Written by Perry Cammisa, DC
Monday, 21 January 2013 01:41
“Structural problems require a structural solution”: This statement makes perfect sense for musculoskeletal conditions. If you break your arm, a structural problem, it is resolved by a structural solution: Reset the bone and cast it. It would seem almost barbaric to take medication for a broken arm. I have been using this analogy for years with my patients when it comes to chronic lower-back pain.
Whole Body Vibration (WBV) technology is extremely efficient and has so many benefits to treating and managing chronic lower-back pain that it should be part of every chiropractor’s practice. It is an integral part of the “structural solution” to the “structural problem.”
I have been educating physicians for years on WBV protocols, benefits and how to incorporate WBV into their practice for better patient outcomes and long-term care. It provides patients the fast results they want to achieve. Yet, I am still amazed when I talk to a chiropractor that has little or no knowledge of this form of therapy. To me, this is like a patient who has never been exposed to chiropractic. After having chiropractic and all its benefits explained, the patient feels relieved that they have finally found the right care. Having physicians learn how to utilize WBV technology and apply it to their patients for better outcomes is one of my passions in practice.
Chronic lower-back pain is a complex condition that involves a multitude of problems, including weak, tight and unstable muscles, degenerative structural changes, segmental fixations, poor posture, unstable feet—the list is sometimes endless. Outside the chiropractic world, patients with lower-back pain deal with traditional medicine, such as a series of injections, prescriptions, PT and multiple MRIs; this sounds all too familiar. Patients who suffer from non-surgical, complicated, chronic lower-back pain are the most frustrated with traditional medicine because they have exhausted all avenues with little or no success. This is where WBV and chiropractic can change the game.
Chiropractic approaches chronic lower-back conditions by looking at the entire musculoskeletal structure and determining where the breakdown is taking place. By assessing posture, spinal alignment and palpation, range of motion, dynamic-muscle testing such as a squat analysis, and a thorough foot exam, patients can be reassured that their chiropractor is truly the expert when it comes to finding a structural solution to structural problems, and patients can then understand why traditional medicine failed.
My introduction to WBV came as a result of a critical personal need. I had spent years suffering with severe low-back pain emanating from a damaged L5 disc and the complicating factor of spondylolisthesis. I lived in constant fear; I knew that any little thing I did could put me flat on the floor. In fact, this was happening with alarming frequency. I was suffering, and my practice was, too.
I trust in the benefits of chiropractic care and knew that I had just not found the right structural solution for my condition. I also had many patients who came to me after surgery, traditional physical therapy and medication-driven pain management, only to find they were no better off—and sometimes far worse off—than when they started. I knew that traditional medical treatments were not an option for me if I wanted to return to living a functional life. For months I researched every new procedure or treatment option available to me, and I kept coming back to WBV. If what the growing number of research articles said about its benefits were accurate, there was a great likelihood WBV would help me, too.
Keeping in mind that WBV units are essentially machines that create vibration, very little was known at the time about the application of WBV to a chronic low-back patient. Searching for protocols on how to use WBV for low-back pain, I came up completely empty-handed. The fact is, six years ago no one really knew how to apply WBV in the clinical setting, let alone how to address lumbar pain and instability.
Therefore, with the initial aim of personal benefit, I surrendered my body to science by electing to use myself as a "lab rat" and developed a protocol for the treatment of low-back pain using WBV. Six months after my real-life experiment began, I realized I had not had a flare-up of any kind. I was more stable and balanced than I had been in many years, and I moved better in every way. I knew I was onto something and that it was time to introduce what I had learned about WBV to my patients.
This was a pivotal point in my career as a chiropractor. I had learned invaluable clinical lessons through personal trial and experimentation that would forever change the manner in which I approach patients. I had discovered a new way to integrate an amazing technology into my existing treatment protocols. The benefits have grown exponentially ever since.
How Does It Work?
The human body has a number of programmed reflexes such as the eyelid reflex, the touch reflex and the stretch reflex. The deep-tendon stretch reflex occurs when an examiner taps the patellar tendon with a reflex hammer. This action stimulates a reflex through the spinal cord and back to the muscles of the thigh that extend the leg: one tap, one contraction. In contrast, WBV induces a continuous stretch reflex called the tonic vibration reflex (TVR) in all involved muscles exposed to vibration stimulus. The vibrating platform causes minute stretches within the muscles that activate TVR. Because WBV platforms vibrate from 30 to 50 times per second (30 to 50 Hz), these involuntary muscle contractions occur at this accelerated rate as well. In other words, as the WBV platform introduces a controlled and measured force to the tissues, TVR is the result. The muscles are working much harder than normal but in a safe and controlled manner.
Six years later, I now have 12 WBV machines in my clinic, and I acknowledge that WBV, after my adjusting table, is the single most important tool I have to offer patients.
When under TVR, not only will the patients' muscles contract and relax at very high rates, but also the number of muscle fibers in every muscle involved exceeds the number of fibers utilized in traditional training regimens. For most people performing conventional strength training, a maximum of 40% of the muscle fibers per muscle are recruited at any one time. WBV recruits between 95% and 97% of the muscle fibers comprising skeletal muscle when TVR is at work.
