Friday, September 28, 2012

Laser Therapy for Wound Healing & Plastic Surgery Recovery

Laser Therapy for Wound Healing & Plastic Surgery Recovery


excerpt taken from Dr. Toshio Ohshiro's paper: "27 YEARS OF LASER TREATMENT: A PERSONAL PERSPECTIVE"

Plastic Surgical Applications of Laser Therapy

After the success of laser therapy in both the pain clinic and dermatology, I moved on more or less in parallel to a number of other indications. In plastic surgery I looked at a number of indications, including flap and graft problems and their solution; wound healing acceleration; control of severe ulcer formation; tissue welding and so on. Failing grafts and flaps due to vascular compromise are a major problem for the plastic surgeon and dermatologist.

Together with my colleague Dr Junichiro Kubota I started in the early and mid eighties-a series of rat experiments to assess the use of LLLT in promoting flap survival. (22) The findings proved that there was a laser-specific reaction in the laser therapy treated flaps compared with the untreated control and non-laser but same wavelength light irradiated animals. We found better earlier perfusion (Figure 24), better angiogenesis (Figure 25) and better flap survival (Figure 26) in the laser-treated group compared with the other two, but no difference between the untreated and non-laser treated group. Subsequent studies using laser speckle flowmetry have corroborated the earlier studies, and clinical experience has borne out the experimental data.(23,24)

Figure 27, courtesy of Dr Yu Maruyama, shows LLLT (830 nm, cw, 60 mW, contact method) saving a necrotic flap following free flap formation to repair a major defect left after a traffic accident. The progress of the revascularization of the flap can be seen, together with the final result. Hematoma formation is a major problem in skin grafting, as the hematoma prevents the take between the graft and the wound bed. Dr Kioizumi presented a series of clinical findings of LLLT in the restoration of failing skin grafts of which Figure 28 is a representative example.(18) Concomitantly he showed in experimental studies(25) that LLLT had a number of important reactions on hematoma. The levels of prostaglandin E12 were significantly increased, which is an antiagregant for platelets. In addition the increased blood and lymphatic flow in the irradiated area significantly increased the presence of nutrients, scavenger cells and neovascularization, while at the same time increasing the levels of lysing agents for the fibrin mesh holding the hematoma together.

The earlier work of Dr Lisa Schindl on LLLT and Buerger's disease, thromboangiitis obliterans,(27) prompted us to start our own work. Figure 29 shows the typical ulcerous destruction of the big toe in an early stage Buerger's patient before and 15 months after 830 nm diode laser therapy. The patient was also in extreme pain, another feature of this disease, and the patient's pain was also totally removed. Figure 30 shows the pre- and post-LLLT plain angiographic findings in the same patient in the affected limb at the femoral artery level. The neoangiogenesic budding and branching is clearly demonstrated, weeks after the first LLLT session, which is the basis of the long-term effectiveness of LLLT in this otherwise incurable progressive and possibly fatal disease. Dr Schindl's follow-up periods are currently well over nine years for her early patients, with no recurrence. Despite our best efforts and instructions, patients will occasionally not practice the correct wound care procedure following surgical treatment. With conventional or lasers, therapy. Unpleasant sequelae occur, such as ulceration, as seen in the patient in Figure 31, taken from my earlier experience. I first used the defocused Nd:YAG on the lesions, with minor success, but with the appearance of the 830 nm diode laser, the improvement was rapid and complete. Other authors have also published a series on the use of LLLT for control and healing of postoperative ulcerations.(19)

Click Here to read the full paper

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Thursday, September 27, 2012

Laser Therapy for Natural Pain Relief

Laser Therapy for Natural Pain Relief


excerpt taken from Dr. Toshio Ohshiro's paper: "27 YEARS OF LASER TREATMENT: A PERSONAL PERSPECTIVE"

Pain Attenuation

The first main applications of laser therapy were in the area of pain attenuation, and the pain clinic remains a major part of my LLLT indications. Typically in the pain clinic we treat acute and chronic pain entities of the musculoskeletal system including postherpetic neuralgia (PHN) [5] spinal pain entities including lumbar pain [6], a variety of headaches [7,8], whiplash syndrome [9], periarthroses of the major joints [10], frozen shoulder [11] and so on.

