All posts in Laser Therapy

Tendinopathy Pain Treatment

Chiropractic care or medication/shots?

Bone marrow stem cell injections vs non-surgical, non-invasive therapy?

DC’s, PT’s and MD’s know that chronic tendon pain is a challenge to treat. Chiropractors and Physical therapists use non-invasive procedures while medical doctors use cortisone shots and now some are using stem cell therapy injections. Research by doctors at the National University of Singapore suggest that bone-marrow derived stem cells accelerate tendon healing.1 Resolving ongoing inflammation is the key to management of these cases.

This is why the great excitement in stem cell therapy, it has the potential to reduce inflammation. BUT, so does TheraLase laser therapy and the use of PiezoWave and EnPuls. These are non-invasive therapies that the general public are not aware of yet.
Even the Center of Translational Regenerative Medicine researchers, in Torino, Italy say: “Tendon injuries represent even today a challenge as repair may be exceedingly slow and incomplete. Regenerative medicine (Tucker’s note – meaning laser and shockwave like the EnPuls & PiezoWave) and stem cell technology have shown to be of great promise.”2

I would much rather have patients try these non-invasive and less expensive therapies before getting a cortisone shot or going through expensive stem cell therapy first.

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Arthritis Relief Chiropractor

Can fish oils help my arthritis?
Health benefits of using Omega 3 fish oils include lowering your risk of heart disease, blood vessel disease, lowering triglycerides, and “thinning” the blood (reducing the risk of clots). It may improve brain development, concentration, learning ability and behavior in children as well as enhancing brain function in adults (60% of the brain is fat and half of that is DHA). I do find it helpful for my arthritic patients (see dose below). Along with recommending supplements for arthritis I use lasers directly over painful joints. These offer a deep heat sensation and helps relieve pain in arthritic joints.

Do tinned and smoked fish count?
Regarding eating fish, I would say that ALL fish is good for you. It is a very lean source of protein. It’s normally the way that fish is cooked that detracts from its goodness – think battered and fried (Not good). Oily fish such as fresh salmon, herring, mackerel, and sardines contains the ‘healthy’, or polyunsaturated, fats that we are advised to eat more of. These types of fish are high in Omega 3 which is called an essential polyunsaturated fatty acid – it is ‘essential’ because our bodies cannot make it so we need to consume it through our diets.
If a product’s been tinned or smoked it will have fewer micronutrients (vitamins and minerals) than the fresh version, however it will still be a good source of protein, low in fat and contain a certain amount of vitamins and minerals. The fish to really avoid are the ones that have been battered, breaded or already have cheesy or creamy sauces on them. Also, fish to eat the least often are deep sea fish (especially large fish) such as shark, marlin, tuna and swordfish. These may contain particularly high levels of mercury. These fish should be avoided by pregnant women and children under 16 years old. Mercury is potentially harmful for children and it can harm fetuses.

How Much Fish Oil Do I Need?
It is recommended that adults and children over 12 years old eat 2 portions of oily fish per week – a portion is 140g cooked fish and it will contain approximately 450mg of Omega 3’s. I typically recommend that clients take supplements of 3 grams of Omega 3 fish oils each day (order at www.DrJeffreyTucker.meta-ehealth.com)(try EPA-DHA 720 or SPM Active). If a client has acute or chronic pain I may recommend even higher doses.

There are some vegetarian sources of omega-3’s like walnuts, flaxseed (linseed) oil, canola oil, soybean oil, etc., all of these are short chain polyunsaturated acids which must be converted by the body into longer chain PUFAs to be useful. Since fish oil already contains long chain PUFAs, it’s the best dietary source. For vegetarians I recommend Biotics Mixed EFA’s.

When taking fish oil supplements, it is generally a good idea to take vitamin E (3 mg for every 1 gram of fish oil) to protect against oxidation. Omega-3s are polyunsaturated fatty acids and Vitamin E counteracts free-radical formation from unsaturated oils.

 

 

 

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Plantar Fasciitis Chiropractor

The bottom of your foot hurts. Maybe one side, or worse both feet hurt! The cause of the pain is probably something related to a change in your walking or running habits. People say to me “I haven’t changed anything so how does it happen?” There has to be something that you are doing wrong that you don’t even know you are doing wrong. It’s often in your gait or posture causing an excessive strain that is creating repetitive irritation of the arch of the foot.