The corresponding body response also means that the deep postural and stabilizing muscles that are typically hard to recruit and contract in order to rehabilitate them—such as the spinal erector, multifidi and transverse abdominus, as well as the pelvic floor muscles—can be safely and effectively addressed. WBV changes the frequency of contraction primarily as opposed to applying added force to the muscle. Accordingly, this approach produces much less stress and strain on the joints, ligaments and other supportive tissues. Due to greater contraction efficiency, no long and exhausting training sessions are required. Therefore, the use of WBV is ideal for both conditioned and de-conditioned individuals.
Care must be taken when applying WBV to any patient base. A thorough understanding of how it should be applied to various clinical conditions is key. Also, patients are often apprehensive about many types of treatments, but most often it is a matter of gaining patients’ trust before proceeding. Fortunately, WBV is a "feel-good therapy"; there is an associated instant gratification that patients can feel. In other words, patients get immediate results. They can feel they did something positive and that it felt good. WBV is safe for almost all patient conditions when applied correctly. Even patients who cannot tolerate massage therapy often respond positively to WBV.
A critical factor of WBV-use in the clinical setting is receiving training from someone experienced using this equipment in a medical and rehabilitation environment. Less is more with WBV, and proper postural biomechanics are essential to training each individual body to strengthen and stabilize. A hurdle I often encounter when teaching the merits of WBV is that even doctors have trouble accepting that five minutes of training can produce a significant benefit. There is no question that frequent, short sessions with adequate recovery time are superior to conventional training methods and schedules. The use of WBV is truly the way to strengthen the muscles surrounding the spine in a fast, efficient manner. In addition, WBV increases the effectiveness and the long-term impact of spinal adjustments and other complementary treatments.
The fun factor that patients experience, along with added active rehabilitation performed in-office, adds an important, positive element to daily practice. Patients are generally more involved in their care; they are active as opposed to passive. This quality has significantly improved patient retention and sense of value of service in my clinic.
Six years ago, I started with one WBV machine. I soon began to notice that people were standing in line waiting to use it. Six years later, I now have 12 WBV machines in my clinic, and I acknowledge that WBV, after my adjusting table, is the single most important tool I have to offer patients. Virtually every patient I care for has benefited from WBV in some way.
My personal experiment has truly paid dividends on many levels. I sincerely encourage other chiropractors to research WBV themselves and perhaps build on what I have started. Get informed and keep moving forward. I truly believe the chiropractic profession needs more movers and shakers.
Dr. Perry Cammisa is Member Medical Advisor, Power Plate®, owner of Ultimate ChiroCare®; the largest Power Plate training and treatment medical facility in North America www.ultimatechirocare.com He co-founded BStrong4Life™, a state of the art proprietary neuro-musculoskeletal training system www.bstrong4life.com He designed and patented several pieces of equipment used in biomechanical x-ray protocols, exercise and rehabilitation. Dr. Cammisa’s expertise has made him a sought-after specialist in cutting edge structural and functional rehabilitation utilizing whole body vibration.
Written by Michael C. Pierce, J.D.
Saturday, 02 June 2012 02:08
Wherever chiropractors are in their continuum of education, energy medicine and Pulsed Electromagnetic Field (PEMF) therapy is worthy of investigation. The Doctor Oz Show recently referred to PEMF as “cutting technology that will change the practice of medicine.”
I have written this article from a layman’s point of view. Chiropractic medicine has helped me, during the past 40 years, to recover from many challenges – brought on by years of college football, shot putting, and competitive weightlifting. During the past year, I have used and benefitted from the iMRS system, utilizing it as a valuable adjunct to my chiropractic treatments.
This article talks briefly about PEMF therapy, its potential value for Chiropractic doctors, and the iMRS systems – www.imrs.com
What is Pemf Therapy?
PEMF therapy utilizes electronic, computer-controlled devices that direct a series of natural magnetic pulses through injured tissue and bones. Each magnetic pulse induces a tiny electrical signal that stimulates cellular repair and improves energy levels without any side effects. These PEMF devices, some approved by the FDA, create a healthy and safe “pulsed electromagnetic field” that replicates the Earth’s natural electromagnetic field, which is key to our survival.
PEMF therapy has evolved rapidly during the past 60 years. Yuri Gagarin provided us with the first scientific evidence of the human body’s total dependence on pulsed electromagnetic fields. In 1961, Gagarin circled our planet for 108 minutes at 18,000 miles an hour. Upon returning to Earth, Gagarin suffered extreme depression, diminished metabolism, reduced perception, bone tissue loss, and even muscle tissue deterioration. Russian space scientists quickly determined that human cells, deprived of the Earth’s natural pulsed electromagnetic field, will die very quickly. Since then PEMF therapy has evolved quickly into a cutting-edge technology – which is often referred to as “The Fifth Element.” Along with food, water, oxygen and sleep, the body needs PEMF to survive.
Science confirms that everything is energy, and that all energy is electromagnetic. All 70 trillion human body cells have electromagnetic frequencies. Stress, trauma, fatigue, disease, and “electrosmog” (biologically incompatible man-made frequencies) all impact negatively on our cell’s natural electromagnetic frequencies.
During the past 130 years “electrosmog” has been gradually polluting the Earth with trillions of unnatural electromagnetic wavelengths (radar, radio, TV, cell phones, appliances, microwaves, Wi-Fi, GPS, etc.). These frequencies debilitate nature and our bodies.