At the 1981 ISLSM meeting in Tokyo, Laser Tokyo '81, my JMLL group presented a paper comparing the use of the defocused Nd:YAG with the first 15 mW GaAlAs portable 830 nm diode laser system for pain attenuation, [12]. Even at that early stage, our results with the comparatively lowpowered diode system were extremely promising. As I developed more powerful systems, I designed a series of trials to elicit the best combination of power and available wavelengths for pain attenuation. From these I discovered that 830 nm produced the most effective overall attenuation of chronic and acute pain, and that the gallium aluminium arsenide diode was most efficient in generating this wavelength. I further found that the output power of 60mW with the continuous wave (cw) GaAlAs system I had developed, the OhLase-3D1, was significantly more effective than 50 mW and below, but greater output powers did not produce concomitantly better results, thus this system was designed to optimize these parameters and has had great success, remaining till today the main system I use in my pain clinics. The system delivers an incident power density of approximately 3 W/cm2, and I usually deliver between 15 J/cm2 and 50 J/cm2 per point in the contact pressure method.

One of my earliest patients was a professional baseball pitcher with extreme acute pain of his arms and intercostal regions diagnosed as muscle strain after overtraining. The thermographic findings pre and post treatment with 60mW 830 nm cw diode laser therapy are seen in Figure 13. The areas of elevated temperature associated with underlying inflammation are clearly seen in the upper figure, and are removed in the lower. Unable to pitch when he presented at my clinic, he went on the three days later to pitch a shutout after one intensive treatment session. In 1987 I took my OhLase-3D1 system to Dr Kevin Moore of Oldham, U.K., no stranger to readers of Laser Therapy. Dr Moore had assembled 26 problematic patients from his extensive pain clinic with a variety of acute and chronic entities. Figures 14 and 15 show two representative examples of an acute sprain and chronic frozen shoulder, respectively, pre and post treatment, taken from a video footage shot by Royal Oldham technicians. We also successfully treated a case of chronic postherpetic neuralgia, which prompted Dr Moore to design his well known double blind cross-over study on PHN,(5) which was subsequently replicated with approximately the same degree of significant success here in Japan, (13) and in Canada.(14)

In addition to acute pain, I also found the system extremely good for chronic pain. Figure 16 shows the thermographic findings in a young lady with chronic abdominal pain, areas of pain and numbness in her upper extremities, painfully cold hands, and irregular menstruation. Contrary to the findings with acute pain, the areas of elevated temperature are replaced with areas of decreased temperature indicative of circulatory problems caused by the chronic nature of the pain. Acute pain, if untreated or treated incorrectly, gradually results in fibrotic nodule formation which compresses nerves and blood vessels resulting in result point seen in the upper part of Figure 16. outcome. The painful sites are now no longer under direct control of the nervous systems, which in turn are the responsibility of the brain. (15) My theory postulates that LLLT removes the fibrosis and restarts the stagnant lymphatic flow, thereby restoring local control to the mother brain. In the lower portion of the figure the dramatic rise in temperature over the entire head, torso and upper extremities is indicative of the whole body warming effect seen with laser therapy,and documented in excellent articles by my colleague Dr Asagai, who treated adult cerebral palsy patients with the OhLase-3D1 as part of a total functional training program with good results.(16) This has led to the extension of my theory of laser therapy-mediated reversal of the sympathetic-dominant highly tense state as seen in Figure 16, pretreatment, and to a parasympathetic-dominant relaxed state, as seen in the post-LLLT findings.

Click Here to read the full paper

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Tuesday, September 25, 2012

ML830 Laser Therapy for Pain

Tom Watson, PT, DPT, of Rebound Physical Therapy of Oregon, speaks about his use of the ML830 Cold Laser. Dr. Watson has used laser therapy in his practice for over 30 years. He uses the ML830 Cold Laser for many conditions including the following: neck pain, shoulder pain, elbow pain, wrist pain, hip pain, knee pain, ankle pain, hand therapy, chronic headache relief, fibromyalgia, neuropathy, & nerve regeneration.


