it works is not by magic. And we know through the Kreb’s Cycle and the electron transport system, how it’s the breakdown of foods that break it down into electrons. You circulate an electron through the electron transport system, the more efficiently you can do this the more efficiently you make ATP. And in the case of laser therapy, the photon is an electron donor. And this is exactly how, using low level laser therapy it affects through the physiological processes that all of us understand, the Kreb’s Cycle and the electron transport system, in order to make ATP. 

Now, nutrition is very important as well, lasers are not a substitute for an adjustment, but they’ll make the adjustment work better, and vice versa. Lasers are not a substitute for a nutritional based practice. However, it is the energy that drives the chemistry, not the other way around. And as we look at, every physiological process in the body’s either oxidation or reduction, and it’s whatever level of expertise and system in the body that you want to apply this to. And when we look in any textbook of oxidation and reduction mechanisms, you recognize that it is ATP and enzymes that is responsible for every single physiological reaction to occur. And this again, this is just making how universal laser therapy is whether you have a structural based practice, acute or chronic injuries, functional medicine, a brain based practice, just how universal the application of low level lasers are.

First rule of thumb for people, as you start understanding this physiological basis, is lasers fit into how you practice. You don’t sit there and have to ask the question, “Oh my gosh, one more new thing.” It always takes some effort to put new procedures into our practice. Anything you already do as a clinician, lasers will just help work better, so, every single indicator system that you have, whether you’re talking the typical chiropractic techniques, even as we start getting in to this variety of, if you’re a homeopath, you do acupuncture, reflexology, lab testing. Every single indicator system is a great reason to apply low level laser therapy and understanding that physiological basis that I just shared with you.

Now, we can just simplify this and even talk about the pain market. So, there’s so many things that we can go into detail about. But if you even brought in a Low Level Laser Therapy just for one specific reason and just the subject of pain, that is no small task to conquer right there. So, there is a biblical plague of diabetes, coronary heart disease, stroke, and cancer. Each one of those is a stand alone, but if you add up all those chronic degenerative diseases, it does not come close to even touching the amount of Americans that have chronic pain. Lasers are very, very proven to help patients with pain. And Erchonia has four level 1A FDA clearances that are even governed just for this particular market. Now, they currently have 14 level 1 FDA clearances in all. Some of them are in some different industries, but, again, it started in 2002. You saw the big boom it made in PubMed and it has created a big boom at the clinician level of how we help patients and it’s not slowing down. So, even just recently with one of their particular products they received an FDA clearance for low back pain.

Absolutely the number one pharmacological reason for pain medication across the world, and it is amazing to see that a non-drug related advice got an FDA clearance for that. But once again, it’s a sinking ship out there. And we as chiropractors have so many advantages to help people, obviously the adjustment is a big one. But also combining the validation of the research, safety, effectiveness, physiological enhancement to the great benefits the adjustment provides. It is literally a perfect match made. If pain is not controlled, which it is not, so there’s an opiod epidemic, and this is not a secret. So, everybody’s aware of this. This again, is just one of those big reasons of why Low Level Laser Therapy is getting the attention that it does. And it’s not slowing down, so we as chiropractors have been a part of the laser market early, early on. And I’ve been involved with it for almost 20 years now of it. 

Got to see how it grows and all the different types of practitioners that have come to use it, and it’s not slowing down, it’s only picking up momentum due to the increased validation. And people understanding how simple and effective that there is to use it. So, we’re going to show you some slides here, just so you can kind of even further grasp, hopefully, a picture’s worth a thousand words. And when you take a laser device and shine it on the area, true lasers will go through clothing and, you know, we even have validated cases of MRIs and X-rays of lasering through casts and seeing exponential healing, pre and post healing. But if you’re not into that, and that can be a big jump for a lot of people. Very easy, expose the area and I prefer the laser directly on skin, but I also know the size of a photon is like you walking through the grand canyon going through clothing. So, we’re not talking LEDs and infrareds here, we’re talking true Low Level Laser Therapy.

