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Old 06-28-2007, 05:41 PM   #1
Garrett Smith
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Thumbs up FAQ I'm preparing on laser therapy...

For those who didn't know, I recently purchased a Low Intensity (aka "cold") Laser Therapy practice from a chiro here in town. I wouldn't have bought it if I hadn't seen it work. Anyway, I'm making an FAQ about LILT for my patients, figured I'd post it here so that anyone who wanted to read it to learn more about it or to offer any suggestions (I'd like to make it shorter, I may take out the BioFlex-specific stuff at the end), feel free. Much of this is directly borrowed from various parts of the www.Meditech-BioFlex.com website, I have just rearranged it quite a bit to my liking. Enjoy!

What is a laser?

The word laser (technically "L.A.S.E.R.") is an acronym for Light Amplification by Stimulated Emission of Radiation. A laser emits electron particles known as photons, which exhibit the characteristics described below:

Monochromaticity: In laser light, all electromagnetic waves have the same wavelength and therefore, the same color.
Coherence: All the photons in laser light oscillate in the same phase.
Directionality: Laser emission is highly directional and can be collimated (lined up in parallel).
Intensity: The primary advantage of lasers is the high intensity directed at a small area (i.e. the focus of the pathology).

Photons are particles of energy that are absorbed by a variety of micro-molecules within the cell, a process which initiates a number of positive physiological responses (for the full list, see below). In essence, this light energy is converted into biochemical energy, resulting in the restoration of normal cell morphology and function. The monochromatic, coherent, and polarized characteristics of the therapeutic light beam permit penetration of deep tissues without affecting normal cells.

What is Low Intensity (aka "cold") Laser Therapy?
Low Intensity Laser Therapy (LILT) is the use of monochromatic light emission from a low intensity laser diode (250 mW or less) or an array of high intensity superluminous diodes (providing total optical power in the 10 to 2000 mW range). The light source is placed in contact with the damaged tissue allowing the photon energy to penetrate to various levels.

There are two types of diodes used in LILT:
1) Superluminous Diodes (SLD) are designed for the treatment of a large surface area. Less powerful than true laser diodes, these diodes applied safely in larger numbers over a wide area. These include red and near infrared diodes.
2) Laser Diodes (LD) have higher power output and narrow beams, making them ideal ‘laser probes’ for deeper penetration and for targeting localized, focal pathologies. Again, this includes both red and near infrared diodes.

What does Low Intensity Laser Therapy do?
By affecting and reversing the offending pathology at the cellular level, LILT optimizes the restoration of normal cellular morphology and function, along with enhancement of the body's natural healing processes. Through the restoration and enhancement of these processes, symptoms disappear. The beneficial effects of laser therapy are cumulative over the course of a
series of treatments.

Light in its various forms has been used for healing from the time of the ancient Egyptian and Greek civilizations. With recent advances in the engineering of devices and the development of appropriate protocols for effective therapeutic applications, dramatic benefits and treatment of many complex medical conditions are achievable.

How is Low Intensity Laser Therapy different from other lasers?
High power or thermal lasers can produce a substantial amount of heat. This destructive potential makes high power laser a key component in industrial applications such as cutting and welding. Thermal laser combines power and precision and therefore has many beneficial uses in surgical and ablative procedures.

Unlike thermal lasers, the low intensity laser beam is 'soft power', athermal (without heat) and can stimulate cellular regeneration and natural healing. Red and infra-red lasers with power outputs in the range of 10 to 250 mW belong in this category, in addition to superluminous diodes up to the 2000mW level.

Low intensity laser energy stimulates cellular function at many levels including metabolism; in essence it promotes the initiation of multiple physiological and beneficial effects in the repair and function of human cells. LILT is widely used in the medical and cosmetic fields, principally because it is non-destructive to the target tissue*, while positively affecting many functions such as collagen formation, cellular metabolism, angiogenesis, lymphatic flow, etc.

What conditions have been successfully treated with LILT?

General

* repetitive stress injury
* carpal tunnel syndrome
* rotator cuff tear
* fibromyalgia and chronic fatigue syndrome
* reflex sympathetic dystrophy
* temporo-mandibular joint (TMJ) dysfunction
* headaches & migraines

Injuries

* ligament and tendon tears
* sprains and strains
* fractures with associated soft tissue injuries
* facet joint syndrome
* bulging and herniated discs
* contusions/bruises

Inflammatory

* any type of "-itis": tendonitis, myositis, synovitis, bursitis
* epicondylitis
* plantar fasciitis
* osteoarthritis and rheumatoid arthritis

Degenerative

* chondromalacia patella
* discogenic and vertebrogenic radiculopathy
* spinal stenosis
* calcifications (e.g. bone spurs)

Other Applications
* accelerated and improved post-surgical healing
* wound healing
* dermal ulcers: venous stasis, atherosclerotic, contact, diabetic, traumatic
* burns: thermal or chemical
* lymphedema (acute & chronic)
* dermatology: scar tissue, stretch marks, herpes zoster (shingles), ezcema, psoriasis
* gout
* lymphedema
* neuropathies (diabetic, etc)

What are the physiological effects, demonstrated by research, of LILT?