Energy medicine and PEMF therapy have developed rapidly during the last five decades. Europe, Russia, India and Japan are still leading the United States in this science. However, with the recent US FDA and Canadian approval of several PEMF devices and therapies, orthopedic doctors and chiropractors are taking note. Countless Olympic teams and sports trainers worldwide are using PEMF therapy for its endurance, pain relief, oxygenation and rapid recovery attributes.
Why is Pemf Therapy Important for Chiropractors?
Traditionally, chiropractic patients have sought immediate relief from painful, debilitating injuries that cannot be cured by medicines, injections or surgery. Chiropractors have been eminently successful in reducing and eliminating pain (which prevails in one of every three Americans). Now, many chiropractors are wearing new hats – as wellness doctors – and are versed in holistic and natural medicine. Energy medicine through PEMF therapy is a key new modality for wellness chiropractors. PEMF therapy promotes natural and measurable wellness and healing down to the cellular level in every tissue, bone and organ of the body.
PEMF systems are relatively inexpensive. Most treatment lasts no more than 16 minutes and does not require supervision. Also, PEMF therapy provides an additional income stream and is non-invasive and harmless.
PEMF therapy has been proven in extensive research for the past sixty years to accelerate repair of bone and soft tissue and relax muscles. It also reduces: pain and inflammation, platelet adhesion, blood pressure and cholesterol levels, and stress.
However, PEMF therapy should not be used for: patients who have implants such as unipolar pacemakers or insulin pumps, epileptics, pregnancy, or children under 2 weeks.
Chiropractic Use of the Imrs
Many PEMF systems can be found on the world market. Most of them have specific uses and advantages, some for home use and others for professional use.
I chose to review and recommend the iMRS for professional chiropractic use, based on the following:
1. The iMRS is German engineered and exclusively manufactured in Switzerland under the highest quality regulations (CE/CB, 93/42 EEC, DIN EN ISO 9001, DIN EN ISO 13485, DIN EN ISO 14001).
2. It is registered and regulated by the FDA and can be legally used in the US.
3. Over 400,000 units have been sold and well-serviced by the manufacturer during the past 18 years.
4. It has a 3-year factory guarantee, backed by a US service center in Ft. Lauderdale, Florida.
5. The new iMRS professional system has excellent, cutting-edge technology, just released in 2011. It has a totally digital, computerized control unit with an interchangeable SD-card, containing 3,000 pre-programmed application variations for specific conditions.
6. The professional system also has an “iMORE” system (interactive Monitoring and Regulation) which measures relevant biological data from the user’s body via a photoplethysmographic ear sensor. The iMRS prepares this data and calculates individual heart rate variability to actively regulate the intensity (flux density) during an iMRS treatment.
7. The professional iMRS system is priced at $4,500.00 – well within most chiropractors’ budgets.
8. An additional brain wave entrainment system (iSLRS) can be connected to the control unit and delivers “wellness for the brain” in conjunction with the PEMF treatment. I was so enthused with the iMRS system that I have now owned and used this system twice daily for the past year.
Chiropractors Using the Imrs
I interviewed three prominent chiropractors regarding their use of the iMRS:
Dr. Glen Bobker incorporates energy medicine into his practice through different modalities such as low-level laser therapy, ultrasound and, more recently, PEMF therapy with the iMRS. Dr. Bobker says that he favors the iMRS over other adjunctive modalities since, in addition to manipulation, it: “…provides the most effective therapeutic results with immediate gratification. Despite its mysterious property of not being able to be seen or felt, PEMF therapy produces highly successful and rapid reduction of pain and swelling and improved joint function. We have had very exciting and dramatic results with acute injuries (Use of probe applicator for 16 minutes on freshly swollen "grapefruit" sized knee shrinking to normal size before our eyes).
This patient ended up buying a unit.” Dr. Bobker also stated that “The iMRS provides an additional income stream for my practice, does not require supervision, and is extremely versatile in how it can be applied to the body. It can give focused therapy by utilizing the probe and pillow applicator or provide a dose of whole body, global wellness by lying on the mat applicator.”
Dr. Ron Hill also uses a wide range of therapeutic/treatment modalities to provide his patients with whole body healing. He has been using MRS systems for 5 years and now has 5 units in his office. Dr. Hill first learned about PEMF when a patient with chronic lumbar stenosis told him about the previous model MRS 2000+. He combined this system with regular manipulation, cured the lady, and has become a firm believer since then. Ron Hill treats many athletes, two of whom are on Canada’s 2012 Olympic team. He is very keen on giving patients immediate feedback on the effects of PEMF therapy. This feedback is accomplished through an oximeter, which measures the concentration of oxygen in the blood. On the average, 8 minutes with the iMRS will increase blood oxygen up to 10%. Endurance athletes worldwide have taken note. In addition, some patients are given an Electro Interstitial Scan, which provides them with immediate feedback on 70 different bodily functions.
Dr. Michael Meehan is a firm believer in energy medicine, stating that “Energy medicine is like homeopathy – less is best.” Most of Dr. Meehan’s patients are given a brief, 8- to 16-minute session on the iMRS whole body mat before chiropractic adjustment. PEMF therapy has been proven to increase oxygen absorption by the body’s red blood cells, which in turn lowers a patient’s inflammation. Oxygen is a natural anti-inflammatory which thins and unclogs blood and increases circulation. Dr. Meehan prefers PEMF therapy for its whole body, long-term, recuperative qualities. “Ultimately,” he says, “we want to affect the body on a cellular level.”
Despite the large body of international, FDA and NASA research and approval, PEMF therapy is relatively unknown to the American public.