So, again, as we’re going directly on the skin for these examples, but it’s not just superficial applications as Harvard clearly said within their report that we read earlier. So, shining on any area, could be a shoulder, could be the foot, even the cranium. And we want you to understand, the first law of photochemistry, is known as the Grotthuss-Draper law, and it states that light must be absorbed by a photoreceptor or a chromophore in order for a photochemical/photobiological reaction to take place. There’s a lot of misinformation out there from companies that are not Low Level Lasers and they have this perceived concept they like to sell to people of more power penetrates deeper. That’s not true. 

And when we do talk about even true Low Level Laser Therapy which is for photobiology, it’s important that heat does not take place in order for that to optimize itself. And a photon has to bind to a photon receptor as we see in that picture right there. And when that happens, then the photon is an electron donor, that electron then goes to the mitochondria, it goes through the Kreb’s Cycle and the electron transport system ultimately making ATP. It’s a very sub-cellular level. And very, very exciting then in terms of it doesn’t just affect the local area, but also has the option to send a cascade reaction in the body, this is called the London Dispersion Effect. So, this can happen through blood flow, cellular signaling, the liquid crystalline matrix, the valence electron, there’s so much that lasers has taught us that happen even once it is just for the local stimulation.

Low Level Laser Therapy also stimulates healing of deeper structure such as nerves, tendons, cartilage, bones, even internal organs. Low Level Laser Therapy can reduce pain, inflammation and swelling caused by injury, degenerative diseases. So, just that reminder in terms of how these things apply to us in practice. Now, chiropractors have always had the concept that nerve roots go to every single muscle in the body, and nerve roots branching go to every single organ in the body. So, you absolutely can take your laser, use it symptomatically my elbow hurts, my wrist hurts, I sprained an ankle, there’s nothing wrong with that. But in the case of us using a PL-Touch, as you’ll see here soon, it has two laser heads where you can treat two different areas of the body at the same time. And we can apply chiropractic principles, you can use both heads over the symptomatic area wherever that’s at, that’s fine. But we can actually put one head on the nerve root that goes to the area of involvement whether it’s a muscle, whether it’s an organ, obviously the safety pin cycle and then there’s many states out there that it is legal for chiropractors to use acupuncture along with chiropractic and what a better modality of an energy healing art, then again, to use Low Level Laser Therapy to help the energy that’s displayed in the acupuncture system. So, so, many benefits as we talk about the brain and the safety pin cycle that chiropractors have talked about for such a long time.

And this again, this is in PubMed. They have a number of studies, and this is really going to be picking up even more and more progress as we look at all the problems with named pathology, the neurodegenerative conditions out there. But some of those neurodegenerative conditions technically may not be in our scope of practice, but the brain is as we talk about the safety pin cycle and the reality of how that applies for us. And in all cases, we would rather prevent more problems than we even treat, rather than be so reactive. But PubMed is very, very clear of using Low Laser Therapy to improve cortical and metabolic capacity and memory retention. And there is a number of studies, and just this division in PubMed is just gonna be exploding here recently with some of the findings that I know have been done, but it’s currently intellectual property at this time. But that same trend is going to be exploding more than ever just in brain research. But even now, growing evidence supports that neuronal metabolic enhancement by Low Level Laser Therapy, not LEDs, not infrared, positively impacts neuronal function in vitro and in vivo.

Now, we’re going to come back a little bit now that you have some really good ideas of what lasers do, the process of how lasers work. We’re going to talk about the light therapy industry. So, everybody refers to themselves as having a laser, but there’s really very few true lasers out there, especially when you’re talking Low Level Lasers. So, the majority of products are light-emitting diodes or infrared, I’m not saying they don’t work at all. However, there is a loss of efficiency when using other products that are not laser therapies. So, we’re going to talk physics 101 here because I want my profession to know specifically what they bringing in to their office and how they’re helping people. So, again, a lot of marketers, individuals may not know the difference, but there’s really a market called Light Therapy. And under this umbrella of light therapy is light emitting diodes, infrared, and of course true lasers as we’re talking about specifically.

