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Some General Information on Painless, Non-invasive, Low-Level Laser Acupuncture |
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By
Margaret A. Naeser, Ph.D., Lic.Ac., Dipl.Ac.
What points work best for my problem?There are no specific, cookbook-type treatment protocols available with low-level laser acupuncture, just as there are no specific, cookbook-type treatment protocols with needle acupuncture. The practitioner needs, rather, a sophisticated knowledge of Traditional Chinese Medicine, and understanding of the actions of the acupuncture points, to be a successful practitioner with laser acupuncture. I do not recommend practicing only with laser acupuncture, rather, I recommend adding it to the collection of acupuncture modalities - i.e., acupuncture needles, microamps electrical stimulation, moxibustion, cupping, Chinese herbal medicine, ion pumping cords, magnet therapies, etc. In America, it is now required that one have a minimum of 1,725 hours of acupuncture training, before one can take the acupuncture exam for certification in acupuncture, from the National Certification Commission for Acupuncture and Oriental Medicine. I hope the information provided below will be helpful. Thank you for your interest in low-level laser acupuncture. For a referral to a licensed acupuncturist who has studied laser acupuncture, please call the American Association of Oriental Medicine, in Catasauqua, PA, 610-266-1433. They can often sort referrals by zip code. How does this work? How can I learn to do it?The area of low-level laser acupuncture is complex. Unfortunately there is no single laser that will do everything, and I do not recommend any specific lasers, I conduct laser acupuncture research with carpal tunnel syndrome, and formerly, with stroke patients with paralysis (acupuncture and laser acupuncture to treat paralysis in stroke, referenced in publications, at the end). Licensed acupuncturists who want to know more about laser acupuncture might consider purchasing one of the publications (listed below) that have been published for this purpose or attending a two-day class I teach for CEU's at the New England School of Acupuncture, Watertown, MA, near Boston entitled:
The next class is in April of 2002. For registration, please contact Ken Zeno: kzeno@nesa.edu or: 617-926-1788, extension 114. I teach this class once a year. If you're reading this page after this date, please contact Ken for future dates of this seminar. Or, see their website at: http://www.nesa.edu Another class, though much shorter in duration (four hours) will be held at the AAOM conference in Hawaii in early November, 2001. Contact the AAOM for more information on their annual get together. http://www.aaom.org Technical considerations of laser acupunctureWith painless, non-invasive laser acupuncture, we work with Class IIIb lasers (5 to 500 mW). One can start to burn the skin at greater than 500 mW (Class IV lasers). With laser acupuncture, we also primarily only work with wavelengths in the red-beam range (600 - 700 nm) and in the near infrared-beam range (800 - 1000 nm). The red-beam laser has only a shallow penetration, around 0.8 of
one mm, direct energy - used on acupuncture points on the hand, foot
(not the heel), face, or sometimes the ear. The red-beam is fine for
the shallow Jing-Well points on the foot. For example, Bladder 67,
for breech position, 5 minutes per day, the last few weeks of pregnancy
(Jin, 1998). It has a 85% success rate according to Dr. Jin. The red-beam laser is usually 600 - 700 nm wavelength; and less than 500 mW. How many joules do you want to use? How many joules per cm square? These are all very important facts for you to know, before you start using the lasers. For example, a 5 mW laser lecture pointer pen with a 5 mm diameter aperture requires a minimum of 3 minutes exposure time on an acupuncture point, to have approximately 4.59 joules per cm square. Some think that the anti-inflammatory effect, and the improved circulation effect starts at a minimum of 4 joules per cm square. This is especially so for wound healing (Mester, Mester, Mester, 1984), and treatment of post herpetic neuralgia (Moore et al., 1988; McKibben & Downie, 1990) and earlier stages of alopecia areata (Trelles, Mayayo, Cisneros, 1984).
If you plan to be treating deeper acupuncture points on the limbs or back, you need an infrared laser (800 - 1000 nm wavelength). The infrared lasers tend to have a deeper effect, up to an inch or so. Again, a very complex topic. Pulsed Laser Settings, and Some Possible Therapeutic IndicationsThese pulse rates (pulses per second) and indications, for each rate are based on P.F.M. Nogier, M.D., Lyon, France. Here, I am referring to them as used with the infrared (904 nm) pulsed, Respond Laser 2400, Respond Systems, Branford, CT. No medical claims are made.