Click Here to Find out more about the ML830 Laser

or Click here for 830nm laser therapy studies




Thursday, September 20, 2012

ML830 Laser Helps New England Patriots & Olympic Training Centers

The Washington Post Reports on ML830 Laser Therapy helping the New England Patriots and the Olympic Training Center Athletes.

The Light Stuff
Cold Laser Therapy Is Joining the Injury Treatment Team


By Lois Lindstrom
Special to The Washington Post
Tuesday, February 17, 2004; Page HE01



The New England Patriots won Super Bowl XXXVIII with some help from a little-known form of laser technology that could change the way athletic injuries and chronic pain are treated.

The treatment, known as "cold" laser therapy or low-level laser therapy (LLLT), has been used internationally for 18 years to treat soft tissue injuries, cervical neck pain, carpal tunnel syndrome, repetitive stress injuries, tendinitis, hamstring injuries, arthritis and wound healing, among others.

The lasers -- hand-held, flashlight-like devices that direct a beam of narrow-spectrum (but not hot) light at injured tissue beneath the skin -- have been integrated into medical practice in Japan, Russia and the United Kingdom. In the United Kingdom, cold laser therapy has become a preferred treatment for "whiplash" injuries, neuralgia and shingles. In Japan, the lasers were approved in 1987 and are in widespread use today.

In the United States, the technology received marketing clearance from the Food and Drug Administration (FDA) in 2002 for treating carpal tunnel syndrome, a painful inflammation of the wrists and hands that results from repetitive motion. But the mainstream medical establishment still considers the cold laser's benefits unproven. Most U.S. users are athletic trainers, chiropractors and practitioners of alternative medicine.

"The medical community needs more scientific studies done in the United States," said Wayne Good, a general surgeon in Waterford, Mich., who participated in the clinical trials that led to FDA clearance of the laser device. Good worked with General Motors Corp., which hosted the double-blind, placebo-controlled trials on serious carpal tunnel sufferers as a way to seek more cost-effective treatment for the condition, which affects many auto workers.

Good said the treatment proved about 70 percent effective in getting injured workers, most of whom had failed to respond to other treatments, back on the job. GM offers the treatment to injured workers in its in-plant medical clinics.

But insurance payment for the procedure is also an issue holding doctors back, Good said. Many U.S. insurers will not pay for cold laser treatment, citing the need for further research proving its benefits.
"If the major insurance companies . . . do not pay for the technology," Good said, "the doctor cannot be reimbursed for treating his patients."



Sport and Health

While mainstream medicine remains on the sidelines, practitioners of sports medicine, who are highly motivated to find new ways to heal soft-tissue injuries and bruises, are getting right into the cold laser game.

In the week preceding the Super Bowl, Boston based registered nurse Ellen Spicuzza treated more than 10 Patriot players with cold laser therapy for tendon and muscle injuries.

"A couple of days prior to the Super Bowl weekend, I treated [Patriot wide receiver] David Givens, who had a locked-up hamstring," she said. She rotated the $4,000, pen-like laser over the "belly" of his hamstring muscle for about five minutes, she said. "The laser released it."

Spicuzza, an independent nurse/physical therapist in Boston, usually treats Patriot players' injuries with medical massage. For the big game, she for the first time used low level laser therapy on the athletes' most troublesome pain spots. Before using the cold laser, Spicuzza was skeptical.

"I am not into gimmicks," she said. "I didn't think it would help."


But she changed her mind after seeing how the laser expedited healing of some players' soreness and pain.

"I don't think [the improved recoveries were] a coincidence," Spicuzza said. "It did help. I used it on a flared-up sciatic nerve, and the player had relief soon after treatment."


The Light and the Tunnel

Spicuzza was trained by Michael Barbour, president of MicroLight Corp., a Houston-based company that in 2001 acquired rights to manufacture the ML830 cold laser device. It was his company's laser that received market clearance from the FDA in 2002 for the non-surgical treatment of carpal tunnel syndrome.

