Do’s, don’ts and dosing for low-level laser therapy to help reduce inflammation and speed healing when treating arthritis and neck pain
Low-level laser therapy helps many conditions and can be a valuable tool for combating arthritis and neck pain, particularly when inflammation is involved. This therapy provides a non-invasive and quick treatment for many people.
For patients, arthritis really is a pain in the neck.
How common is arthritis and neck pain?
It’s widespread. Between 50-85%1 of all people will have experienced some form of neck pain during their lifetime. Many of these people will seek out some form of treatment, whether it be from over-the-counter pain relief to chiropractic, and even surgery.
Fortunately, many of the causes of neck pain can be cured with non-invasive therapies (see below).
Symptoms of neck pain include:
- Pain worsened with holding your head in one place (driving or working at a computer)
- Muscle tightness and spasms
- Pain or numbness in arm(s) or hand(s)
- Reduced neck or head rotation
- Headache
For some people, several causes of neck pain, such as poor posture and injury, will eventually develop arthritis. Arthritis in the neck is very painful and can cause significant other problems if left to degenerate over time. That’s where chiropractic steps in and can help reduce pain and degeneration, both through manual methods and by assisting people in learning better habits.
Causes of neck pain
Unfortunately, there are many causes of neck pain, and often, no one particular cause is the direct link to a person’s neck pain. Instead, most people experience several of these issues over time from:
- Poor posture
- Strain/sprain (previous whiplash)
- Obesity
- Previous injuries
- Nerve compression
- Muscular tension
- Disc herniations
- Radiculopathy
- Arthritis/degeneration
- Spondylolisthesis
- Tumors/cancer
Most of these issues can be helped with chiropractic treatments. Even obesity can be helped by educating patients on proper nutrition and the need to begin a more proper exercise routine. A holistic approach will include several therapies that target the different potential causes.
Differentiating arthritis
It’s important to distinguish between the two types of arthritis before treatment:
Osteoarthritis — Osteoarthritis comes from repetitive motion or injury degrading the connective tissue or cushioning tissues between the bones. Typically, osteoarthritis occurs in specific joints or sections of the spine most prone to movement. Chiropractic can be a significant help, helping to relax the joints, providing space to reduce inflammation, and offering corrective devices or exercises to reduce the damage.
Rheumatoid arthritis — Rheumatoid arthritis is an autoimmune condition where the immune system attacks the connective tissue, cushioning tissues or fluids between or around the bones, resulting in a degradation of the tissues. Chiropractic treatment can potentially increase the damage if a systematic reduction in inflammation throughout the rest of the body is not addressed first.
LLLT as a treatment option
The emerging field of low-level laser therapy provides a chiropractor with a non-invasive option to help reduce inflammation and increase the healing and repair of tissues when dealing with arthritis and neck pain. It can reduce pain and disability2 when used at 4-8 joules with a 785-860-nanometer wavelength. It’s also effective at 1-3 joules with a 904-nanometer wavelength.
Some studies3 show increased tissue repair and even the potential for tissue replacement using LLLT. In addition, other studies indicate varying the wavelength and using different pulses can increase the healing effect and longevity of the treatment.
LLLT shows significant anti-inflammatory effects, particularly against the inflammatory cell infiltration and cytokines 24 hours after treatment4. The studies show that low-level laser power is more effective than higher power settings. Longer treatment cycles, and more frequent treatment cycles, produce longer-lasting relief as time goes on.
This is significant for people with rheumatoid arthritis, as the inflammation around the joint can increase the degradation and immune effects on that particular joint. When combined with proper rheumatology treatment, a reduction in inflammation can slow down the progression of arthritis.
In the case of osteoarthritis, reducing pain can help increase a person’s likelihood of exercising, which can significantly reduce the causes of pain and degradation. Therefore, it can be an effective tool for a chiropractor as part of a holistic treatment that combines LLLT with behavioral modifications, such as proper posture education, exercise and weight loss education. In addition, reducing issues such as nerve compression, herniation and other treatable disorders with more traditional chiropractic techniques can enhance the effects of LLLT, and vice versa.
An LLLT dosing protocol
Although every treatment is different, and the various models offer variation, general clinical guidelines are accepted when using LLLT:
- Initial doses should start shorter and weaker initially until it is established a person’s sensitivity to the lasers.
- More frequent doses are recommended, as they show better outcomes.
- Photochemotherapy, the general stimulation of blood flow by light therapy, should be included — 50 Hertz for five minutes or 30 joules to the proximal artery of the affected joint — as blood flow helps reduce inflammation and increases repair of tissues.
- Once the initial symptoms are resolved, a recommendation for preventative treatment can help keep the inflammation reduced and mobility intact.
Some success has been reported in extending the treatment down the spine and over the shoulders to particularly vulnerable areas and muscular areas where the pain originates. The therapy on the shoulders, down the spine, and even into the hips and legs shows some success in relieving arthritis and neck pain. However, that is up to the individual chiropractor and person treated to determine its usefulness.
Caution needs to be used with laser therapy, as it can cause damage to arteries and nerve tissues. This is particularly important when dealing with neck pain, as most laser therapy is contraindicated for use near the brainstem.
LLLT can be effective for both arthritis and neck pain when used correctly and in conjunction with other therapies a chiropractor can provide. Understanding the origin of the pain and the corrective measures being taken can provide longer-lasting recovery and higher patient compliance.
ANTHONY CRIFASE, DC, CNS, DACBN, is double board-certified in clinical nutrition and maintains an active virtual functional medicine and chiropractic practice. 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
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2974793/
- https://bmjopen.bmj.com/content/9/10/e031142
- https://www.fallingwaterscenter.com/services/laser-therapy/laser-research
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3978432/