The iMRS is an excellent PEMF therapy system, well suited for most chiropractors involved in Energy Medicine. Many chiropractic patients, including the author, have decided to buy the iMRS for daily use at home. PEMF therapy is addictive, in a positive sense. Life cannot be sustained long without food, water, oxygen and low-level electromagnetism. With constantly increasing levels of electro-pollution, the iMRS is a key tool for those who strive for overall wellness.
Michael Pierce is an international attorney, native Nebraskan, living in Panama. He is a life and world traveler, poet and writer. His passion and hobby is good health and longevity through alternative medicine. On a typical day, Michael can be found: meditating on his iMRS mat, Skyping foreign clients, moving mind and body in the gym, and enjoying good food, friends, and belly laughter.
Written by John W. Fiore, D.C.
Friday, 01 June 2012 21:30
Some of the most difficult patients Doctors of Chiropractic face in full-time practice are the cases of severe brachial neuritis, sciatica, torticolis, and hot discs (disc protrusions and bulged, slipped, herniated, or ruptured discs are treated synonymously, for they all refer to the nucleus pulposis slipping postero-lateral inside the annulus fibrosis), to name a few. Each of these conditions can demonstrate high levels of intractable pain, with INFLAMMATION. Pain injuries that are so excruciating can not only make patients difficult to handle during examination and X-rays, but they are difficult to treat, especially with manipulation, while the patient is in the acute stage.
Unless electrotherapy, or the DC’s selection of other in-office treatment, can substantially reduce the patient’s pain, Long Term CryoTherapy (LTCT) should be used. Written instructions should be given to the patients so they can apply the process at home. This will begin to mitigate the pain and inflammation. More often than not, this allows the Dr. to take control of the situation in severe cases.
As we all know, inflammation has four cardinal signs. They are HEAT, REDNESS, SWELLING, and PAIN. They always appear together with the same intensity as the severity of the pain. Therefore, the more extreme the pain becomes, the more redness, heat, and swelling will develop. The good news is that if you remove one of these signs the other 3 will be removed as well.
How Long Does It Take To Stop Pain?
This is where LTCT fits into a DC’s practice. Pain will dissipate in the same proportion as the calories that are absorbed. CryoTherapy can remove the heat by absorbing the calories out of the body in a safe, effective, convenient, low-cost way. The deeper the pain, the longer CryoTherapy must be used in order to absorb the calories out of the painful area. To do this, the cold application needs to be applied for HOURS. That is why I refer to this as “Long Term CryoTherapy” (LTCT).
LTCT consists of using an 11" ice cap filled with ice and a little water to start the melting process. This type of cold pack will have a temperature of 34 to 40 degrees Fahrenheit, and is perfectly safe. This is the most probable ideal therapeutic temperature. It will not cause frostbite even if it is applied 24 hours a day. Frostbite can only occur when the skin temperature is brought down BELOW 32°F. For this reason, using gel packs, whose freezing point may well be below32°F, is not safe.
This type of cold pack will have a temperature of 34 to 40 degrees Fahrenheit, and is perfectly safe.
A logical question might be, “Why would gel packs freeze the skin when ice packs do not?” The answer is, when pure water freezes, the temperature of ice never gets below 32°F. Once water freezes it becomes inert and will not become colder. It stays at that temperature even if the ice is in a deep freezer where the temperature is below zero. Gel packs contain chemicals whose freezing point may be as low as -10°F. Therefore, if placed in a freezer where the temperature is 15°F, the gel would take on a temperature of 15°F.
If these gel packs were used one after another, on the same area, it could then bring the skin temperature below 32°F, which could then burst the skin cells (frostbite) that freeze at 32°F. Skin cell walls bust because the high water content in the protoplasm continues to expand when the temperature drops from 39°F to 32°F. That’s why water frozen in an ice tray expands to produce a lip or hump on the ice cube just before it freezes.
The goal is to lower the injured body area to 40°F or lower for a prolonged period of time to reduce and absorb the heat, and do the job above 32°F. Then the swelling, redness and pain will begin to disappear.
The above 4 disorders, mentioned above in paragraph one are not, by far, the only inflammatory conditions. There are many hundreds of conditions that exhibit INFLAMMATION. Conditions like surface trauma, first and second degree burns, brush burns, myo-fascitis, insect bites and other superficial injuries usually only require CryoTherapy for a short period of time. Topical CryoTherapy sprays and ointments usually suffice to reduce the heat from these surface inflammations and do help to promote healing. However, more cold power is needed if the surface injury is severe. The time required for surface inflammation could be for as little as 20 minutes to 2-3 hrs, depending on the extent of the injury.
Most all spinal pain conditions, including brachial neuritis, sciatica, disc conditions, subluxations, bursitis, neuritis, tendonitis, osteitis, and, surprisingly enough, peritonitis, colitis, enteritis (Crohn’s Disease), appendicitis, cystitis, and many other words ending in ‘itis’ are 1 to 6 inches deep in the body. Almost all of these conditions respond well to LTCT to reduce the inflammation, as long as LTCT is applied long enough to abate the pain. The time required for LTCT should be constantly applied from 4 hours to 24 hours a day. It may take one or several days to eliminate the pain in acute cases, because many of the above conditions are 3-6 inches in depth. Using ice packs with only ice and water takes about 2 hours to lower the body temperature about 10°F at 2 inches in depth, without lowering skin temperature below 32°F.