Now, this is not throwing anybody under the bus. This is public knowledge. And again, a lot of confusion has occurred in years because it is such a booming market. And if you really just want to cut to the chase, you can ask any company, show me your 510(k) clearance. So, anybody that’s making a lot of claims that they do a lot of research or they treat all sort of things better than anybody else, you could just say that’s great. Show me your 510(k) clearance. This is like asking a chiropractor for their chiropractic license number. Everybody has to have one and your state has a scope of practice. And so, essentially companies and their product has a specific indication of use, kind of similar to what they can make hardcore claims with. And sadly, what people will find is over 90% of the time, they don’t have any research and it’s also not even a true laser.

So, there is different 510(k) clearances out there. So, one of them you’ll recognize is an ILY FDA Clearance. And this is what the majority of manufactures may have out there. And again, it’s just public knowledge, you can ask them. So, the ILY category is based on a mechanism of heat. It’s not photobiology and it says specifically that on their specific indication of use. And so, the ILY category has been around for over 40 years. It was originally based on what was done with the heat lamp, and so it’s just grandfathered in with that. So, all you do is you just go online and you download a piece of paper called a Substantial Equivalency of Predicate Devices. And you just fill it out and turn it in, it’s going to take you about 90 days to get your 510(k) clearance for topical heating, it doesn’t require any research. And that’s what every company out there has almost and the ones that don’t there’s a couple that did some research as well, but Erchonia, the biggest difference maker, that they did initially that created the entire boom was Level 1A studies which no one’s doing that. And it is the Level 1A research and validating a specific product that created that entire boom in PubMed that I showed you. And that has validated an entire industry. So, the concept of light therapy had been around for decades earlier, just never validated to the level that it has, and research benefits have grown greatly since the time and conceptions of the earlier versions of light therapy.

And this Level 1A research benefits an entire chiropractic profession because there’s a lot of chiropractors that use these Level 1A FDA cleared devices. And ultimately, it comes down and it validates you the single user and the great care you’re providing people in your office. So, to go into a little bit more detail of the visible spectrum as we talk about lasers, LEDs, or infrareds for instance. So, lasers and LEDs are in the visible spectrum which is from 390 to 760 nanometers. Infrared starts at 761 nanometers and above, it doesn’t mean infrared don’t work at all, it’s just you’re going to learn about the efficiency of how these work. So, as we look at the characteristics of light therapy of sunlight which is all spectrums. LEDs even if it comes to a single dot, the waves are not parallel to each other. And they’re not monochromatic. It loses a lot of efficiency from a photobiological standpoint. So, when you’re dealing with true lasers, it’s monochromatic, where 635 nanometers is 635 nanometers. Very little to no tolerance with that, 660 would be 660 nanometers, okay. LEDs would scatter all over the place, they would not be monochromatic. They’re not specific wavelengths even though if on the paper it says that, if you put them on a photon meter they would not be. So, LEDs are very cheap to make compared to a laser diode and it’s based upon this specificity and validation that it takes to do with that.

Now, with true laser therapy, it can be used a distance off of the body. With LEDs, generally, you know, you want it very, very close to the source because they are not monochromatic or coherent, they scatter. And of course, infrareds definitely have to touch the surface because they’re invisible, you can’t see them anyway. And again, they’re very non-coherent. So, research absolutely identifies the differences between these products. And even in this particular case in 2004 just a paper of Cosmetic and Surgery Times discussed Low Level Laser Therapy outshines other modalities. The scientist compared laser and LED therapy. LEDs lack mono-chromaticity and coherence quality of a laser, but they’re much cheaper to purchase and operate. With normal wounds, an LED gives 3% acceleration in healing compared to 30% for laser. Now, when we look at infrareds, infrared starts at 761 nanometers, one of the biggest differences you’re going to see with this is the amount of energy per photon. Now, the energy per photon is a 100% dependence on the wavelength. 