Plantar fasciitis starts with some inflammation of the fascia on the bottom of the foot and eventual thickening of the plantar fascia. I don’t have to tell you that it can be a severe irritation. In order for me to evaluate and correct plantar fasciitis I examine the whole Superficial Back Line of fascia, which starts at the bottom of the foot and goes all the way up to your head. We might find this fascial band tight anywhere along its entire length. Fascia is the primary force transmission system in your body. If it cannot transmit force efficiently, there is too much strain in certain places: the bottom of the foot is often one of the spots that takes the burden of the excess stress (resulting in too much strain).

The examination includes checking for tightness in the muscles around the calf, especially the soleus and toe flexors. I also check stability and force generation in your glutes, psoas, quads, and abdominals. If they are inhibited or weak the lower leg and foot have to do more work. More work leads to pain and discomfort. A common movement pattern dysfunction of plantar fasciitis is lack of strength and timing of the Gluteus Maximus. Weak glutes contribute to foot dysfunction.

Key non-invasive treatments: 

EnPuls (radial pulse therapy or shock wave therapy) and Piezowave Therapy (Acoustic pulse therapy)

These therapies significantly reduce pain and inflammation while stimulating the formation of new collagen matrix in damaged foot tissues. Properly applied shock wave therapy with optimal dosage is one of the best modalities available for effective treatment of Plantar Fasciitis. Often you will feel significant changes and improvements within several sessions.

 

Kinesiology Taping 

Taping is an effective tool for alleviating symptoms and helping to form new movement habits. Sensory input from the tape on skin ignites the brain maps in discovering new options for movement. Tape adds stability. More stability leads to increased movement variability. Being stability is a good thing.

 

I am the only Chiropractor in Los Angeles with these combinations of modalities to target treatment to the site of pain and I teach patients the use of corrective exercises. This approach leads to more positive outcomes. The body will tell you very quickly what it likes and what it doesn’t like. If you feel better and it lasts you are on the right track. If you don’t, that’s a sign you need to change approaches. I can combine radial pulse waves, acoustic pulse waves, laser therapy, taping, and strength work to help you heal better and faster.

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Knee Pain

In the Journal of Knee Surgery doctors from the Department of Orthopaedic Surgery, University of Pittsburgh had this to say about regenerative medicine:

  • Biologic agents (stem cells and blood platelets or PRP therapy) are gaining popularity in the management of bony and soft tissue conditions about the knee. However, what they don’t say is that these therapies have risks! I encourage patient’s to start with non-invasive, non-operative therapy in the athletic and aging population.

I agree that Platelet-rich plasma (PRP) and stem cells have shown promise in the treatment of various conditions. I see improved outcomes following shockwave therapy and or laser therapy in early osteoarthritis of the knee, as well as in chronic patellar tendinopathy conditions. My feeling is to start with non-invasive regenerative therapies such as laser and shockwave and then go with injections on an as-needed basis.

  • There is evidence that supports PRP in the augmentation of anterior cruciate ligament (ACL) reconstruction. But there is research for shockwave too. Shockwave therapy research exists for collateral ligament and meniscal injuries as well. I’m especially excited about the results we see with knee osteoarthritis using the laser and shockwave devices.
  • …As the volume and quality of evidence continue to grow, biologic agents are poised to become an integral component of comprehensive patient care throughout all orthopedic specialties. (2) I completely agree with this statement.
  • The use of stem cells as a biological approach to treat cartilage lesions and osteoarthritis has widely increased. The same is true for Laser and Shockwave therapy.
  • Different sources have been investigated for clinical application, especially targeting knee or ankle cartilage disease.(3) I continue to be especially excited about the results we are seeing with the shockwave therapy and laser combination treatment.

I think athletes or high activity people with joint pain need to learn about the choices between stem cell injections and non-invasive laser and shockwave treatments to restore damaged cartilage, and also to act as a protector against future deterioration of the knee joint.

1 Kopka M, Bradley JP. The Use of Biologic Agents in Athletes with Knee Injuries. J Knee Surg. 2016 May 20. [Epub ahead of print]

2 Filardo G, Perdisa F, Roffi A, Marcacci M, Kon E. Stem cells in articular cartilage regeneration. Journal of Orthopaedic Surgery and Research. 2016;11:42. doi:10.1186/s13018-016-0378-x.

