All Posts tagged warm laser

Laser for pain

When I looked to purchase a new Laser for my practice, I really did my research. I picked a Laser that I could use while performing deep tissue massage. The Laser plus massage provides pain relief faster than Laser alone.

Here is what I am seeing after using the laser in my day-to-day practice…

Patients like the soothing warm feeling of the Laser with deep tissue massage better than hands-on only.

Laser is best known for healing and anti-inflammatory effects. I am not disappointed by the results.

For an acute injury, the sooner you get in for the Laser treatment the quicker the healing process.

Patients like when I apply the Rock Tape after the Laser.

For long term chronic pain problems, combining the Deep Muscle Stimulator, Radial Pulse Therapy, exercise, and nutrition are getting the best results.

The Laser is useful for treating large painful areas like the low back, and in a short time obtains pain relief.

The laser is solving difficult knee, shoulder, ankle and foot pain.

Typical Laser sessions can last from 5 – 15 minutes.

The current price of a laser session in my office is approximately $40. Other Doctors are charging $60-90 for Laser treatments and they are using less quality devices.

Laser treatments are safe, they last, they are effective for analgesia of painful conditions, they penetrate deeply.

Call the office at 310-444-9393 to try the Laser with massage.

 

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Laser Therapy for Pain Relief

I stopped using the Biolase and am now testing out a new Laser device/system.  Class IV Laser Therapy  for pain relief are becoming more and more mainstream. I started using laser more than 5 years ago. I have more experience with warm laser than most practitioners. Laser therapy reduce pain associated with inflammation and swelling.

Sometimes I use the laser as a stand alone treatment and with other clients they require laser in conjuction with Radial Shock Wave Therapy, the Deep Muscle Stimulator (DMS), SCENAR or hands-on therapy.  I continue to recommend  stretching, corrective exercise and diet recommendations.

I also look at clients  shoe wear and arch supports(or lack of support) – sometimes wearing better or different shoes with inserts helps make a big difference in low back pain. I discuss sitting and standing posture. Prolonged sitting without taking a break is a major contributor of back and neck pain. The new recommendation for taking a break from sitting is stand-up every 20 minutes for at least two minutes– don’t let your muscles tighten up in the first place. Reduce the time spent sitting!

Please come in and feel the new Laser. Call 310-444-9393

Staying innovative as always! Best, Jeff

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Corticosteroid injections

Corticosteroid injections ease the pain of tennis elbow short term but may worsen it long term, according to a meta-analysis.

The injections significantly cut pain scores over the first four weeks with a standardized mean difference of 1.44 compared with no intervention (*P*<0.0001), Bill Vicenzino, PhD, of the University of Queensland in St. Lucia, Australia, and colleagues reported online in *The Lancet*.

But by six months, the effect had reversed to significantly favor no treatment (standardized mean difference -0.40, *P*<0.003). And at 12 months, no treatment still looked better than the injections (standardized mean difference -0.31, *P*=0.05).

Action Points
– corticosteroid injections ease the pain of tennis elbow short term but may worsen it long term.
– this study concluded that there is insufficient evidence for the efficacy of corticosteroid injections for treatment of tendinopathies of the Achilles and kneecap.
– other tendinopathies showed mixed results.

There is insufficient evidence for the efficacy of corticosteroid injection in tendinopathies of the Achilles and kneecap, and the rarity of acute tendon rupture with corticosteroid injections — less than 1% in the meta-analysis — was reassuring, the editorialists noted.

Other injections, such as such as plasma-rich protein, prolotherapy, or sodium hyaluronate injections, should still be considered experimental with no evidence that any are a magic bullet for tendinopathy, they cautioned.

Of the 2,672 patients in these trials, 1,171 had tennis elbow. For them, corticosteroid injections were consistently better in the primary outcome of protocol-defined pain score at one month with large effect sizes compared with no intervention, nonsteroidal anti-inflammatory drugs (NSAIDs), physiotherapy, and orthotic devices.

At six months, though, tennis elbow showed significantly poorer reductions in pain compared with no intervention, NSAIDs, physiotherapy, and platelet-rich plasma injections. The same pattern was seen at 12 months with the exception of no difference between NSAIDS and corticosteroids.

Notably, repeated corticosteroid injections — ranging from three to six over 18 months — actually yielded poorer long-term pain results than just one injection.