And longer wavelengths and 830 nanometer infrared has a lot less energy per photon than a 635 nanometer laser. A 940 nanometer infrared has a lot less energy than an 830 nanometer infrared. So, and the size of the battery has nothing to do with this. So, you could put a liquid cooled hemi on one of these products. And it’s going to affect the energy of a photon, absolutely zero. So, as we just give, this is a chart from NASA describing the energy of photons through a spectrum. And so, for the infrared range, you’re looking at 0.124 electron volts of energy per photon, where in the visible light spectrum, you’re looking at 2.48. So, you’re looking at a 20 times difference just from that aspect of it. And that transfers over to the photobiological changes that you get in the energy transfer. It’s all about absorption into the cell.

I know we’ve given you a lot of information already here, and we’re going to get to just some of the slides that depict how easy it is to use with the hands on applications. And hopefully, one more bit of science here before we move on, even though infrareds start at 761 nanometers, there’s a unique physiological window even prior to infrared. This is in the visible spectrum, so, this would still affect LEDs and true lasers where infrareds absolutely will not affect what they’re talking about here because they have so little energy per photon. But in order for 400 nanometers to 660 nanometers, it has sufficient energy to displace electrons to a higher energy state, we’re talking the valance electron here. And the outer shell has to be full in order for it to be active in its energetic usable physiological state. The higher energy electron is now more available for donation when you’re using 400 to 660 nanometers. Not saying above 660 doesn’t have some benefits but this is a major, major contribution to photobiology that you just cross off the list, scientific fact, if you’re using above 660 nanometers you’re not getting any of those benefits. So, as it is discussed longer wavelengths can penetrate deeper but at a great cost of not being absorbed. And also when you see the effects of the valence electron, this is why Harvard says even using low level laser therapy with very low power outputs, how it absolutely can even heal deep organs inside the body.

So, for people who don’t know and there’s so much research out there, that’s why we want to simplify it and really put it in a usable form. More is not better, so, when we’re talking about this concept in science it’s related to Arndt-Schulz curve. Weak stimuli excite physiology and very strong ones arrest it. And again, if you just look at research papers where it talks about 5 joules per centimeter squared, had a very beneficial effect, but just going up to 10 to 16 joules started seeing a decrease in cell viability and actually injury to the cells involved. So, in this particular paper, they measured using devices that created heat and as we looked at the temperature of the tissue and the treatment time in minutes, at five-minutes of laser therapy the cells were the absolute lowest temperature. And as we start looking at our bar graph there, at five minutes this measures the cell viability when the cells are at the lowest temperature you see the absolute peak cell viability. But as soon as you start heating the tissues using a radiation device, you start seeing a decrease in cell viability. 

And the more you heat the tissue the more pronounced that gets. So, once again, this is just a reflection of the Arndt-Schulz curve. We want to really help you understand how this information transfers into your office of how you can help more people having a physiological product of success and also how that transfers over to increase and then monetizing in your product of the future of the light therapy market. So, so many safe effective ways toes to nose to use true Low Level Laser Therapy. You can use it attended or unattended. And so, there are specifics that you can get with your Erchonia rep, we’re going to be inviting Diane Southwick on here very soon. So just understand there’s lots of variables, the particular unit we’re talking about here today the PL-Touch has two laser heads. One is known is the Preset Head and one is the Programmable Head. 

So, there’s a number of different variables that can be applied here and you can hold these in the hands such as the picture shows, you can put them in a stand. All sorts of very simple applications and too much to go into detail right now, but in terms of these units are made for practitioners’ ease of use. Lots of different programs, you can even store directly into this. You have control of all these where you can just apply anything, sprained ankles, acute pain, chronic pain, anything you can think of, you can put in 40 preset programs. And you see the stand in the lower right-hand corner, so, these stands work so great for unattended protocols, the doctor can be involved as well. Here’s me treating somebody that’s hooked up to an EEG and we’re actually doing a brain treatment right then and there. It’s really fascinating to watch the EEG change right as you apply the laser on top of the other great benefits that are applied.