Now, this is the very big news–never before published to my knowledge. When using LTCT on inflammation, the chance of infection is almost ENTIRELY ELIMINATED. Logical thinking proves it, and this is why: Bacterial growth is slowed down by lowering temperatures; which is why laboratory chemists place Petri dishes containing bacteria in an incubator at 99°+F. This is, of course, to grow the bacteria at their optimum temperature in order to accelerate their growth. Bacterial growth is practically non-existent below temperatures of 50°F or less. A good illustration of lower bacterial growth is why we place a steak in a 40°F refrigerator. Better yet, we place meat in a freezer to slow bacterial growth even more to make it last for months. Moreover, we all can relate to stories of people dying on a glacier in the North or South Poles only to be found many years later totally preserved. Why? Because of little or no bacterial growth to destroy the body. So, deductive reasoning would guide us to conclude that CryoTherapy DOES reduce bacterial growth by lowering temperatures, and thereby stopping infections.
WHAT A SURPRISING BENEFIT it is to know that just by using ice therapy the DC can control and STOP INFECTION in its tracks. A chiropractor can be confident that from the moment the LTCT is applied, bacterial growth will begin to reduce, and the body has a chance to recover more rapidly. Many inflammations that get too hot will accelerate bacterial growth and become infected if it remains that way for a prolonged period of time.
Relieving pain can certainly enhance any DC’s practice, and preventing or stopping the advancement of infection is certainly a big bonus.
How to Implement LTCT in a D.C.’s Office
Provide an instruction sheet, a lumbar belt, and 1 or 2 ice caps for your patients in acute pain to apply at home. The lumbar belt should be used to apply the ice pack to the patient’s low back. Application to the cervicals can be convenient also, by using a bath towel (folded lengthwise in thirds, draped over the neck with the ice pack placed underneath. Tie the two ends of the towel in front above the chest with 2 or 3 rubber bands, which prevent choking of the throat). For both areas the patient can mill around freely while being treated. For other areas of the body, use the most practical way to fasten the ice pack. The ice pack will last up to 2 hours and has to be recharged with more ice for extended treatment.
There are several kinds of ice bags (caps) on the market. There is the type that is made of cloth on the outside and rubberized inside. It’s been our experience that this type will crack and leak after several uses. The FAULTLESS CO. makes the blue rubber-ish textured type that almost never leak, and may last 10 years or more. The 11" Faultless ice cap can be purchased at nearly any drug store or can be bought wholesale at Bodyline Comfort Systems and sold to your patients.
If you wish to know more about LTCT, call Bodyline @ 800-874-7715 and ask for one free “Ice Magic” booklet and a sheet that instructs patients on its use, which you may copy to hand out to all patients. Also, visit the Bodylines website @ www.bodyline.com.
John W. Fiore, DC, attended Purdue University, majoring in Chemistry, Physics, and Biology graduating from Lincoln College in 1954. Practiced together with his brother for 40 years and invented the “Back-Huggar” in 1968, and the “Neck-Huggar” in 1982, and founded Bodyline Comfort Systems in 1968. Served five years as secretary of Florida Chiropractic Association. Author of “Discaltic Aberrations of the Spine” (Disc Theory of Chiropractic) published in the 1974 Edition of the Journal of Clinical Chiropractic.
Written by George Gedevanishvili, M.D.
Tuesday, 01 May 2012 17:07
he history of laser began in 1917 when laser theory was first postulated by Albert Einstein in his fundamental work “Zur quantum theories der strahklung”.1 The actual word LASER stands for Light Amplification by Stimulated Emission of Radiation and the use of that term was first published by Gordon Gould in 1959. However, it took over 40 years after Einstein’s initial work before the first laser was actually fired up by the American physicist Theodor Meiman in Malibu, California in 1960.2,3
Since its first introduction, laser technology has become part of many important items and processes in our everyday life. It is integral to things like laser pointers, CD players, and remote controls. Today, there are many hundreds of different lasers on the market, but they all can be divided into two major categories: “Hot” lasers that generate heat during the application and “Cold “or low-level lasers which do not generate significant amounts of heat.
High-powered lasers, most of which are continuous wave lasers, have output greater than 500mW. This type of laser can produce a significant thermal effect, thus limiting exposure time, and can constitute a huge disadvantage over low-level super-pulsed lasers.
For continuous wave high-powered lasers to be safer, the beam has to be of very low energy. For example, a continuous wave laser beam with the output of 200mW concentrated on an area of 1cm2 for about 8-10 minutes can produce first degree burns.
The second category is low-level lasers that produce a negligible amount of heat. Their output power is up to 500mW (per light emitting diode). This type of laser is capable of producing important photo-chemical and photo-physical effects on cells in the body. Low-level lasers can be either continuous wave or super-pulsed.
Power output for Super Pulsed Lasers can be as high as 50W. With this huge output power, Super Pulsed Lasers can deliver very significant amount of energy, which is compatible to High Powered Laser but without creating any noticeable thermal effect. This is due to extremely short bursts (100-200 ns) and the fact that tissue does not have the time to “react” with heat production to the high energy levels over such a short period of time. This characteristic of super-pulsed lasers makes them the treatment of choice for conditions that require longer exposure time to achieve therapeutic effects.