For rotator cuff tendinopathy, the 10 trials showed conflicting short-term results for corticosteroid injections ranging from a medium effect compared with placebo to no difference compared with NSAIDs or physiotherapy. Intermediate and long-term results showed no differences among the treatments.

For medial epicondylalgia (also known as golfer’s elbow), the one study available showed no benefit of corticosteroid injection even in the short term.

For tendinopathies of the leg, the one trial evaluable indicated a large short-term pain reduction with corticosteroid injection, but more for patellar than Achilles tendons.

Given these findings, the researchers cautioned in the paper that “response to injection should not be generalized because of variation in effect between sites of tendinopathy.”

Adverse events seen with corticosteroid injection included atrophy (9%), pain (8%), depigmentation (less than 1%), and one case of tendon rupture of the Achilles tendon (less than 1%).

Among the other types of injections, the researchers found:

– The sclerosing agent polidocanol (Asclera, also known as lauromacrogol) improved patellar tendinopathy but not Achilles tendinopathy or tennis elbow.
– Platelet-rich plasma yielded mixed results with no short- or intermediate-term pain reductions in one study for Achilles tendinopathy but a large effect at intermediate and long term in a second study.
– The collagen-building substance sodium hyaluronate substantially improved tennis elbow at all time points compared with placebo in one study but was no better than electrotherapy for rotator cuff tendinopathy in another.
– Injections of an irritant to stimulate the body’s repair mechanisms (prolotherapy) held no reduction in pain short term but a big effect at six months for tennis elbow in one study and no difference at any time point for Achilles tendinopathy compared with the combination with eccentric exercise in a second study.
– Botulinum toxin (Botox) showed a big pain reduction short term for chronic tennis elbow compared with placebo in one trial.

The study received partial support from the National Health and Medical Research Council of Australia.

*Primary source: *The Lancet
Source reference:
Coombes BK, et al “Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy: a systematic review of randomised controlled trials” *Lancet* 2010

 

Dr. Tucker recommends a trial course of warm laser and/or Deep Muscle Stimulation (DMS) for such injuries prior to cortisone injections. A reasonable trial course may include 6-7 sessions. If the pain improves the warm laser and/or DMS can be continued. If the trial course did not help, it is reasonable to try another course of treatment.

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Laser Treatments

Laser therapy has been around for a long time but it is considered cutting edge treatment for musculoskeletal injuries and pain.
Laser therapy stimulates cellular activity, expediting the healing processes to reduce inflammation and repair damaged tissue. 

You can feel the warm deep tissue penetration. This deep heat significantly increases the body’s cellular production of ATP (Adenosine-triphosphate) to reduce inflammation and heal the inflamed area.

Here are some of the benefits of using the deep tissue penetration that laser provides safely and effectively:

Healing and pain relief with no side effects, drug interaction effects, or invasive surgery.

Treats acute and chronic conditions as well as post surgical pain.

Pain relief is often felt immediately.

Most laser treatments take only 10-20 minutes.

Are you a potential candidate?

  • If you have pain that is of musculo-skeletal origin, laser therapy may be for you:
    This includes sports injuries, back and neck pain, any joint pain (knee, shoulder, ankle, etc), bursitis, tendonitis, tennis elbow, contusions, strains and sprains, carpal tunnel syndrome, chondromalacia patellae, arthritis, fibromyalgia, heel spurs, plantar fascitis, migraine headaches, neck pain/whiplash, nerve root pain, postoperative pain, repetitive stress injuries, TM joint pain and more.
  • If you have the wound that is slow to heal and has been resistant to treatment, you may be a candidate for laser therapy. This includes slow healing fractures, as well as soft tissue injuries and ulcers.
  • If you have multiple trigger points (sore spots in the muscles) that do not go away, you may be a candidate for laser therapy. This includes areas associated with fibromyalgia.
  • If you have had Prolotherapy or PRP, and wish to accelerate the response of healing, you may be a candidate for laser therapy. This includes any area that has been treated with Prolotherapy/PRP injections.
  • If you need Prolotherapy or PRP therapy but are afraid of needles, you may be a candidate for laser therapy.
  • Laser therapy stimulates the same areas that Prolotherapy targets. It does it without needles, but requires a lot more time and repeated treatments to gain the result that can be gotten from Prolotherapy and laser together.

Feel free to call me directly at 310-473-2911 or call my cell phone at 310-339-0442

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What is High Power Deep Tissue Laser Therapy?