Once you get established patients, you very easily can have the patients hold these. So, even if it’s on some particular areas that you move, commonly the brain 60 seconds each lobe, is kind of a standard application as we show there. You don’t have to hold that once we educate patients. The effectiveness and how we first administer it, but otherwise they can do it on their own as well. The stand is absolutely fantastic. Here’s an example where we’re just going to be treating the shoulder, you could put both laser heads over the area of symptomatology no matter where it’s at, but we’re applying chiropractic principles where we’re lasering the central nervous system as it applies to the area of involvement, the shoulder right there. And you can imagine how many combinations there are based on the central nervous system, and how you can work with those things. So, the flex stands are great. Any handheld laser can be use unattended within stands and in a variety of different environments and applications, face up, face down, seated. 

And we do a lot with rehabilitation. Many of that can be done in a particular place, but even as you see us doing some side work for the glute medius and minimus. Just putting the lasers in the stand and having the patient just remain in an area, but firing muscles. Lasers work point-and-shoot, lasers work even better through activation when you can fire the nervous system, you will even get conversion of that laser energy even more effectively than the studies that are validated in PubMed. Now, we are going to be taking questions at the end of this. Diane Southwick is now going to come on, they’re going to be loading her slides. So, I have had the pleasure of working with Diane, I’ve known her. She’s been with Erchonia for 13 years, and I had the pleasure of knowing her before that. She has over 25 years in the chiropractic profession. And she is absolutely fantastic as well. She’s done clinical support, and answers a lot of questions for doctors through all these years. I’m going to turn it over. And Diane, thank you for being with us today.

Diane: Well, thank you, Jerome. It’s really a pleasure to be here. For those that are on attendance on the webinar today, I’m actually speaking to you from Snohomish, Washington, I’m right outside the Seattle area. It’s my pleasure to be here and to share with you information about what makes Erchonia standout, especially in the research and moving the low level laser therapy forward. A little bit of background about myself. I’ve been involved as Jerome mentioned, with Erchonia for 13 years. I’ve been working with chiropractors going close to over 25 years, I think I’m coming up on 30 before too long and it’s been my pleasure over the last several years to actually represent for Erchonia in my area, but also to place lasers into doctors’ offices that I’ve known for years and watch the change that has been evolved in their office. The information I’m about to review, all of it is available, so, at the end of the webinar you’ll my contact information along with other representatives that you may be familiar with. And you can reach out to us or myself, and actually request some of the science or the information I’ll be sharing.

As Dr. Rerucha pointed out, Erchonia has actually been in business for over 20 years now. And during that time, their cornerstone has always been research and I’m going to share some of the actual studies with you that they’ve actually…with all the data for the last few years. Before we get to actually some of the published articles, just wanted to point out that Erchonia being in business for over 20 years, has actually trail-blazed the way for many other companies. We feel we’ve proven time and time again, the effectiveness of low-level laser therapy as an emerging paradigm and a technology that is here to stay. We’re looking forward to the future. We do value this as part of the cornerstone. One of the things that Dr. Rerucha pointed out that it’s important to educate the doctors as we have our seminars. And one of the things we like to cover is when we mention the clinical level trials. This document here talks about Level 1 all the way to Level 5. There is a difference in Level 5, that would be something that perhaps you and I would decide to have a theory and come up with a plan to treat several patients in your office. We might fall into Level 5 category. When you’re talking about Level 1 which is required for any FDA clearance of 510(k), it is multi-center, double-blinded, placebo controlled.

