Laser Therapy for Female Pelvic Conditions

Isa Herrera, MSPT, CSCS, of Renew-PT in NY, NY, was featured on NBC News. Isa treats the following conditions using the ML830 Cold Laser with great results: Dyspareunia, Vulvodynia, Lichen Schlerosis, Interstitial Cystitis, Endometriosis, Post-Surgical Scar Pain, Bladder Pain, and Pelvic Floor Muscle Spasms. Isa states that many of her patients receive relief after the first treatment.


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Laser Therapy for Orthopaedic Applications

Laser Therapy for Orthopaedic Applications

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

Orthopaedic Applications of Laser Therapy

LLLT is ideally suited for orthopaedic indications, many of which cross-over from the pain clinic, including sprains and strains, tendinitis, contusions, bone fusion, slow-union fractures, whiplash syndromes, frozen shoulders, rotator cuff syndrome, rheumatoid disorders, and so on. The experimental work in this field has been very supportive of the excellent clinical findings. Bone fusion happens faster with LLLT.(27) Superior osseointegration, whereby biocompatible implants are integrated into and with growing bone tissue, has been demonstrated experimentally, and clinically.(28) Delayed union fractures have been cured with LLLT,(29) even in the presence of bone disease such as osteomyelitis (Figure 32).(30) Lumbar disc herniation has been reversed, with strength and elasticity returned to the weakened annulus with better retention of the nucleus pulposus (Figure 33, with MRI imaging).(31) Arthroses, in particular rheumatoid arthritis, have been successfully treated with LLLT, and experimental data back up the clinical findings with reduction of the RA signs in blood chemistry and smoothing of pain-related microvilli on the joint cartilages.( 32,33) Figures 13 and 14 above are good examples of acute and chronic cases successfully and speedily treated with LLLT.

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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)

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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.

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