Short Term Effects
Production and release of beta-endorphins (these are morphine-like substances produced by various cells in the body that inhibit the sensation of pain).
Cortisol production is increased (cortisol is the precursor of cortisone). This enables the body to combat the stress associated with trauma or the disease process.
The short-term effect is significant in 5-10% of cases during or after the conclusion of the initial treatment, but is not as important as the long term or cumulative effect.

Long Term Or Cumulative Effects
ATP (adenosine triphosphate) production is increased resulting in improved cellular metabolism
DNA (deoxyribonucleicacid) production, the protein building block of tissue, is substantially increased
Neurotransmission is facilitated due to elevated levels of serotonin and aceytylecholine
Mitochondrial activity is stimulated resulting in cell replication etc. (i.e. replacement, regeneration and repair of abnormal cells)
Modulation of macrophages, fibroblasts and other cells
Angiogenesis (formation of new blood vessels)
Regulates cell membrane potential, essential in Na, Cl and K ion transfer (electrolyte balance)
Cytokines and other chemicals enhancing cellular communications are released

Other Effects
The immune response is stimulated
Lymphatic drainage is improved
The histamine response is positively altered
Production of growth hormone is increased
The body's natural healing processes are enhanced

The beneficial physiological changes noted above are the result of tissue regeneration and cellular stimulation. Many other positive activities are modulated including the humoral immune and cerebrospinal fluid systems. These effects are highly significant and are currently under investigation in research laboratories in order to accurately delineate the scientific aspects of this process.

What are the advantages of Low Intensity Laser Therapy?
Non-invasive
Non-traumatic
Non-toxic
Easily applied
Highly effective
No known negative side effects

How does LILT compare with other conventional treatments?
For many years, rehabilitation therapies including ultrasound, EMS (electrical muscle stimulation) interferential current, and TENS have been used extensively throughout the world to treat pain and stimulate the healing process. Unlike LILT however, the healing effects of these treatments have been disappointing as they appear to modulate symptoms only. In contrast, LILT is able to influence the pathology directly at the cellular level, resulting in therapeutic benefits that are more profound and indeed curative. Frequently alternative therapies act as counter-irritants, creating a transient increase in arterial circulation and the release of endorphins, providing temporary symptomatic relief only.

How long does a treatment take?
Treatments are typically 30 minutes to one hour in duration for any particular condition or patient.

How many treatments are needed?
The number of treatments will vary with regard to the individual's presenting problem(s). Just as every medical condition varies, so will the individual response to therapy. In a recent clinical report summarizing over 1000 patients treated with the BioFlex Professional LILT system at time of discharge, patients had averaged slightly less than ten treatments to resolve their condition completely.

How much is a treatment?
Treatments at our clinic are $55 per half hour treatment. Treatments are scheduled for either a half hour or an hour, depending on the situation and number of areas that require treatment.

Is the treatment covered by medical insurance?
Insurance coverage varies. We provide patients with the necessary documentation to allow them the opportunity to bill their insurance plan on their own. Payment for provided services is required at the time of treatment.

What about the negative effects of radiation?
LILT produces radiation as photon energy in the visible and near infra-red regions of the electromagnetic spectrum. Worldwide research conducted over the past thirty years indicates that normally functioning cells are not adversely affected by this type of irradiation. Unlike other forms of radiation, i.e. x-ray, etc., this process is beneficial rather than harmful to tissue.

Are there any contraindications, or reasons not to utilize LILT?
Yes, there are two basic contraindications. *Patients on photoactive (sensitive to light) medication and women in their first trimester of pregnancy. Appropriate clinical factors vary and must always be considered.

What is the BioFlex Professional LILT System?
BioFlex is a highly sophisticated therapeutic device that combines the potential benefits of both low intensity laser with superluminous diodes for the effective treatment of many medical disorders. Developed and engineered by Meditech International Incorporated, BioFlex represents the decade's most significant technological advancement in LILT. Indeed, it is felt to be an important 'new therapeutic dimension'. It is the major LILT system in use in this office.

BioFlex has been cleared by the FDA, Health Canada and has been granted the CE mark of approval for distribution in the European Economic Community (EEC). It has also met the manufacturing standards of UL and ISO. LILT has been endorsed by the American Academy of Pain Management as a safe and effective form of treatment for pain.