It is important to know that when you step forward to using Low Level Lasers that the modality that you’re using has been proven to be effective, and efficient, and safe. The clinical trials all are important information, you can find up on the internet. if you go to the internet you can find any of the trials that are currently underway. If you go to clinicaltrials.gov, you can then put in Erchonia and you can search to see what’s in process. Currenty, Erchonia is involved in Level 1 clinical trials to further the category. Right now we’re involved in autism. We also have Alzheimer’s, Parkinson’s, Diabetic Peripheral Neuropathy, and we’re actually in the process doing our second study for chronic neck and shoulder pain. This list which I can provide to everyone if they would like to have this information, is the actual clearances by indication. There’s 14 FDA 510(k) clearances to date since 2002. As Dr. Rerucha mentioned earlier, we’re going to focus on the five that are related to pain. In January of 2002 is when we got our first FDA market clearance for the providing temporary from minor chronic neck and shoulder pain. As Dr. Rerucha referred to, that was actually our second Level 1 trial. 

When we submitted the first data in 2000, the FDA was not familiar with this much of a change and because of the data they really want us to submit another Level 1 clinical trial which they did. And in 2002 we got our first FDA market clearance. And also, as pointed out earlier, that required the FDA to actually establish a new category of a non-heat lamp type laser. So, we’re pretty proud of changing the dynamic of low level lasers as far back as 2002. In 2004, we continued to focus on pain and this was when we received the liposuction procedure for the thighs, hips, and stomach for the reduction of pain associated with the recovery process. This was our plastic surgeon, cosmetic surgeons that would use our laser prior to the procedure because they knew it would pre-load the cells and the patient would need less medication, there’d be less bruising and less scar tissue. In 2008, we received a post-surgery pain [inaudible 00:42:26] for the following bilateral breast augmentation surgery. In April 2014, reducing chronic heel pain arising from plantar fasciitis. In May of 2018, our most recent one, indication for pain, was provide relief of minor chronic low back pain.

Here are some of the published studies that are focused on these five different clearances. This is the first one, and these are published studies. You can see the reference there on the top of your screen. I have all of these studies which I’d be happy to send to you. This is the first one in 2002 for chronic neck and shoulder. And as the slide does share, this is when they did have to create the new NHN code for non-heat lamp type laser. In September of 2014, this is the study for the assisted liposuction and reduction of pain associated with surgery. It was interesting to also note that there’s 75% of participants met the major success criteria compared with only 32% of the placebo group. As we’ll talk a little bit in the slides that follow, is our placebo lasers are used with LED lights. So, as Dr. Rerucha pointed out, there is light therapy benefit but not to the degree of a true laser diode. What’s also interesting to note is that Erchonia follows in their clinical trials the patients, not only within 24 hours, this was also 7 days, 2 weeks, and 4 weeks post-surgery.

This indication is in April of 2008, this is on the breast augmentation and pain also associated with surgery. again, validating the use. This treatment was a four-minute treatment the pre and four minutes post procedure treatment. The laser was held about approximately six inches away from the targeted area. And as Dr. Rerucha pointed out and showed you on the previous slide, is that you can use the lasers…excuse me, in an unattended stand. This on the chronic heel pain, this was in 2014…Well, I guess I’m in Seattle, I’m not…I’m a little too dry, I suppose. This I wanted to point out that the patients were treated 2 times a week for 3 weeks for a total of 6, and were reevaluated 2 weeks post procedure, and also at 6 and 12 months post procedure to validate the efficiency going forward. Many doctors will ask me, “Well, how long does this is last?” And with this study, following the patient’s 12 months post procedure, you’ll notice that they went from the average of 67.8, down to 6.9. Then our most recent one for pain, the chronic low back pain. This is a treatment session of 20 minutes, and it was 2 times a week for 4 weeks, it was a total of 8 sessions. And again, during the clinical trial the patient was followed-up to this study post procedure at week 8 and measurement was noted.