3 Yang X, Zhu TY, Wen LC, Cao YP1, Liu C, Cui YP, Meng ZC, Liu H. Intraarticular Injection of Allogenic Mesenchymal Stem Cells has a Protective Role for the Osteoarthritis. Chin Med J (Engl). 2015 20th Sep;128(18):2516-2523. doi: 10.4103/0366-6999.164981.

  1. Nyland J, Mattocks A, Kibbe S, Kalloub A, Greene JW, Caborn DNM. Anterior cruciate ligament reconstruction, rehabilitation, and return to play: 2015 update.Open Access Journal of Sports Medicine. 2016;7:21-32. doi:10.2147/OAJSM.S72332.
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Sports Injury Chiropractor Brentwood

 

Suffering from Sports Injuries?

For our body to function properly we need energy. The mitochondria are the cells in the body responsible for energy supply to the cells and releasing energy for the body. Oxygen enters the body cells, and the oxygen converts into CO2 and H2O, which takes place in the mitochondria. Food we eat gets turned into nutrients and gets connected to the transference of oxygen. This results in a molecule known as ATP (adenosine triphosphate). This action is essential in virtually any bodily activity, from the motion of our muscles to the transfer of nutrients and waste materials in and from the cells. Furthermore, ATP is essential for the generation of electrical signals in the nervous system.

 

Without oxygen (and adequate nourishment) there simply would be no ATP. Without ATP we simply wouldn’t be able to move, let alone have the capacity to think. If ATP is decreased, muscles start to become sore and ache. Many people are ATP deficient from taking statin drugs, adrenal gland dysfunction, lack of sleep, breathing dysfunctions, poor nutrition, and lack of recovery from sports and work outs.

 

Dr. Jeffrey Tucker uses non-invasive regenerative medicine therapies for sports-related musculoskeletal injuries that are often related to oxygen and mitochondrial dysfunctions. Basic science supports the possibility of enhanced recovery from sports injuries using diet, nutrition and the application of lasers, shockwave machines and breathing strategies.

It’s clear the TheraLase Laser and PiezoWave treatment has an effect. What is not as clear is how it lessens pain but it does decrease pain. It’s possible the PiezoWave impulse is lavaging the area moving along inflammatory substances, or increasing stem cell production that decreases inflammation, or if the shock wave stimulation of stem cells release substances that affect other cells.

Some case studies have shown that the Piezo Wave or Enpuls shock wave treatments can decrease calcifications in tendons and joints, and even regenerate worn-out cartilage.

Dr. Jeffrey Tucker sports injury chiropractor in Brentwood uses non-invasive shock wave therapy and laser as a safe alternative to cortisone or prolotherapy for the treatment of athletic injuries related to poor ATP production.

 

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Chronic Pain Chiropractor

It is well established that regular exercise can help with disorders such as fibromyalgia, chronic low-back pain and arthritic conditions. Most chronic pain and sports medicine practitioners will agree that gentle aerobic conditioning is a good place to start exercising. After an aerobic baseline is achieved, strength training for larger muscle groups becomes appropriate. Core training exercises will most likely be recommended as part of a chronic musculoskeletal condition prescription. It’s not likely that you will be introduced to ‘training to fatigue’ exercise, high-intensity interval training or plyometrics if you have chronic pain. The new model of therapy based on research includes:

  • The use of TheraLase laser and shock wave therapy as a non-invasive approach to treat cartilage lesions and osteoarthritis has widely increased as confirmed by the growing number of clinical trials published on this topic.
  • The use of these procedures in clinical application is gaining in popularity. The cost of these machines has been expensive and kept doctors out of the field.
  • Different sources have been investigated for clinical application, especially targeting knee or ankle cartilage disease.3

Other recommendations for chronic pain patients (even high activity patients) are nutritional supplements to restore damaged cartilage. Some combination of Ginger, Rosemary, Quercetin, Curcumin, Hops, Alpha-Linolenic Acid, omega 3’s and and a ketogenic diet can also act as a protectors against future deterioration of the joints.

1 Kopka M, Bradley JP. The Use of Biologic Agents in Athletes with Knee Injuries. J Knee Surg. 2016 May 20. [Epub ahead of print]

2 Filardo G, Perdisa F, Roffi A, Marcacci M, Kon E. Stem cells in articular cartilage regeneration. Journal of Orthopaedic Surgery and Research. 2016;11:42. doi:10.1186/s13018-016-0378-x.