Some continuous wave lasers use a shutter mechanism to decrease the amount of energy delivered at a given time. This is called the duty cycle, which is the ratio between the length of time when the laser is on and off. If there is a mechanical block in place (shutter mechanism), the energy delivered by the Laser can be reduced by as much as 50%, depending on how long the shutter stays on. With the super-pulsed laser, the pulsing occurs naturally. Due to the chemical composition of a laser diode, there is a natural “flashing” of light energy from 0 to maximum power. For example, a super-pulsed laser with the output of 10W will have a duty cycle of 0.1%.4
Medicinal use of Low Level Laser Therapy (LLLT) dates back to 1967, when Hungarian scientist Endre Mester first observed that by using low-level laser on the shaved back of mice, hair grew back faster than in the control group.5 Since then many more scientists have been exploring the effects of Low Level Laser Therapy on different health-related conditions including pain, inflammation and swelling.
The big question among physicians today is: Are all lasers made equal? The answer is simply no, since the therapeutic effect of low-level laser relies heavily on the type of laser, its mean power output and depth of penetration. Depth of penetration in turn depends on wavelength, frequency and media type that the laser passes through to reach its target. For example, visible light low-level laser with a wavelength of 635-650 nm can penetrate skin to a depth of less than 1 cm. A laser with the wavelength of 835 nm can penetrate to a depth of about 3 cm and a super-pulsed GaAS laser with a wavelength of 904 or 905 nm can penetrate to a depth of about 5 cm. This ability to penetrate deeper into tissue and deliver high energy without thermal effect makes the GaAs 905 nm super-pulsed laser tool of choice for treatment of musculo-skeletal conditions.6,7
Media through which the laser passes to its target will also affect its therapeutic activity. The therapeutic window, defined by the frequency range where laser therapy is most effective, lays in the wavelength diapason from 632.8 to 905 nm. The Window is separated into two very distinct areas by the bio-absorption property of melanin which decreases radically at 780 nm.
Laser therapy has minimal contraindications and virtually no side effects, which makes it the treatment of choice for rapid, non-invasive pain and inflammation relief.
In an animal model intended to investigate effects of LLLT on pleural inflammation, Lopes-Martins et al. showed that carrageenan caused pleurisy in mice, and application of LLLT reduced migration of inflammatory cells.8
For many years, the analgesic effect of LLLT was thought to be due to a simple increase in endorphin production, but Honmura et al., by blocking opiate receptors with Naloxone, showed that this effect did not rely purely on endorphins.9 In a related study, Mrowiec et al. demonstrated that Nitric Oxide plays an important role in the analgesic effects of LLLT. In this animal model study, the pain-relieving effect of a GaAs laser was blocked after rats were injected with a NO syntheses inhibitor.13
In the article “A Meta-Analysis of the Efficacy of Laser Phototherapy on Pain Relief”, Fulop et al. indicated that Low Level Laser Therapy was more effective in pain relief and provided an increase in cervical ROM compared to a placebo.10 Gruszka et al. conducted a small study using LLLT on a group of 15 patients with single or multiple lumbar disc herniations. GaAs pulsed laser was applied to both lumbar spine and pain radiation sites. The treatment frequency was set at 3 to 5 times per week for 4 months. The results were monitored by CAT scan, EMG and gait analysis. At the end of the treatment, all patients reported to be free of pain. Diagnostic tests, such as gait analysis, neurological signs, and EMG documented objective improvement. The CAT scan, performed at the end of treatment, showed a decreased disc protrusion.11
In the double-blind and randomized placebo control study, Gur et al. demonstrated efficacy of 904 nm GaAs laser therapy in management of patients with chronic myofacial pain in the neck.12
There are many different marketing claims made by different companies, but there is one that is especially disturbing and needs to be addressed in this article. A laser cannot be used through clothes and achieve the same therapeutic effects as one used on bare skin. When light gets in touch with the clothing, it either gets absorbed (black or dark clothes) or deflected (light colored clothes). It is imperative to use the Laser on bare skin, or if performing therapy on bare skin is absolutely impossible, through a simple white cotton thin tin top as natural fibers are more permeable to light.
According to Jan Tunér and Lars Hode, world’s leading experts on Laser therapy, cloths with different thickness and color can potentially decrease Laser light penetration by 80 to 100%.14
With more than 6,000 scientific articles published to date regarding the clinical application of laser therapy and with around 250 new research papers being published each year, laser therapy is one of the safest and most researched modalities. As a result, it's utilization is gaining popularity among physicians in different disciplines.
- "Zur Quantentheorie der Strahlung" ("On the Quantum Theory of Radiation"). Physika Zeitschrift. 1917;18:121-128.
- Gould, R. Gordon (1959). "The LASER, Light Amplification by Stimulated Emission of Radiation". In Franken, P.A. and Sands, R.H. (Eds.). The Ann Arbor Conference on Optical Pumping, the University of Michigan, 15 June through 18 June 1959. pp. 128. OCLC 02460155.
- Maiman, T.H. Stimulated optical radiation in ruby. Nature. 1960;187(4736):493–494. doi:10.1038/187493a0.
- "The New laser Therapy Handbook" Jan Tuner and Lars Hode. Prima Books; 2010. p.86.
- 5Mester, E.; Szende, B., and Tota, J.G. Effect of laser on hair growth of mice. Kiserl Orvostud. 1967;19:628–631.
- http://www.laser.nu/lllt/Faq1.htm#How deep into the tissue can penetrate.