Laser Therapy is a non-invasive, safe, and effective treatment modality where light is used to relieve pain, reduce inflammation, and promote wound healing and soft tissue repair. Most therapy lasers on the market today have a power range from 5mw to 500mw, making them a cold laser. Our laser will emit a power range from 1000mw to 10,000mw, making this a high-power heat deep tissue laser that can put an end to your pain fast!

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Laser treatment

I use High Power Laser Therapy (7.5 watts). Laser stimulation has been shown to increase blood flow and lymphatic drainage while, at the same time, stimulating endorphin and enkephalin release for pain management. Stimulation with laser reduces inflammation, and promotes nerve regeneration.

High Power Laser Therapy has the ability to reach deep within the body when compared to Low Level Laser Therapy. Laser energy apperas to also biostimulate collagen and fibroblast growth.

I usually use the laser in combination with hands-on therapy and I often use the Deep Muscle Stimulator (DMS) as well. Exercises are taught based on the Functional Movement Screen (FMS) and squat evaluation.

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Chronic Pain Guidelines

In April 2010 a new list of  Chronic Pain Guidelines was published by The American Society of Anesthesiologists.

The new recommendations are designed to help clinicians who treat pain. The objectives are to optimize pain control, enhance physical and  psychological well-being, and minimize adverse outcomes.

The new guidelines appeared in the April issue of Anesthesiology. The recommendations apply to patients with chronic noncancer,
neuropathic, somatic, or visceral pain. The taskforce focused on interventional diagnostic procedures including diagnostic joint block, nerve block, and neuraxial opioid trials.

The key to chronic pain is creating an individualized treatment plan focused on optimizing the risk-to-benefit ratio. Treatment should progress from a lesser to greater degree of  invasiveness.

The new guidelines advocate for multimodal interventions for patients with chronic pain. The taskforce suggests that a long-term approach that includes periodic follow-up evaluations should be developed and implemented as part of the overall treatment strategy. In addition, when available, multidisciplinary programs may be used.

The new guidelines detail

* ablative techniques,
* acupuncture,
* blocks,
* botulinum toxin,
* electrical nerve stimulation,
* epidural steroids,
* intrathecal drug therapies,
* minimally invasive spinal procedures,
* pharmacologic management,
* physical therapy,
* psychological treatment, and
* trigger point injections.

Drugs for chronic pain include anticonvulsants, antidepressants, benzodiazepines, N-methyl-D-aspartate receptor antagonists,
nonsterioidal anti-inflammatories, opioid therapy, skeletal muscle relaxants, and topical agents. The taskforce discusses each in detail and recommends strategies for monitoring and managing adverse effects and patient compliance.

Anesthesiology. 2010;112:810-833.

Dr. Tucker comment: Over the years my practice has evolved to treating chronic pain patients. I work with my clients medical doctors to design personalized programs. My current approach to chronic pain is to use warm laser, physical therapy, breath and body awareness, gentle corrective exercises, natural topical agents, and nutritional therapy. The exercise rehabilitation approach I use is unique in that I blend several techniques to create a treatment plan that gives clients responsibility for participating in recovery. Clients particularly like the detailed nutritional information I provide.

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Beating back pain with DMS, laser & corrective exercise training

Chronic back pain can ruin your life. Dr. Tucker suggests that a targeted program of DMS, warm laser & corrective exercise training can accelerate recovery.

I hate when clients have to miss work or workout days because of low back pain. I have experienced low back pain and I understand  the misery, pain and frustration it causes. Debilitating back injuries can be helped with controlled activity, movement therapy, warm laser and Deep Muscle Stimulation (DMS). First I get rid of the acute back pain and swelling with the warm laser. Then I use the DMS on the back spasms. I still use other treatments such as moist heat, therapeutic ultrasound, massage and electrical stimulation because these have  positive effects too.

Part of recovery is the continuation of normal daily activities. Bed rest is only recommended when you can’t get out of bed because it hurts too much to move.

As soon as possible I like to see clients begin corrective exercise. We begin with gentle controlled movements that usually use just your bodyweight. Then we can progress to band or stability ball therapy lessons. Eventually I train my clients in kettlebell maneuvers. Kettlebell training helps with fat loss, core strength, and range of movement. If you like Pilates and yoga or wanted to learn these methods, you will love Kettlebells. Training the ‘core’ has become a popular focus in recent years, and I’m all about improving the “core” to prevent future episodes of low back pain.

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Efficacy of Low-Level Laser Therapy for Body Contouring and Spot Fat Reduction.