Examples of Laser Protocols using Pulsed Infrared laser, as listed aboveHeel Spurs: Often with cases who have a Traditional Chinese Medicine diagnosis of Deficiency, I do not use F6 at all. For example, with Heel Spurs in a case with Deficiency (often Ki Def.), I try F4 for 5 or 10 minutes; then F3 for 5 minutes; then F2 for 5 minutes; then F1 for 5 minutes. The patient can simply rest the heel onto the laser block (four laser diodes in an array, in the 4-inch by 3-inch laser block that is part of the Respond laser equipment), while sitting up, using pillows for support. The exact treatment times are probably not known, but it seems to be important to use primarily the F4 down to F1 with Deficient cases (I have observed that using too much of F6, alone, Disperses too much, and the patient has no effect from the treatment at all. The number of treatments may be 12 (every other day) or less, depending on the case. I learned this treatment from Jennifer Blahnik, L.Ac., Wausau, WI (715-854-9234) and Beloit, WI (608-365-6771) -M. Naeser, Ph.D., L.Ac. The Respond Systems Co. also manufactures an infrared (IR), 904 nm, continuous wave, single probe which has a higher power output, than the pulsed probe. The continuous wave probe is 500 mW. This probe delivers 1 joule per cm square every 2 seconds. Ten seconds with the continuous wave, 500 mW IR probe may also help to improve the circulation at the tender spots in the fascia, on the heel spurs. If the 500 mW IR probe is used first, on the tender spots, it is also recommended to follow up with some Tonification on these areas, with lower Nogier frequencies with the pulsed IR laser, for a few minutes, as mentioned above. Low Back Pain: Also, when treating low back pain, for example, while the acupuncture needles are in Bl 23, place/tape the laser block (4 laser diodes in an array, in the 4-inch by 3-inch laser block that is part of the Respond System laser equipment) next to the needles, either in between L and R, Bl 23 (across the spine), or lateral to Bl 23, especially if pain is there. The IR laser local stimulation next to the acupuncture needle seems to improve the circulation there. I learned this from Ken Branco, L.Ac., Westport, MA (kbranco@javanet.com). Ten seconds with the continuous wave, 500 mW IR probe may also help to improve the circulation at the tender spots on the back, prior to initiating work with the pulsed laser probe. When the 500 mW IR probe is used first, it should be followed up with Tonification - either with the lower Nogier pulsed frequencies with the IR laser, or with acupuncture needles or moxa. This is also a method used successfully by a licensed acupuncturist in Hull, MA, Jeanne Christianson, L.Ac., jchris2@mediaone.net Legal issues regarding the practice of low-level laser therapyLow-level laser therapy is considered investigational by the FDA, and no medical claims of cures are permitted in the US, at this time. It is my understanding, however, that if low-level lasers are defined within the state scope of medical practice (as it is in Massachusetts for licensed acupuncturists), then the FDA will not interfere, as long as the licensed acupuncturist does not make any medical claims of cures. We do have an independent institutional review board (IIRB) for laser acupuncture (research) in Massachusetts, with which the licensed acupuncturist may register his/her laser and his/her laser acupuncture treatment protocols, for a specific disorder, etc. This board is limited to licensed acupuncturists in Massaschusetts, only. The licensed acupuncturist also obtains informed consent from each patient. I have published a laser acupuncture, introductory textbook (listed below), and there is a 48-page addendum to the textbook which explains FDA regulations from written materials in the 1980's. The information regarding the issue of low-level laser therapy being within the scope of medical practice per state regulations, per state, is only from verbal conversations with the FDA in the last year or so - I have nothing in writing. The information regarding investigational use, and the issue of being within the scope of medical practice per state regulations, per state, is only from verbal conversations with the FDA in the last year or so - I have nothing in writing. In theory, if the licensed acupuncturist uses the low-level lasers, without registering with an IIRB, and there is a complaint by a patient directly to the FDA (there have been none since we started in Mass., 6 years ago), then the FDA has the right to take away the lasers from the acupuncture office, as I understand it. This is fairly complex and I cannot speak for the FDA. Where can I get a laser?Some laser vendors are the following, and I repeat that I do not endorse any lasers, nor do I make any medical claims of cures for any lasers.
Expert sources for more information:Licensed acupuncturists in the U.S. who have a great deal of experience with low-level laser therapies, especially for Carpal Tunnel Syndrome are Kenneth Branco, Lic.Ac., Westport, MA, and Michael Ranft, Lic.Ac., Hot Springs, Arkansas, mranft@aol.com. Another licensed acupuncturist in the U.S. who has a great deal of experience with low-level laser therapies is Peter Courtnage, Ph.D., Lic.Ac., in Englewood, CO. LaserLLC@aol.com A chiropractor who has extensive experience with low-level laser therapies is Scott Deuel, D.C., Castle Rock, CO. LLLTDC@aol.com There is also the North American Association for Laser Therapies, newly formed (NAALT). Contact Lynda Woodruff, Ph.D., P.T. the President of NAALT for more info: lwoodruff@ngcsu.edu Dr. Woodruff is located in Dahlonega, GA, North Georgia College State University. She is also conducting low-level laser research there with treating pain in carpal tunnel syndrome. She uses lasers manufactured by Phil Passy, at LaserPath, Inc. His email is: info@laserpath.com Laser Acupuncture Teaching Publications:
Other laser acupuncture publications include:
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