- "The New laser Therapy Handbook" Jan Tuner and Lars Hode. Prima Books; 2010. p.53.
- Dr. Rodrigo Alvaro Brandão Lopes-Martins, Regiane Albertini, Patrícia Sardinha Leonardo Lopes, Jan Magnus Bjordal, and Hugo Caire Castro Faria Neto. Spontaneous Effects of Low-Level Laser Therapy (650 nm) in Acute Inflammatory Mouse Pleurisy Induced by Carrageenan.. Photomedicine and Laser Surgery. 2005 Aug;23(4):377-381. doi:10.1089/pho.2005.23.377.
- Honmura et al. Analgesic effect of Ga-Al-As diode Laser Irradiation on Hyperalgesia in Carragenin Induced Inflammation. Laser Surg. Med. 1993;13:463-469
- Fulop, Andras M. DPT; Dhimmer, Seema DPT; Deluca, James R. DPT; Johanson, David D. DPT; Lenz, Richard V. DPT; Patel, Keyuri B. DPT; Douris, Peter C. DPT, EdD; Enwemeka, Chukuka S. PhD. A Meta-analysis of the Efficacy of Laser Phototherapy on Pain Relief”. FACSM Clinical Journal of Pain. 2010 Oct;26(8):pp. 729-736. doi: 10.1097/AJP.0b013e3181f09713 Original Articles.
- Gruszka M., et al. Effect of low level Laser Therapy on herniated lumbar discs. Laser Surg. Med. 1998; Suppl 10:6.
- Ali Gur MD1,*, Aysegul Jale Sarac1, Remzi Cevik1, Ozlem Altindag1,Serdar Sarac. Efficacy of 904 nm gallium arsenide low level laser therapy in the management of chronic myofascial pain in the neck: A double-blind and randomize-controlled trial. Article first published online: 22 SEP 2004 DOI: 10.1002/lsm.20082
- Janina Mrowiec, Aleksander Sieron, Andrzej Plech, Grzegorz Cieslar, Tomasz Biniszkiewicz and Ryszard Brus. Analgesic effect of low-power infrared laser radiation in rats. Proc. SPIE 3198, 83 (1997); doi:10.1117/12.297992
Dr. George received his M. D. degree from Tbilisi State Medical University in the Republic of Georgia (the former Soviet Union). He also has a BA certificate from Tbilisi Business School. Dr. George is a Clinical Consultant, and the Director for International Business Development for Multi Radiance Medical, a manufacturer of Low Level Laser Therapy equipment. To learn more, you may contact Dr. George at
Written by Kevin Lau, D.C.
Friday, 16 March 2012 21:02
A look at the unique 3-step approach to treat scoliosis
n an age when scoliosis is being viewed as much more than a mere spine curvature, a holistic view offers the essential dictates of diet and exercise to form a non-invasive and long-term solution to the disease, aided by the use of the state-of-the-art devices from Meditrac, Vertetrac as well as the Dynamic Brace System (DBS). It’s a story about Andrea, a 44-year-old mother of two, born with scoliosis, who gained full recovery with non-surgical correction methods. Not only did Andrea experience a 20 degrees correction in her curvature, but she is also a much happier and healthier individual now.
Scoliosis - the scenario
Recent research suggests that at least one in four kids suffering from scoliosis might have to opt for surgery. Such is the prevalence of the disease that is best defined as the spine’s curvature from side to side, forming a ‘C’ or ‘S’, instead of a straight line.
Historically, the traditional line of treatment for scoliosis has mostly traced a three-step line. The first step usually starts when an abnormality is noticed in the body and a curvature observed in an x-ray. According to the line of therapy I have implemented, this stage mostly begins by assessing the exact degree of curvature, looking into the dietary habits and then prescribing a correctional routine comprising of appropriate diet and exercise.
On the contrary, in the current scenario, for curvatures less than 20 degrees of Cobb Angle, it would normally be decided to adopt the wait and see approach for the curvature to go away on its own, which in most cases doesn’t happen. Following this highly laid-back approach, when the curvature passes approximately 25 degree Cobb Angle, the next immediate resort is to take to bracing, and if even after bracing the curvature reaches past 40 degrees then surgery is recommended, when all else fails.
To wait and watch?
Research shows how the tendency to wait and watch leads to aggravated damage in terms of physical as well as psychological health and also causes a financial drain. Studies estimate that more than 20,000 scoliosis fusion surgeries are performed every year in the US. In most of the cases, neither the rigid nor the soft braces are as effective in preventing further curvatures and hence invasive surgeries.
In most of the cases, neither the rigid nor the soft braces are as effective in preventing further curvatures and hence invasive surgeries.
Needless to say, it could be extremely hazardous to simply wait and watch. Scoliosis mostly starts as a spasm of muscles on one side of the spine. This might be happening due to a dysfunction in the way the brain perceives the position of the spine.
It further propels the spine to curve to that particular side, causing the ligaments and muscles on that side to harden. This hardening actually explains why the spine becomes crooked. The typical ‘S’ shape will start forming when the same phenomenon begins to happen with the other side of muscles as well. That explains why it is best to disrupt this ongoing process and halt the progression of scoliosis as early as possible.
A different viewpoint
However, the traditional line of treatment is now being debated amongst professionals. A greater need is being felt to view scoliosis as a neurological condition that affects the spine in the form of a curvature.