One of the things I spend time with, with doctors, they’ll ask me for more information on the difference of lasers versus LEDs. Now, this is a really good article, I can email anyone that wants the link to this. Dr. Rerucha did an excellent job at pointing out the differences, but this is not an Erchonia piece, it’s actually you can find it on the internet, it’s a really good resource and explains really well the differences too. One of the things that’s we found as we do our clinical trials and we’re applying for FDA clearances is that when we talk with doctors, a lot of them will say, “Well, why are you using 635? Why are you staying with certain wavelengths?” And the reality is or the reasoning is, is because they yield results. The 635 is the wavelength that you will see in the PL-Touch as Dr. Rerucha was showing you in the slide. One of the most impactful things is that the 635 wavelength, does help accelerate DNA replication. And it’s a preferred laser for healing.

Another question we get asked quite often is, when we’re looking into the cell, the question about how much is too much? How far is it penetrate? Some of the language that you’ll encounter when you start looking at the different published articles and manufacturer to manufacturer, is the joules. And this helps, there are waves…there are internet locations out there that can help you assess how to calculate the joules when you’re doing treatment areas. And again, I have this information if you’d like me to past it on to you. There’s laser classification, there are actually laser safety classifications. And there is different locations, you can actually go to Wikipedia and you can Google low level laser safety classification. And this is also Laser Institute of America, you could look at their indications on Class 1 to Class 4 and they’ll point out the different classifications and the safety issues that might arise with the classification of lasers that you choose to use in your office.

Another common question is regarding how do I bill for this, if you choose to do…a lot of our doctors have cash plans and and a lot of them also want to bill insurance. This is a recent article by Brandy Brimhall, you may be familiar with Brandy, she speaks all over the country, and this is an excellent article that really goes into the detail on why you should be billing certain codes for Low Level Laser [inaudible 00:48:47] And I would be happy also to share this one with you. When I work with my clients and they have questions about how do insurance companies or how do you look at the efficacy for using Low Level Lasers? This is a particular paper I like to send out. It was put together by the Council on Chiropractic Guidelines and Practice Parameters. And Dr. Vernon and Dr. Mike, they actually looked at 112 articles in the literature. They choose to use the published articles and information that were only consistent with Level 1 studies for their evaluation. If you look into this article, it also…their conclusion is that laser therapy received a rating of A. They were the only thing in the modalities they looked at, and they had looked at TENS units, acupuncture, ultrasound, and the only thing that did receive an A rating was laser therapy.

We’re going to quickly go through a little bit of information about when you do [inaudible 00:49:56] Erchonia client, how your support continues long after your purchase of the laser. We have over hundreds of seminars across the country, this is just a lineup, you probably recognize some of these folks. Dr. Murphy, Dr. Rerucha, Dr. Rob Silverman, Dr. Trevor Berry, Dr. Scott Tauber, and Kirk Gair. And these seminars, they’re accredited, they’re all available for 12 CEs and we continue to touch on many different aspects of practice of how you integrate laser. Whether you’re sport, performance, neurology, whiplash, or nutrition, laser fits in, it never replaces the current care you’re giving it just adds to this. This is just, the next couple slides just shares with the upcoming dates. If you would go to the erchonia.com/seminars, you will see a list of all the seminars for this year and there may be one that might be close to you.

Erchonia continues to do on their platform educational webinars and we archive these also. These are always available to our clients, or doctors that are interested in learning more. One of the things that Erchonia has instituted on some of our select lasers. There are clinical education development coordinators that are actually assigned to specific laser clients, and they’re there to help and cover education and ongoing training. When the laser is shipped and then received, there are follow up with any of the regional representatives and internally also. We have the webinars, we have our website where you can see find the provider, there are a marketing portal, and again, our dedicated clinical education development coordinators. One of our most valued, I would say assets, is a doctor marketing portal. We go beyond and help the doctors, be able to put information out to the community whether they’re using social media or they just want to email to their current database. We have that information available for them on our marketing portal. Erchonia started over…well, this would be their 18th Annual Golf Tournament which is a fun sharing of information this year in Florida. We will actually incorporate our Thursdays are our cocktail party, Friday they have the golf tournament. And then the weekend is followed with a 12-hour class with Dr. Dan Murphy and Dr. Rerucha, doing a 12-hour laser course. More information if you would like to find out a little bit more. This is also, whether you play golf or not, or if you want to put a foursome together, this is a fun way to visit with the company and also improve your golf game.