3 Yang X, Zhu TY, Wen LC, Cao YP1, Liu C, Cui YP, Meng ZC, Liu H. Intraarticular Injection of Allogenic Mesenchymal Stem Cells has a Protective Role for the Osteoarthritis. Chin Med J (Engl). 2015 20th Sep;128(18):2516-2523. doi: 10.4103/0366-6999.164981.

  1. Nyland J, Mattocks A, Kibbe S, Kalloub A, Greene JW, Caborn DNM. Anterior cruciate ligament reconstruction, rehabilitation, and return to play: 2015 update.Open Access Journal of Sports Medicine. 2016;7:21-32. doi:10.2147/OAJSM.S72332.
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Knee osteoarthritis: Stem cells vs laser/shockwave therapy

New research continues to establish stem cell therapy as a first line of treatment for athletic joint injuries.

In the Journal of Knee Surgery doctors from the Department of Orthopaedic Surgery, University of Pittsburgh:

  • Biologic agents (stem cells and blood platelets or PRP therapy) are gaining popularity in the management of bony and soft tissue conditions about the knee. They are becoming the mainstay of nonoperative therapy in the high-demand athletic population.

In my office I use non-invasive laser and shock wave therapy as the first line of treatment of various joint conditions. We are demonstrating improved outcomes following laser and shock wave therapy treatment compared to standard physical therapy modalities such as ultrasound and electrical stimulation. To my knowledge, I am not aware of studies that compare TheraLase laser and Enpuls shockwave or PiezoWave acoustic wave therapy to injection. We are the most experienced Los Angeles chiropractic office for providing non-invasive treatment for early osteoarthritis of the knee, chronic patellar tendinopathy and plantar fasciitis.

  • Early clinical evidence also lends support for PRP in the augmentation of anterior cruciate ligament (ACL) reconstruction. Research investigating the role of biologic agents in collateral ligament and meniscal injuries is ongoing. Studies assessing the utility of stem cells have shown encouraging results in the setting of osteoarthritis.

Again, I prefer to have patients start with a trial of TheraLase and shock wave therapy especially for knee osteoarthritis instead of spending a lot of money and risk with shots/injections. 

  • I believe the shift is occurring where the volume and quality of evidence continues to grow for biologic agents, and laser/shock wave therapy are poised to become an integral component of comprehensive patient care throughout all orthopedic specialties.2

1 Kopka M, Bradley JP. The Use of Biologic Agents in Athletes with Knee Injuries. J Knee Surg. 2016 May 20. [Epub ahead of print]

2 Filardo G, Perdisa F, Roffi A, Marcacci M, Kon E. Stem cells in articular cartilage regeneration. Journal of Orthopaedic Surgery and Research. 2016;11:42. doi:10.1186/s13018-016-0378-x.

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Stem Cell Therapy Without Shots?

I have written many articles on laser and shock wave therapy and how these modalities can improve degenerative disease especially of the spine, hips, knees and shoulders.

 

Similar to what stem cell injections are claiming to do in the spine or joints, shock wave therapy and laser therapy also effect cells that turn up communication with the immune system and begin exchanging new cellular messages. The result of a stem cell shot is still expensive and risky whereas a shock wave session or laser session is non-invasive and safe. Both tell the immune cells to mobilize healing factors to the site of damage.

 

Let’s use the research to understand how these therapies work:

When stem cells get injected into a diseased joint (ex. spine, knee) the stem cells have the ability to change/morph into other cell types and multiply. They also signal the native stem cells and other growth factors to regroup and begin repairing damaged joints. Without an injection, I use shock wave therapy and laser to stimulate growth factors and inhibit molecules that have a role in inflammation.

Mesenchymal stem cell MSCs (connective tissue stem cells) suppress inflammatory T–cell proliferation and provide an anti-inflammatory effect. The treatment inhibits damaging chronic inflammation.1

 

If you have a bulging disc in the spine, research in the medical journal Stem cells translational medicine suggests that stem cells, without direct injection to the site of disc lesions in the spine, can repair disc lesions by changing the healing environment of the spine. This means we can use stem cell recruitment to inhibit disc degeneration and disc herniation by way of the complex interplay between stem cells and immune system cells in achieving successful disc tissue regeneration.

