Wednesday, July 8, 2009

Cold laser therapy. How does Cold laser therapy work? Cold laser for Carpal tunnel syndrome in NYC

Cold laser therapy. How does Cold laser therapy work? Cold laser for Carpal tunnel syndrome in NYC.

More and more people are learning about the benefits of cold laser therapy for a variety of conditions ranging from carpal tunnel syndrone to back and knee pain.
The article below describes in detail the mechanics of how this treatment works.
I have been using cold laser therapy in my Manhattan practice for years.

Healed by the Light
By Jeffrey M. Nelson, MD and Karen P. Nelson, MA
The cell is a machine driven by energy… In every medical tradition before ours, healing
was accomplished by moving energy.
- Albert von Szent-Györgyi (1967)
Light energy has been used for healing since the earliest recorded medical history, but
has gone out of favor in Western medicine with the advent of the existing paradigm of a
more surgical and pharmacological basis. Recently, a shift in thinking has been emerging
with an explosion of research, exploration and utilization of energy medicine modalities
such as micro-current stimulators, bone growth stimulators, broad-spectrum multiple
frequency Tesla coil devices, and low-level or cold lasers.
Despite years of research demonstrating the benefits of low-level laser therapy (LLLT) as
a modality for wound healing, Western medicine, and its adjunct professions, have been
slow to adopt this technology. LLLT has been an essential part of therapy for
practitioners around the world for almost 20 years, but it is only recently catching on in
the United States. Still, the vast majority of students of medicine and allied health
practices in this country are not being taught its efficacy and use. It’s time we opened our
eyes to the light.
One of my first eye-opening experiences with LLLT in wound recovery was with a burn
patient. As a plastic surgeon and medical director of a burn and wound center, I see large
numbers of acute and chronic burn injuries as well as wounds of various etiologies. One
particular gentleman had a home fire that melted his carpet and he was forced to walk
across it in bare feet to get out of his home. He presented with very deep foot burns and
severe pain. He was on chronic narcotics due to an old back injury, so I knew his pain
would be difficult to manage. At presentation his pain was exceptionally severe and the
bottoms of his feet were purple, swollen and sloughing skin. Within two minutes of
treatment with the 635nm Erchonia® cold-diode laser his pain decreased by a selfreported
75%, and his skin went from blue and purple to pink right before our eyes! As
you can imagine, our jaws dropped and this particular laser therapy has been a part of my
practice ever since.
How It Works
The exact mechanism of action of LLLT is not completely understood; however, there
are several theories based on cellular research conducted over the last two decades or
more. The basic premise is that LLLT stimulates cell activation processes which, in turn,
intensify physiologic activity. Healing is essentially a cellular process and light energy
initiates a cascade of reactions, from the cell membrane to the cytoplasm, to the nucleus
and DNA. This is called cellular amplification; a phenomenon whose demonstration
earned the Nobel Prize in Physiology or Medicine in 1994.
There are many biological processes that take place in tissues that have been shown to
respond to LLLT in the 630-640 nanometer wavelength range. One of these processes is
the enhancement of ATP production in the mitochondria, which provides more energy
substrate for cellular healing and tissue recovery post injury. This wavelength has also
been shown to decrease inflammatory mediators in wounds and increase endogenous
endorphin release.
When one considers that wounds have varying degrees of cellular and vascular damage,
the wound site can be in a potentially anaerobic state. Cells deprived of oxygen or blood
supply have a potential to increase lactic acidosis and therefore amplify local cellular
damage. Normal physiologic healing requires growth factors and cytokines to be released
at the wound site. These cell mediators call inflammatory cells to the wound which clean
up damaged tissues, fight bacteria, and stimulate fibroblasts and vascular cells to grow to
try to heal the zone of injury. The physiologic concept is that LLLT improves cellular
metabolism and accelerates the process of debris cleaning, improves neutrophil bacterial
clearing and hastens cellular division. Therefore, all stages of wound healing; hemostasis,
inflammation, cell proliferation and migration, collagen synthesis, wound contraction,
and wound remodeling proceed more rapidly and more efficiently.
A key issue to understand is that LLLT, as a category, covers a broad range of
wavelengths. Individual wavelengths have individual physiologic results. The 635 nm
wavelength is the monochromatic output that has been shown to be the best wavelength
for improving cellular metabolism and therefore, improving wound healing.
Another important property of an effective laser is that it be a true laser, which, by
definition, produces the emission of coherent light, generated at a precise, stable
frequency, in a focused direction. Products that use Light Emitting Diodes (LEDs) are not
true lasers. They produce non-coherent or random light, generating random frequencies.
Coherent light energy is critical when treating the human body.
One more consideration is the optimum power necessary for bio-stimulation. The Arndt-
Schulz Law of photo-biological activity, essentially states that “less is more” when it
comes to energy for improved cellular physiology. The Erchonia® LLLT provides the
best wavelength (635 nm) for cellular physiology at very low energy (2-5 mill Watts) to
stimulate cells to function better. If the stimulation is too intense, there may actually be
an inhibitory effect, or possibly degeneration or destruction of cells.
Healing Research
Our research with burn patients demonstrates several advantages to the 635nm LLLT in
burn/wound management. The most immediate advantage is an average of 70% decrease
in pain at the wound site within 5 minutes of a two-minute treatment per 4% total body