Okay, as we finish up here, I want to quickly share a little bit of the PLT pricing and return on your investment. Probably what the most important thing to share with you, if you’re considering at all moving forward with the laser, they have a significant sale right now on the PL-Touch that we’ve been highlighting. It is $3,000 off. This is the one that’s picture in the slides. As Dr. Rerucha did, we can actually add on to your purchase an unattended laser stand. An easy way to get in if you want to hold on to your capital is doing a lease-to-own. It’s a very simple process, you can apply online our one page application and you can actually get same day approval and you can choose your terms from 12 to 60 months. This is just an example, once you’ve been approved, you can do one payment, no payment down, 90 days delay. Or in some cases on approved credit, you can do as simply $99 for the first 6 months. And then your regular payment would kick in in month seven.

Just to quickly show you that most of the doctors that I deal with on the average, they will report to me that they earned anywhere from $1400 to $2000 a month on their laser income. This is a simple statistic here that shows if you use the laser 4 times a day, that’s 60 times per week at even at conservative $25, you can quickly see that annually is $20,800. And if your lease payment in most cases run around $212, that’s an avenue, your revenue adjusted after your payment, of over $18,000. This is an important screen because this tells you all the external, regional representatives for Erchonia. You see myself down there in the bottom right. But we have Malia in the Southeast, Shawn Bean n the East Coast, Penny Sneed in the Southwest, and Kimberley Hayden in the Midwest. You may recognize some of those folks, so please feel free to reach out to them. Here is the contact information for Erchonia corporate office. And I thank you for listening to me today. I hope I didn’t crack up too much there, and you were able to clearly hear what I had to share. But again, we’re here to share more information with you if you want any of the information I covered today. And Rick, I’m going to turn it back over to you for some questions that the doctors and attendees might have.

Rick: Thank you to both representatives. This has been extremely informative. We’ve been collecting some questions from our audience and we’ve got about four minutes. The first one, does Low Level Laser Therapy cause heating of the tissue?

Dr. Rerucha: So, with true Low Level Laser Therapy the answer is no. So, anytime you do start getting a warming of the tissue that would exceed what the definition of true Low Level Laser Therapy is which is completely photobiological, which means there’s no heating of the tissue, it is all based upon absorption of the energy, tissue regeneration, and everything explained in creating the ATP synthesis, but there is no heating of the tissue.

Rick: Thank you. And one more question for the doctor. I know the benefits of laser, how do I explain, best explain them to my patients?

Dr. Rerucha: That’s a great question. So, out of 6700 research papers, it comes down to 2 simple concepts. So, I tell everybody in my classes to rehearse this as part of your simple report of findings. So, whenever a clinician or patient asks me, how do lasers work? I say, lasers work on two basic principles. Lasers work by increasing the energy necessary for injured cells to heal and regenerate. And lasers also help injured cells communicate better. So, every research paper you will see come down to those two principles. They may change what’s being measured such as circulation, ATP, nitric oxide, all sorts of things. And if you really want to keep it simple just to your patients, lasers work by increasing the energy necessary for injured cells to heal and regenerate. And that’s it, and that’s a completely accurate statement.

Rick: Thank you so much, Doctor. We’ve run out of time, we did have a couple other questions, but we’ll post the questions and answers on the CE website and they’ll be included in the transcript emailed to attendees. At this time we’d like to thank our sponsor, Erchonia and Dr. Jerome Rerucha for today’s webinar. Remember, this webinar, including our speakers’ PowerPoint presentation has been recorded. We’ll alert you when the webinar is available online. Thank you again for attending and we look forward to seeing you next time. Have a great day.