 

Using non-invasive therapy and exercise the goal is to regenerate the outer tissue of the disc and contain and lessen the inflammation around the bulge. TheraLase will bring more oxygen to the damaged disc and accelerate healing by reversing the low-oxygen (degenerative or dying) environments in the spine. Everything heals with more oxygen.

 

Stem cell activation is able to reduce or prevent herniation by suppressing the non-healing inflammation.2 The take home message is that non-invasive EnPuls radial shock wave therapy, PiezoWave acoustic therapy, and TheraLase laser combined with exercise and diet have unique healing capabilities. Is this treatment right for you? Contact me at my office 310-444-9393.

 

1 Davatchi F, et al. Mesenchymal stem cell therapy for knee osteoarthritis: 5 years follow-up of three patients. Int J Rheum Dis. 2016 Mar;19(3):219-25

2 Cunha C, Almeida CR, Almeida MI, Silva AM, Molinos M, Lamas S, Pereira CL, Teixeira GQ, Monteiro AT, Santos SG, Gonçalves RM, Barbosa MA. Systemic Delivery  of Bone Marrow Mesenchymal Stem Cells for In Situ Intervertebral Disc Regeneration. Stem Cells Transl Med. 2016 Oct 11. pii: sctm.2016-0033.

 

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Knee arthritis pain! Massage, Laser, Chondroitin?

Along with the hundreds of thousands in the U.S. who have total knee replacement surgery done every year, many more are held hostage by drugs — from risky OTC meds to terribly dangerous Rx ones — that they have to take daily, just to be able to function.

A study published in the BMJ (May 2017) discusses the benefits of the supplement chondroitin for painful knee joints. Chondroitin is typically derived from animal or fish cartilage and was found to be just as powerful as one of the most widely prescribed Rx drugs for arthritis.

Do you need glucosamine and chondroitin? If you have pain from knee arthritis, chondroitin may be the better choice. The researchers put chondroitin to a head-to-head test with one of the most commonly used Rx meds for the condition, Celebrex which is the only “COX-2 inhibitor” left on the pharmacy shelves (Vioxx and Bextra were taken off the market after untold numbers of patients suffered heart attacks and strokes after taking them).

Chondroitin is extremely safe, and was just as good as Celebrex at stopping pain and improving joint function. The study and experience with patients demonstrates that Celebrex kicks in faster, the improvements from taking 800 mg of chondroitin daily were just as effective after several weeks. And it continued to be as good as Celebrex right through to the end of the entire study.

Chondroitin should be offered to patients with knee arthritis as a first-line treatment.

There are, however, certain circumstances in which chondroitin supplements should be avoided. One is if you have an allergy to shellfish, especially shrimp, as many are derived from fish cartilage. Another is if you have prostate cancer, as some research has found that it may help prostate-cancer cells to spread.

And that’s where glucosamine can be taken instead. Glucosamine, which can also be made from shellfish (so check labels carefully if you’re allergic), has been the subject of numerous studies and found to be extremely effective for the pain and stiffness of arthritis.

While these two are most often found as a team in supplements, since they work even better together, you should still be able to find either glucosamine or chondroitin by themselves.

I use Laser therapy, massage and offer supplements for arthritis pain relief. This is the best non-drug, non-risky combination therapy for knee arthritis available. Call the office at 310-444-9393 to schedule an appointment.

Sources:
“Chondroitin sulfate as good as widely used anti-inflammatory for knee osteoarthritis” BMJ, May 23, 2017.

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Chiropractic & Inflammation

Dr. Tucker uses natural ways to fight back against inflammation without resorting to risky meds.
For example:

  • Research continues to support a Mediterranean-style diet that can help improve the “quality of life” for arthritis patients. That includes cutting down on red meat, eating more servings of fish and veggies, adding a variety of nuts to your diet and using olive oil almost exclusively in your cooking and meals. Dr. Tucker can also recommend specific vitamins for you to take to help decrease inflammation.
  • Laser therapy — Dr. Tucker has two types of laser treatments to offer for pain relief! This method of treatment is safe and especially useful for inflammation in the neck, shoulders, hips and spine.
  • While exercise may be the last thing you probably feel like doing with an ‘inflammation’ condition, being more active, even small increases in movement have been found to help. One study that looked at over 1,600 adults with arthritis found that just 45 minutes of moderate activity a week was enough to significantly improve their ability to function. Swimming is said to be one of the best exercises you can do, even when you’re having an arthritic flare. Call 310-444-9393 to schedule an appointment.
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