Where is BioFlex in use today?
Across Canada, the United States, Europe, South America and Asia, BioFlex is being used by an increasing number of physicians, chiropractors and physiotherapists. In the twelve years that the therapy has been available at the Meditech clinics in Toronto, more than 100,000 patients have received successful treatment with the BioFlex and its predecessor systems.

The technology is currently being utilized in thirty countries. The Toronto Raptors and The Miami Heat of the NBA, The Toronto Maple Leafs and the Toronto Blue Jays, have also used BioFlex for their injured players with excellent results. In addition, many athletes from the world of golf, hockey, tennis and increasingly ballerinas, figure skaters, gymnasts and other performers in artistic sports are experiencing the positive effects of this therapy.

Where has clinical research on BioFlex been conducted?
Ongoing clinical research of various disease entities is conducted onsite at Meditech's two rehabilitation centres. Several controlled studies have been performed since 1996 using the BioFlex Professional System; two of these involved experimental models of Delayed Onset Muscle Soreness (DOMS) and Rheumatoid Arthritis. The outcomes of both studies showed BioFlex producing significant and positive results. A synopsis of these studies is available on our website.

Meditech has also embarked on an extensive program of beta testing of the BioFlex user protocols. In January, 1997, two BioFlex Professional Systems were placed in beta sites, one at the University of Toronto in a teaching hospital and one at the University of Ulster. Additional research is being conducted in private clinics. Results from all centres have indicated that the benefits derived from the BioFlex Systems are both positive and dramatic.
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Old 06-30-2007, 07:16 PM   #2
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i regularly get laser at PT, primarily on wrists and elbows, more for maintenance than specific injjury treatment. i'm convinced it helps.
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Old 07-01-2007, 10:26 AM   #3
Mark Gebhard
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A laser emits electron particles known as photons, which exhibit the characteristics described below

Yes, I'm being pedantic, but...

This was distracting to me. Photons are different than electrons, so maybe say, "A laser emits electromagnetic particles" or maybe just "emits particles." Scientific errors, even if they're minor, kill credibility for me if I'm skeptical going in.
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Old 01-30-2008, 11:02 AM   #4
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Garrett,
I'll be adding a post for you on another topic, but I'd like to know more about this therapy... how do we find it in our area (besides a Google search). Do most chiro's carry one (mine does not)?

How do we bring up the topic as it pertains to "maintenance" as Gregg does?

Thanks for your time!
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Old 01-30-2008, 02:24 PM   #5
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John,
First place to look for a practitioner who uses the same equipment I do is at www.meditech-bioflex.com . Let me know what you find in your area.

For more info/research on LILT, go to www.healinglightseminars.com and have a look around, definitely check out the "Laser Research Library" link. Good stuff there.

Or Pubmed "low laser" in combo with the technical name of a condition you want to look up. For example, search "low laser diabetes". Look for lasers that are between 600-900nm in wavelength.

Using that approach, I accumulated about 50-something studies on LILT and gums/jaw treatments. I may present on this topic to the local dental study group!
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Old 01-30-2008, 05:42 PM   #6
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Mark, I just saw your comment. Thank you, that's a good point. I'll fix that for the future.
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Old 01-30-2008, 05:55 PM   #7
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Thanks!
Just did a quick check and here's what I found...
Chiropractic Health Services
David Williamson D.C.
3200 Guess Rd
Durham NC 27705

About 2 hours from me.....

I'll look into it and see what happens.
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Old 05-12-2008, 06:18 PM   #8
Joyce Behrendt
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Thanks for posting this, Dr. G. I had not heard of it.

Have you treated any diabetic patients for neruopathy with this? What about frozen shoulder?

The Rebuilder is another gadget that can help rebuild nerves and reduce or eliminate pain. Have you heard of that? and how do you think it compares with LILT?

http://www.rebuildermedical.com/
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Old 05-12-2008, 07:52 PM   #9
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Joyce,
I do treat diabetic neuropathy with LILT--the most important part to prevent re-occurence being the "meat and veggies" diet prescription. It's like putting new tires on a car that still has bad alignment--the problem is going to re-occur unless the cause is dealt with.

Frozen shoulder can be treated with LILT, absolutely. B12 injections can help significantly in some cases as well.

I don't see why the Rebuilder couldn't work, I'd like to see some more research on it. It's in the "energy" realm of medical devices, like LILT, but it's a different type of application. I think LILT can be applied to a much broader spectrum of health issues.
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Old 05-12-2008, 08:22 PM   #10
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I went to see what Wiki said about LILT...
http://en.wikipedia.org/wiki/Cold_laser_therapy

Looks like it could use some expertise...
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