Carpal tunnel syndrome occurs when tendons or ligaments in the wrist become enlarged, often from inflammation. Nearly 500,000 Americans have surgical treatment for carpal tunnel syndrome each year; surgery costs $8,000 to $10,000 per patient, according to the American College of Orthopedic Surgeons.

Unlike surgery, treatments involving low level laser therapy are non-invasive and require no healing time. There are no gels or ointments applied prior to the treatment. The most notable sensation is the pressure of the head of the laser on the skin, though some patients report a small tingling.

Cold laser treatments usually cost $25 to $50, with a typical course of treatment involving 10 to 15 sessions over time.

Barbour said that while the FDA cleared the laser only for carpal tunnel syndrome treatment, "medical clinicians have the option of using it for adjunctive use for pain therapy if in their medical opinion it is indicated." Such off-label uses are common in the world of drugs.

Proposed by Albert Einstein in 1917, low level light therapy was not developed until 1960. A Hungarian surgeon, the late Endre Mester, first reported his experience using laser light to treat non-healing infections and inflammations in rats. Mester's reported 70 percent success rate in treating these infections led to the development of a science he labeled "laser biostimulation," or the stimulation of the local immune system.

According to Richard Martin, a Santa Monica, Calif., photobiologist specializing in laser therapy, cells and tissues subjected to inflammation, edema and injury have been shown to have a significantly higher response to low level laser irradiation than normal healthy structures. There is no evidence the light damages the cells.

Since 1967, more than 2,000 clinical studies have been published worldwide on cold lasers. Supporters of the technology cite the fact that most are positive, showing the devices safe and effective in a variety of clinical uses.

Others come to different conclusion, saying most of the studies are small and poorly controlled and lack a standardized treatment that could let researchers compare results equally. The Cochrane Collaboration, an international nonprofit group that evaluates research about clinical practices, has published several reports on low level laser therapy; the most recent were issued this year. The researchers found that data from several studies showed no benefit in treating osteoarthritis pain -- but two of the studies in particular showed very positive results. The group concluded there is an "urgent need" for large-scale clinical trials for this use.

Another research summary concluded that low level laser therapy was effective in reducing pain and morning stiffness for those with rheumatoid arthritis. But there were no differences in the treated subjects in overall disability, swelling or range of motion. And no data was available for effects beyond 4-10 weeks of treatment.

Other Cochrane reports show some benefits from low level laser therapy for frozen shoulder, but no benefits when used on rotator cuff tendinitis.

Swedish physicist Lars Hode, president of the Swedish Laser-Medical Society, says the safety and efficacy of low level laser therapy is better documented than that for ultrasound therapy, which is well accepted medically. However, he says, there were some negative articles about cold lasers 20 years ago.

"In the '80s, the medical industry had inferior lasers," he said. "With the advent of stronger lasers at reasonable prices, the situation today has changed considerably."



Olympian Ambitions

The U.S. Olympic training centers in Colorado Springs and Chula Vista, Calif., are using cold lasers. The Olympic training center in Lake Placid, N.Y., plans to offer the therapy within a few months.

According to Edward Ryan III, director of Sports Medicine for the U.S. Olympic Training Center, the cold laser has given athletes significant relief from pain and increased their range of motion. Because the device is hand-held and portable, he said, it can even be used in competition venues.

Chadwick Smith, clinical professor of orthopedics and bioengineering at the University of Southern California Medical School, has mainstream medical credentials and is enthusiastic about cold lasers.

"Cold lasers speed the healing process," said Smith, who uses the device in his clinical practice. "It used to take at least seven to ten days for a hamstring injury to heal. Cold laser therapy cuts it down to two to three days."


As for Ellen Spicuzza, she said the Super Bowl experience led her to use the cold laser on her own neck, which she injured in a skiing accident 10 years ago.

"I used it in my hotel in Houston during Super Bowl weekend," she said happily. "It brought me quick relief of my muscle spasms."


Lois Lindstrom is author of "Memoirs of a Swedish War Nurse" (Goose River Press, 2002). She is based in Stockholm and is co-writing a book about cold laser therapy with a Swedish clinician.