Caruso-Davis MK, Guillot TS, Podichetty VK, Mashtalir N, Dhurandhar NV, Dubuisson O, Yu Y, Greenway FL.
School of Human Ecology, Louisiana State University, Baton Rouge, LA, 70803, USA.

Obes Surg. 2010 Apr 15. [Epub ahead of print]
PMID: 20393809 [PubMed – as supplied by publisher]

BACKGROUND: Low-level laser therapy (LLLT) is commonly used in medical applications, but scientific studies of its efficacy and the mechanism by which it causes loss of fat from fat cells for body contouring are lacking. This study examined the effectiveness and mechanism by which 635-680 nm LLLT acts as a non-invasive body contouring intervention method.
METHODS: Forty healthy men and women ages 18-65 years with a BMI < 30 kg/m(2) were randomized 1:1 to laser or control treatment. Subject's waistlines were treated 30 min twice a week for 4 weeks. Standardized waist circumference measurements and photographs were taken before and after treatments 1, 3, and 8. Subjects were asked not to change their diet or exercise habits. In vitro assays were conducted to determine cell lysis, glycerol, and triglyceride release. RESULTS: Data were analyzed for those with body weight fluctuations within 1.5 kg during 4 weeks of the study. Each treatment gave a 0.4-0.5 cm loss in waist girth. Cumulative girth loss after 4 weeks was -2.15 cm (-0.78 +/- 2.82 vs. 1.35 +/- 2.64 cm for the control group, p < 0.05). A blinded evaluation of standardized pictures showed statistically significant cosmetic improvement after 4 weeks of laser treatment. In vitro studies suggested that laser treatment increases fat loss from adipocytes by release of triglycerides, without inducing lipolysis or cell lysis. CONCLUSIONS: LLLT achieved safe and significant girth loss sustained over repeated treatments and cumulative over 4 weeks of eight treatments. The girth loss from the waist gave clinically and statistically significant cosmetic improvement. Dr. Tucker's Comment: I have used the warm laser coupled with the Deep Muscle Stimulator (DMS) in conjunction with the 28 day cleanse and seen very good results. Patient's actually lost weight in the thighs and buttocks.

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Muscle Imbalance

Combinations of muscle weakness and tightness cause musculoskeletal pain. The most difficult part of treatments are to the muscles that become inhibited, (restrained, blocked, or suppressed) because this requires patients to perform exercise at home on there own. Muscle inhibition is common in the neck, low back, and extremities.

Inhibition refers to the inability of a muscle to contract fully on demand. This inhibition is a neurological response and manifests particularly at the extreme ranges of motion – when the muscle is contracted fully. A muscle may have strength at the mid-range, but be very weak when moved into a shortened position; this creates instability at the joint. When the body senses instability, other muscles tighten up as a form of protection. To improve these muscle and joint imbalances I expect my clients to perform the exercises that I prescribe as part of my treatments.

Inhibitied muscles usually generate hypertonicity/tight muscles in adjacent regions of the body (low back & hip, neck & shoulders)). In other words, the relationship between weak and tight muscles is reciprocal. Inhibition is frequently found in muscles resulting from injury, inflammation or pain and that inhibition or weakness leads to reciprocal facilitation of its antagonist(s) muscles.

When a muscle has been over-stressed or over-worked, the result is altered feedback from the nervous system. This causes a reduced capability for the muscle to contract, from the instability through full physiological range. The end result is an inability for the muscles to properly stabilize joints. This is a major point that I want you to understand. I teach you stability (strength) exercises to train the weakened muscles to hold the joints in place again.

Again, please understand, hypertonicity in a muscle leads to blockage(s) or weaknesses in other muscles close by. Inhibited (weak) muscles are capable of spontaneous strengthening when the inhibitory reflex is identified and remedied (most commonly through joint or soft-tissue manipulation).

Muscle hypertonicity/tightness/spasm generates inhibition in surrounding regions of the body, and so spasm is treated first using the Deep Muscle Stimulator, warm laser, manipulation and deep soft tissue massage therapy.

The inhibited (weak) muscles are treated with exercise, rocker boards, wobble boards, and other tools. I prefer to teach clients bodyweight exercises, resistance band exercises, stability ball maneuvers and kettlebell training.

I pay a lot of attention to posture because the postural muscles tend to be short, tight and usually hypertonic. This is why some times I will teach you to stretch, and other times I will teach you to strengthen your muscles.

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