Light is one of the oldest therapeutic agents.
Greek physicians frequently prescribed “heliotherapy.” The use of light continued unabated well into the 20th century, when it was largely supplanted by the advent of antibiotics and anti-inflammatory medication. Einstein first introduced the concept of a laser (Light Amplification by Stimulation Emission of Radiation) in 1916, but it was not until the 1960s that it came into medical use as a focused, high power beam with a photo-thermal effect–it vaporized tissue by intense heat. In 1967, however, a Hungarian physician, Endre Mester, MD, noticed that, just as sunlight is damaging in large amounts but beneficial in small amounts, the laser, at low power, stimulated accelerated tissue healing. Thus “cold” or “soft” lasers came into widespread use in Europe. Now they are referred to as “low level” or therapeutic lasers because they produce a beam that does not cause tissue destruction or heating. In 2002 they were approved by the FDA for use in the USA. Phototherapy is defined by the North American Association for Laser Therapy as “a therapeutic physical modality using photons (light energy) from the visible and infrared spectrum for tissue healing and pain reduction.” While well established in dermatology, ophthalmology, and medical acupuncture, phototherapy is relatively new to the field of physical medicine.
All light is part of the electromagnetic spectrum, which runs from radio waves (long), to visible light, to gamma rays (short). Extreme monochromatic light (such as laser light) however, was never experienced before evolutionarily–it is a stimulus unique to the experience of any organism. The more unique the light, the more the organism is required to resort to adaptive mechanisms to resolve the energy imparted by the stimulus. For this reason, laser light is considered unique in generating adaptive, healing reactions. Injured cells and tissues emit enzymes that encourage the receipt of photons more readily than healthy cells and tissues. These photoreceptors are primarily located in the mitochondria (“powerhouse” of the cell) and convert light energy to electro-chemical energy that is, in turn, used by the cell for accelerated tissue repair and healing.
The therapeutic laser I use in my office is the MR4, manufactured by Multi Radiance Technology.
It was developed in the 1980s for the Soviet Space Program and has undergone continuous refinements since. Russia remains one of the universally recognized technological leaders in drugless modes of treatment. The MR4 was the first of its kind to combine: 1) super-pulsed infrared laser radiation; 2) pulsating broadband infrared non-coherent light; 3) pulsating red light (LED); and 4) a constant magnetic field. These four act simultaneously and synergistically to provide a non-invasive, drugless, safe, and painless method to relieve pain, reduce swelling, and promote tissue healing in both chronic and acute conditions. While the optimal wavelengths remain constant, varying the frequency provides great versatility in targeting the depth of the interface between the laser and the tissue. The simultaneous use of variable frequencies with the most therapeutic wavelengths, measured in nanometers (nm), optimizes outcomes at all depths of penetration and across the entire phototherapeutic window.
The super-pulsed laser (905 nm) exerts a powerful stimulating effect on blood circulation, cellular membrane metabolism, and nerve function without destructive thermal effects. The clinical effects, penetrating 1-13 cm, depending on the frequency:
• Stabilization of the cellular membrane
• Activation of RNA and DNA synthesis
• Reduction of edema, swelling, and pain
• Increased ATP production and cellular oxygenation and metabolism
• Increased synthesis of prostaglandins (localized hormones)
• Improved microcirculation and blood fluidity via increased histamine, nitric oxide, and serotonin
• Stimulation of T cell production
• Anti-inflammatory response via acceleration of white blood cell activity, enhanced superoxide dismutase levels, and decreased levels of interleukin-1, C-reactive protein, and neoptorin.
The non-coherent infrared light (875 nm) exerts a powerful harmonizing influence on the central and autonomic nervous systems and:
• Provides gentle heating of the surface tissue layer • Improves microcirculation
• Stimulates epithelial cell growth and regeneration • Reinforces laser penetration into target tissues
• Acts upon pain receptors in the skin, raising their pain threshold
The non-coherent red light (660nm) has superficial penetration and provides:
• Localized pain relief • Improved microcirculation • Reduction of swelling
The static magnetic field holds the laser ionized molecules disassociated, with the following therapeutic effects:
• Increase of energetic molecular and cellular potentials • Improved tissue trophism
Additionally, the MR4 I use is the newest model and employs what is known as SKENAR technology, also developed as part of the Russian space program.
This technology is a built-in electromagnetic sensor that provides feedback on changes in the physiology of the skin surface to help identify areas with underlying inflammation, muscle trigger points, aberrant acupuncture points, etc. that can be identified by changes at the surface. This allows maximum treatment time at the localized areas that are most involved in the injury rather than treating a larger and less specific area in a “shotgun” or “zone” approach traditionally used in laser therapy.
The medical conditions that respond to laser therapy include soft tissue injuries such as:
• Sprains/strains • Carpal tunnel syndrome • Repetitive use syndromes
• Tennis elbow • Myofascial and muscle injuries and trigger
• Chondromalacia patella • Plantar Fascitis • Disc Protrusion
• Sciatica and other nerve pain syndromes
Degenerative joint conditions such as rheumatoid arthritis and osteoarthritis, the neurogenic pain of shingles, trigeminal neuralgia, diabetic neuropathy, reflex sympathetic dystrophy, and complex regional pain syndrome, and chronic non-healing wounds such as venous ulcers, burns, and diabetic ulcers also respond well to laser therapy. Since it is conducive to healing of epithelial tissue, it is even beneficial for infections or other inflammations causing sore throat or other inflamed tissues in the mouth.
The complete treatment protocol may incorporate not just the local area of complaint but also the lymphatics, innervating spinal segments, acupuncture, auriculotherapy, foot refloxology, and/or Korean Hand Therapy points that may be associated with that area. Naturally, I am using the MR4, when appropriate, as an adjunct to my normal course of manipulation and other manual therapy procedures.
While there is often improvement following the first treatment, there is a cumulative improvement with successive treatments, ideally spaced 1-2 days apart. The number and frequency of treatments needed to note improvement varies depending on the condition and the health status of the individual. Typical treatment time is 15 minutes. While there are no known side-effects, because the treatment activates the immune system, chronic conditions may occasionally become more acute briefly as the healing response is induced to resolve the condition.