Click Here to Read the Full Article

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Laser Therapy for Dermatological Skin Applications

Laser Therapy for Dermatological Skin Applications
excerpt taken from Dr. Toshio Ohshiro's paper: "27 YEARS OF LASER TREATMENT: A PERSONAL PERSPECTIVE"

Dermatological Applications

Following early success in the pain clinic, I moved on to assess the use of LLLT in dermatology-related diseases and conditions, including hypertrophic scars and keloids,(17) revitalization of failing skin grafts and flaps,(18,19) hyperand hypopigmentation, vitiligo,(20) atopic dermatitis, atrophic skin, psoriasis vulgaris, strawberry hemangioma in infants,(21) and so on. Figure 17 shows the progress over two years of the use of LLLT alone (830 nm, 60 mW, cm, 30 J/cm2) in treatment of a hypertrophic keloid following an abdominal operation in a female. Figures 18 and 19 show the effective use of LLLT in the treatment of systemic vitiligo. Figures 20 and 21 show laser therapy used to effective by control and treat atopic dermatitis, an increasing problem here in Japan. Figure 22 shows the use of laser therapy in the combination of iatrogenic vitiligo and border hyperpigmentation caused by overtreatment of a systemic vitiligo with PUVA (psoralen and UVA) therapy. LLLT reduced the hyperpigmented border and restored some normal pigment to the hypo- and depigmented zone, with a very cosmetically-acceptable result. Strawberry hemangiomas (SHs) are a major problem for infants and their parents. The conventional wisdom adopts a 'wait and see' attitude, as a large majority of these troubling lesions spontaneously resolve. However some may involve the eyes, threatening the sight of the patient. Others can involve and restrict the nasal airway. Many are subject to frequent bleeding, either spontaneous or through self-excoriation. In these cases, treatment is certainly required. However, we treat all SHs with LLLT, as the involution phase is reached much earlier, and very often with much better results. Figure 23 shows a representative example of the course of successful involution of large SHs on the arm of young girl.

Click Here to read the full paper

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Laser Therapy for Sciatica and Piriformis Syndrome Pain Relief

Sciatica By George S. Pellegrino, LMT, CMTPT, RMTI and Victoria L. Magown, CMTPT, LMT, RMTI MyoRehab The term “sciatica” has been around for a long time. In fact, it was first used in the year 1450 when it appeared in the Oxford English Dictionary. Today, it is ommonly used to describe low back and buttock pain often accompanied by pain radiating down the thigh. About 40% of the population will experience sciatica at some time during their lives. Sciatica and other low back pain symptoms disable 5.4 million Americans a year. It has cost America at least $16 billion a year in lost productivity, and patients more than $16 million in out-of-pocket healthcare expenditures. Sciatica and Piriformis Syndrome are often accompanied by numbness and other sensory disturbances in the area involved with the sciatic nerve. This is because both conditions produce pressure on part or all of the nerve. Another source of these same symptoms can be the result of Myofascial Trigger Points (MTrPs) in a muscle that has little to do with the sciatic nerve or its nerve roots. Gluteus minimus MTrPs will produce pain in the hip, buttock, and thigh all the way to the ankle (Illustration B). When this occurs, it is appropriately referred to as “Pseudo-sciatica.” At MyoRehab, the results of an in-depth evaluation combined with medical findings are employed to identify the underlying causes of these often confounding symptoms. This insures the application of the most effective, non-surgical, drug free treatment protocol. Because the treatment protocols used at MyoRehab are specific, in the case of True Sciatica, therapists certified by the American Society of Laser Therapy in the use of Low Level Laser Therapy (LLLT) treat the cause, not the symptoms. The MicroLight ML830 “cold laser” is one of the most powerful among the tools applied. The 830 nanometer wavelength of the MicroLight laser has the deepest reach (5 cm) into the body of any “cold laser” and is FDA approved (Illustration C). Click Here to Read the Full Article and studies on Laser Therapy for Sciatica

Tuesday, September 18, 2012

Platlet Rich Plasma Injections PRP with Stem Cells and Laser Therapy

Dr. Holland gives his review of the ML830 Laser and describes his use of the laser within his practice.