surface area (TBSA). Other research has shown that LLLT increases natural endorphins
in patients. This increase in endorphin release would explain why we often see decreased
pain for days at a time. I believe we are also seeing an immediate decrease in sensory
nerve stimulation and a decrease in sympathetic stimulation. This decrease in sympathetic
tone and sensory nerve stimulation provides the decrease in pain within minutes. During
our studies with burn patients we noticed that they had less swelling in their wounds,
visibly improved perfusion (blood supply) to the tissues and faster healing. When patients
have continued LLLT and we follow them post-healing, they have less scar formation
and less purritus (itching) in their scars. Currently, we are undertaking a multi-center,
double-blinded trial that will explore the potential of LLLT in healing burn injuries and
decreasing their late complications.
Our success with the burn-injured patient led us to apply LLLT to the management of
other complex wounds. Some of the wounds we have treated include diabetic wounds,
decubitus ulcers, post-orthopedic surgery wounds and skin and myocutaneous flaps. We
use the laser to decrease inflammation, improve tissue perfusion and decrease pain at the
wound site; each a tremendous advantage to the patient and the treating practitioner.
Complementary Advantages
The Erchonia® laser’s first FDA approval was obtained for the management of neck and
back pain. The advantages in improving musculoskeletal pain carry over to the physical
therapy and occupational therapy arenas. We have found in our clinical work that
patient’s stiffness and sense of tissue tightness greatly decreases after LLLT treatments.
Typically, an improvement of 30-50% occurs with just one treatment. Many extremity
wounds have long periods of immobilization associated with them; from splinting,
surgery, or just a protective mechanism of pain control. LLLT treatments increase the
patient’s recovery of range of motion (ROM). This mechanism of improved ROM is
separate from pain control and protective issues. Later, after a burn or wound injury,
many patients will report no pain, but have problems with tightness and stiffness. Within
minutes or hours of LLLT treatments they report significant (>30%) improvement in the
tightness. We have also found that many patients may have a functionally normal ROM
by goniometer measurements, yet feel very tight or stiff. The LLLT greatly improves
their subjective assessment of tightness, however their ROM may remain the same.
Basic Mechanics
The Erchonia® laser is a very portable, user-friendly, hand-held unit. Treatments take
about 5 minutes total on average, so it fits easily into a clinical treatment schedule.
Erchonia® laser can be used with full contact with the patient if needed, but most
treatments are done about 6-12 inches away from the surface area so there is no crosscontamination
if the patients’ wound is colonized with resistant bacteria. LLLT can be
used in the setting of open wounds, burns, tissue injury, surgical recovery, neuropathy,
deep tissue injury or active infection. There is no known “tissue problem” that is a
contraindication; however, I would not suggest treatment of a known active cancer until
more studies are done specifically in cancer cells. To date, there is no evidence that
LLLT converts normal cells to cancer cells.
LLLT can be used near and over hardware such as artificial joints. Pregnancy is not a
contraindication, but it is suggested that a pregnant patient not be treated due to
medical/legal issues. Though there are no known problems with the use of LLLT on a
patient with a pacemaker, it is not suggested that it be used directly over the pacemaker
or pacemaker wires.
LLLT can be applied through dressings and clothing, though, in my practice, I like to
observe the areas when treated. In the physical therapy setting this is important because
dressings or garments don’t always have to be removed. The number of treatments
depends on the problem being addressed and may be as little as one and as many as 20
spread over several months.
There can often be increased exudate in an open wound for LLLT increases tissue
perfusion which can increase wound fluid. Pain at the treatment site is rare, but can occur
on occasion with a mild increase in pain that then significantly resolves in 1-2 hours.
As a plastic surgeon in charge of a burn and wound center for many years, I have had the
opportunity to assist multiple patients with pain management, wound healing and
physical recovery with the use of 635 nm LLLT. This modality has been the best new
technology I have had to offer my patients in the last decade. It is my hope that others
will latch onto this technology and bring it forward, for it is a completely non-invasive
option that provides so many physiologic advantages with no apparent side effects.
Dr. Jeffrey Nelson is a plastic surgeon who has been involved in wound healing for more
than 20 years and is currently the Medical Director of the burn and wound center at St.
Mary’s Hospital in Tucson, Arizona.
Karen Nelson has an advanced degree in physiology and is working as a medical writer
in Tucson, Arizona.
Chiropractic,Physical therapy,Pain management,Spinal decompression.
Visit website at
It's unlike any treatment anyone has ever experienced.

Cold Laser Therapy can:

(1) REDUCE PAIN by stimulating cells to produce their own
endorphins, a natural painkiller,
(2) PROMOTE FASTER HEALING by stimulating cells to
increase the production of two major healing enzymes by as much
as 75%,
(3) REDUCE INFLAMMATION by as much as 75%,
(5) RELAX MUSCLES and muscle spasms,
(6) DECREASE SWELLING by stimulating lymphatic drainage,
(7) ENHANCE THE IMMUNE SYSTEM by increasing the number of "killer" cells by 400-900%, and most importantly,
(8) RE-ENERGIZE CELL MEMBRANES to allow transport of essential nutrients across cell walls (nutrients will not cross an injured or sick cell wall, thus slowing healing) allowing a healthy new cell to grow.
To sum it up, if you are suffering with pain consider cold laser as a treatment option.
Cold laser for carpal tunnel in NYC

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