The field of phototherapy is another emerging area of medical science and technology that holds tremendous potential for healing and can be helpful for those suffering from chronic pain. It involves the application of red to near infrared light produced by Low Level Lasers Diodes (LLLD) and/or Superluminous Diodes (SLD) over injuries or wounds to improve soft tissue healing and to relieve pain. It is referred to by various names including Low Level Laser Therapy, Low Intensity Laser Therapy and Cold Laser Therapy.
The word "laser" is an acronym for Light Amplification by Stimulated Emission of Radiation. The first lasers were produced in the 1960's evolving from the theories of physics described by Albert Einstein. A laser is an electronic device that emits monochromatic or coherent light that is all of one wavelength. The laser beams are very focused and can travel long distances without being dispersed. Lasers are produced at many wavelengths of the electromagnetic field. High powered or thermal lasers (greater than 950 nanometers) produce a substantial amount of heat. They have many industrial and medical applications and are used for cutting and welding and surgical procedures. Scientists and doctors discovered that low powered lasers or non-thermal (not heat producing) lasers between the visible red and invisible near infrared wavelength or 600 nanometers to 900 nanometers produce a positive tissue response stimulating cellular regeneration and natural healing. Super luminous diodes are a focused light source that contains a narrow band of wavelengths. They are employed in light therapy using the same wavelengths as low level lasers. In general super luminous diodes devices are good for treating a large surface and laser diodes are good for focusing on a small target.
Although phototherapy remains controversial in mainstream medicine there are many studies demonstrating its effectiveness. Research shows that when photons of light penetrate the skin and the underlying tissue a whole cascade of healing effects occur that stimulate the production of ATP, increase RNA and DNA synthesis, elevate levels of serotonin and endorphins, stimulate mitochondrial activity, stimulate the immune response, enhance collagen synthesis, stimulate the respiratory chain, increase the production of growth hormone, improve lymphatic drainage and alter the histamine response. Phototherapy is used in the treatment of a variety of conditions including wounds, burns, muscular skeletal injuries, repetitive stress injuries such as carpal tunnel syndrome and rotator cuff tears, inflammatory conditions such as rheumatoid arthritis, dermatological conditions and lymphedema. Its effects are cumulative and long term and often curative. Phototherapy thus presents a highly effective, non-invasive and non-toxic alternative to pharmaceutical drugs and surgery.
In 2002 the Food and Drug Administration began approving phototherapy devices for pain relief. Today phototherapy is administered primarily by chiropractors although other health care practitioners also use the devices. There are large number of manufacturers of phototherapy devices, some for sale for home use but needless to say not all devices are equal. When seeking a phototherapy practitioner, it is important to research the system used. I was fortunate to find a chiropractor in my area that uses the BioFlex system. www.bioflexlaser.com. BioFlex is manufactured by Meditech Interntional Incorporated and founded in 1989 by Fred Kahn, one of the pioneers in Low Intensity Laser Therapy. Meditech has the world's largest laser therapy clinic in Toronoto, Canada where they treat thousands of patients each year. They have researched and developed various protocols for specific conditions. Their system tailors many variables including power density, energy density, frequency, duty cycle, waveform and treatment duration to each individual patient.
My first experience with the Bioflex System was not successful. At the time I had fibromyalgia pain in most of my extremities and was subject to full body flares when I overdid it physically. My chiropractor treated my most painful areas in my arms and legs which produced no noticeable improvements after 20 sessions. When treatment was stepped up to include more areas treated in one session, this provoked a flare. Then a year and a half later I revisited this therapy with an alternative approach that proved successful. I had recently made considerable progress in my muscle condition with EMG biofeedback (for more on this go to: fibrofriends.typepad.com/fibro_friends/2010/05/biofeedback-therapies-for-cfs-fms.html) but the soles of my feet remained sensitive and sore. This is a form of plantar fasciitis with a fibromyalgia presentation of occurring in both feet. In the first session my chiropractor just treated the soles of my feet with an array of super luminous diodes. This triggered my left sided pain pattern. Since fibromyalgia is a systemic condition affecting the entire neuromuscular system I surmised that it might be effective to treat the top of the spine as well. This area along with the muscles at the top of the back on either side of the neck has been identified by some health practitioners as the "ring of fire" for people with fibromyalgia. My chiropractor placed an array of super luminous diodes across the back of my neck, which he refers to as the "head waters" of the nervous system feeding the spinal cord. By treating the soles of the feet and the top of the spine simultaneously we were treating regions where the nerve impulses began and ended. My left sided pain pattern was not triggered by this approach. According to the Bioflex protocol, I was treated for 10 minutes at 660 nm and then 15 minutes at 840 nm after which my chiropractor did additional treatments with a hand held laser instruments on my feet. The sessions were very relaxing and lasted about 45 minutes each. After 10 sessions I observed a dramatic decrease in my muscle tone as measured by my EMG unit and improvement in my overall muscle condition. After about 15 sessions the pain in my feet was considerably better but the sessions made me feel tired afterwards and disturbed my sleep the night of treatment. I talked to my chiropractor and learned that he had increased the power of the treatments because I was doing so well. Once we backed down to the original low power I no longer had these adverse effects.
Phototherapy in combination with EMG biofeedback training has proved to be a beneficial combination for me to control my fibromyalgia but it has not cured my condition. In general I would describe the effects as palliative rather than curative. I think that phototherapy has a lot of potential for healing in persons with fibromyalgia and muscle pain in those with chronic fatigue syndrome, however it is important to carefully observe of one's reaction and to not over treat due to the sensitive nature of the nervous system in these conditions.
Another light therapy that has been used successfully with fibromyalgia patients is the Photonic Stimulator, a device that emits unfocused infrared light. The Photonic Stimulator has similar benefits as other low level phototherapy devices reducing pain and promoting tissue growth. In addition it temporarily blocks sympathetic nervous system activity reducing anxiety and irritability and is used as an adjunct to neurofeedback by LENS practitioners.
Here I am in one of my BioFlex treatment sessions. Note the SLD array behind my neck.
Here is a picture of the SLD arrays treating the soles of my feet.
Photonic Laser treating a sore spot on the top of my foot.