Dr. Holland uses the ML830 Laser before and after platlet rich plasma injections PRP with stem cells to treat chronic wounds. Doctors report that the ML830 Laser has shown to reduce pain as well as accelerate the body's wound healing phase. Dr. Holland also uses the ML830 Laser for Injured Tendons and in conjunction with Joint Injections.


Click Here to Find out more about the ML830 Laser

or Click here for accelerated wound healing studies using the 830nm laser




Tuesday, September 11, 2012

Laser Therapy for TMJ TMD

Treatment for TMJ Pain with ML830 Laser Therapy
Dr. Donald G. Kimble Neuro Muscular TMJ Specialist

There are a variety of treatment modalities, which can be divided into Phase I and Phase II.
The purpose of Phase I is to eliminate muscle spasms, TMJ swelling, bruxism (grinding of the teeth) and any dislocation, and generally reduce any type of pain. This treatment usually includes the use of the TMJ appliance (mouth splint), exercises, medication, different therapy, and natural muscles relaxants, and Micro-light Cold Laser Treatments (ML830) to relieve TMJ pain. The ML830 ia a non-invasive, non-thermal laser, capable of penetrating deep into tissue. It is one of the most fascinatingnew healing advances, and is FDA CLEARED to treat and manage TMJD pain, muscle and joint pain relief.

The purpose of Phase I therapy is to definitively correct any discrepancies, if necessary, between the upper and lower jaws. Phase 1 therapy may include adjustments of the TMJ joint, orthodontics, surgery or a combination of treatments. It is important to note that Phase II therapy should not be attempted without successful Phase 1 treatment.

Phase I Therapy is usually composed of three types of treatment, all aimed at reducing or eliminating muscle and joint pain.

Therapy No.1
The use of an intra-oral splint (The TMJ Appliance). The TMJ appliance is a computer designed intra oral device that fits most adult mouths without adjusting. It is specifically designed to assist in the treatments of TMJ disorders. The TMJ appliance has been designed by Australian Dentist Dr. Chris Farrell, in response to the need for a low cost intra-oral splint that could be implemented by health care providers, as well as dentists, for the many patients who present with symptoms of TMJ disorders. It is specifically designed to assist in treatments of TMJ disorder. No molding, adjusting or custom fitting is required.

Therapy No. 2

The use of different modes of treatment to reduce muscle and nerve pain. This is a special natural pain relief supplement called (SERENITOL). Proven effective in reducing the reversing the effect if Sleep Apnea, Bruxism, nightly TMJ dysfunction, insomnia, Anxiety Neurosis, Chronic Fatigue and other sleep related disorders. Use of Serenitol, used properly and conservatively is very benefical.

Therapy No.3
The use of MicroLight ML830 Cold Laser Therapy. The ML830 Laser is a non-thermal laser capable of penetrating deep into tissue. FDA CLEARED to treat and manage TMJD pain, muscle and joint pain relief, the ML830 Laser is also used to treat carpal tunnel syndrome at our office.

One of the most fascinating and used healing advances is the ML830 low level laser. We are pleased to announce that the ML830 laser has received clearance for the treatment of TMJD and Carpal Tunnel Syndrome.

Laser therapy has been successfully used around the world for over 25 years, with no reported long-term or irreversible side effect. TMJD sufferers are now free to seek relief from TMJ jaw pain through a new non-invasive form of therapy before resorting to surgery. We have had excellent results using the non-thermal laser to relieve pain and promote healing of the painful tissue.

Phase I therapy is considered reversible. In other words, if treatment of phase 1 therapy is discontinued, no detrimental changes will have occurred. If the patient sees no improvement, then they are no worse off than before they began treatment.

Dr. Donald G. Kimble Neuro Muscular TMJ Specialist



Click to Learn More about ML830 Laser Therapy for TMJ TMD

Read the Full Article on Laser Therapy for TMJ

Studies on Laser Therapy for TMJ and TMD