Experts view scoliosis as a symptom of a deeper underlying issue, one that implies a bigger biochemical and mechanical dysfunction in the person. A great example is the case of Alisa L., a 56-year-old school teacher who reported incidence of high cholesterol, severe digestive problems and strong lower back ache. In my book, Health in Your Hands, I have described my treatment methods, which include correcting her dietary habits and showing her how to eat healthy. Not only did the drug-free approach relieve her of her back pain with the use of Vertetrac and DBS, it also eliminated the digestive problems and normalized her cholesterol levels.
The 3-step approach
I must admit that I view human disease from a holistic viewpoint, and firmly believe in the power of the human body and mind over disease and health. From reducing a 15-year-old’s spine curvature from 45° to 28° and a 70-year-old’s curvature from 16° to 4°, I have been using these amazing principles of nutrition and exercise to cure scores of scoliosis patients.
My approach to scoliosis follows a multi-dimensional 3-step approach, implemented as follows:
Step 1: To identify the nutritional routine, dietary habits, deficiencies and an inappropriate pattern which might be the underlying cause and hence the potential solution to the worsening scoliosis.
Step 2: To identify the exercise needs and plan a customized fitness regimen for the patient.
Step 3: Offering a holistic approach to reducing the impact of the disease on the patient’s life.
The comperehensive nutritional approach
Based on the findings of modern nutritional researchers, I follow a unique categorization approach when it comes to using nutrition as a means to identify and cure the disorder. When planning a course of treatment for a patient with symptoms of scoliosis, it begins by soliciting the need to eat according to the basic genetic make-up of the patient, categorized as the protein, carbohydrates or the mixed types. I will then prescribe a food pattern such as the Paleolithic diet.
Interestingly, there is an association between bone health and gut health
A typical case of mine demonstrates the power of such a Paleolithic diet very well. The patient in question was underweight to start with, which had strong correlation with his history of scoliosis. Put on a diet of fermented foods such as kefir and sauerkraut, his digestive tissue was healed and he was advised to eat food which suited his metabolism. In such cases, I mostly strive to cut down on sugars and grains and emphasize the need to increase the intake of organs and fats, comprising of fat-soluble vitamins D,K, and A.
Equally interesting is the case of Isla W., a 24-year-old athlete who once was categorized as the fast oxidizing protein type and received corrective treatment and nutritional advice.
Similar case studies and detailed research point towards significant correlation between nutritional disorders and scoliosis. Interestingly, there is an association between bone health and gut health, which suggests how nutritional habits can aggravate or for that matter cure scoliosis while about 80% of the immune system resides in the gastrointestinal tract.
The customized fitness regimen
There is an effective combination of overall muscular fitness along with use of Vertetrac and the Dynamic Brace System (DBS), offering a highly patient-friendly dynamic lumber ambulatory traction system and treatment for idiopathic scoliosis.
Going by Meditrac's watchword, Traction on the move, both of these devices, the Vertetrac as well as DBS, offer a unique approach to scoliosis treatment because they are patient-friendly, cost-effective and highly result-oriented. For instance, Vertetrac, an absolutely unique lumbar traction system, goes much beyond what the traditional traction system does. It combines traction with horizontal force to facilitate a simultaneous 3D treatment with asymmetrical traction options. To be used only for very brief sessions, both Vertetrac and DBS disrupt your physical movements to the minimum. Actually decompressing and remodeling the spine, these even allow you to easily walk, sit or stand even while wearing the device.
My fitness regime is perhaps best explained in the case of Cher, whose spine curvature worsened from 38° in her first diagnosis when she was merely 13 years of age to 55° years later. Following my approach, I started treating her and after a 6-month-long intervention into her dietary habits and a regular, planned fitness regimen, including the use of Vertetrac and DBS, her scoliosis finally showed a 15 degree improvement.
The key premise
My therapeutic techniques are based on the strong foothold of proper postural habits and a healthy lifestyle and combine the power of the right posture with a set of easy-to-follow, specific body balancing stretches, core building and body alignment exercises to form an appropriate fitness regimen.
In fact, the latest research on scoliosis actually points to the possibility of re-training the brain through a set of highly specialized scoliosis exercises.
To begin with, I start by leading the patient to spot the tight muscles in his back, defined by the portions that will give discomfort when stretched. According to my belief, any type of stretching and strengthening exercises will only be of help if both the patient and his physician know exactly how and at which spots his body is out of balance. The process is further carried forward by identifying the muscle groups that are tight and the bones that might not be in their exact positions.
In fact, the latest research on scoliosis actually points to the possibility of re-training the brain through a set of highly specialized scoliosis exercises. In relation to the suspected neurological origin of the problem, these exercises are expected to develop new neurological pathways which the brain is likely to take to, hence the likely cure.
Through a series of scientifically designed stretches and body alignment exercises, such as Neck Rotators, The Stretch Reflex, Neck Side Flexion, Neck Extensors, Levator Scapulae Stretch, Scratch Stretch, and Trunk Side Bending and Lumbar Scoliosis Stretch, the target of correcting the balance within the body and reducing the symptoms of scoliosis could be attained.
Dr Kevin Lau D.C. is the founder of Health in Your Hands, a series of tools for Scoliosis prevention and treatment. The set includes his book Your Plan for Natural Scoliosis Prevention and Treatment, a companion Scoliosis Exercises for Prevention and Correction DVD, and the innovative new iPhone application ScolioTrack. He is a member of International Society On Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT).
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