33 new LLLT papers for you this month including: a review of 21 papers on muscle performance, fatigue and repair, a controlled multicenter trial on male pattern baldness, another trial on oral mucositis and how about this, 810nm laser ameliorates diabetes!
The BMJ reported that the US Centers for Disease Control and Prevention had declared there was a national epidemic of prescription drug overdoses which led to 14,800 deaths in 2008. This is more than cocaine and heroin combined for the same period. If you think this an exaggeration click here to see the full government report.
They highlight the following key points :
Death from opioid pain relievers (OPR) is an epidemic in the United States.
Sales of OPR quadrupled between 1999 and 2010.
Enough OPRs were prescribed last year to medicate every American adult for a month
Abuse of OPRs costs health insurers approximately $72.5 billion annually in health-care costs.
And just in case you were not astonished already, I will remind those of you that have not heard me say it before that NSAIDs were the 15th biggest cause of death in the USA according to the New England Journal of Medicine 1999. Unfortunately there is no abstract so I am going to show you a little snip from the full paper
Available only to people who have attended a THOR training course in the last 3 years. All treatments are based on our four step method which includes treatment of the injury, trigger points, lymphatics and nerve roots.
Take a look to see how it works and let us know what you think.
The title of last months PMLS editorial was Low Level Laser Therapy (LLLT) and World Association for Laser Therapy (WALT) Dosage Recommendations. Written by the Scientific Secretary Prof. Jan Bjordal. He describes how far we have come and the importance of the WALT dosage recommendations. No abstract is available for editorials so I have prepared one for you below. Continue reading →
A guidance document on myofascial pain syndrome (MPS) published on the International Association for Study of Pain web site finds “strong evidence” for Low Level Laser Therapy (LLLT). We have archived a copy here and you can find the original source here . Myofascial pain syndrome is often confused with fibromyalgia so it may be worth reading this blog to help understand the difference.
The BMJ sports medicine journal (BJSM) published a systematic review of conservative and surgical interventions and found “strong evidence for the effectiveness of laser therapy” adding to the rapidly expanding list of authoritative journals endorsing LLLT.
American Physical Therapy Association (APTA) Clinical Guidelines recommend Low Level Laser Therapy (LLLT) for Achilles tendinopathies. The report says “Clinicians should consider the use of low level laser therapy to decrease pain and stiffness in patients with Achilles tendinopathy.” Hooray, it’s only been 20 years since Chukuka Enwemeka first published his tendinopathy research. It is unfortunate that the guidelines neglected to comment on the importance of treatment parameters, they incorrectly describe energy as “intensity” and failed to mention Tumilty’s systematic review which found that 55% of LLLT tendinopathy studies failed due to incorrect power density and / or energy delivered.
Results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders.
It is nice to see LLLT making it into mainstream medical recommendations.
Published in the journal Spine; a systematic review of the literature 1980 – 2006 on the use, effectiveness and safety of noninvasive interventions for neck pain and associated disorders. 139 papers admitted into this review.
CONCLUSIONS: For whiplash-associated disorders, evidence suggests that educational videos, mobilization, and exercises appear more beneficial than usual care or physical modalities. For other neck pain, the evidence suggests that manual and supervised exercise interventions, low-level laser therapy, and perhaps acupuncture are more effective than no treatment, sham, or alternative interventions.
In the BMJ Last Saturday Anita Jain wrote “Gold jewellery, cars or an exotic foreign holiday, these are among the luxury gifts listed in a parliamentary committee report as being used by pharmaceutical companies to coax doctors into prescribing their drugs”. She goes on to describe the “3C strategy” employed by drug companies. “convince if possible, confuse if necessary, and corrupt if nothing else works”. Many (she says) will say an emphatic no to luxury gifts, but what about discounts, conference fees, hotels and flights?
Since we have been working with more doctors these days (rather than therapists) I am being approached with requests for hotel and flight costs and I confess I have conceded.
Why does this happen?
a) Because this is the world they live in (i.e. it is normal to have industry pay)
b) Academic and educational budgets are tight and industry has more money than it knows what to do with (they think).
So what should I do ?
I have conceded and paid out a few times, but not with any enthusiasm as we are not yet making $ billions in profits, but my conscience wrestles with it. I do not want to be guilty of behaving like bad pharma but then again I want our product to be accepted by mainstream medicine, so what should I do?
28 new papers for you this month, starting with the most entertaining: “successful management of acute-onset torticollis in a giraffe” which included a laser to reduce “cervical muscle hypertonicity”, an RCT on cellulite (see commentary), an analysis of 589 tooth extractions in patients under bisphosphonate therapy following LLLT, chronic rhinosinusitis, oral lichen planus, combined bone marrow aspirate and LLLT on bone healing, mesenchymal stem cells and LLLT on peripheral nerve regeneration and more …..
How does LLLT / cold laser therapy work? click here
At first glance this cellulite paper looks like a well designed study, but if you are familiar with LLLT parameters then you may notice something odd about them:
6 treatments (3 x week for 2 weeks) this is probably a good treatment interval
8 x 10 inches (516 cm2) that is a very large area
5 x 17mW Green 532nm this is a poor penetrating wavelength
Combined power of 102mW that is a tiny amount of power for such a large area
Irradiance 0.2mW/cm2 that is less than sunshine on a clear day
15 mins twice (two side of the body) that is a long treatment time
Fluence (dose) 0.18J/cm2 per side that is not enough to do anything
Blue Cross and Blue Shield Kansas (BCBS) have updated their assessment of LLLT and it is still considered “experimental” despite referencing the “strong evidence” conclusions in systematic reviews published by the British Medical Journal (BMJ) and International Society for the Study of Pain (IASP). Then there is The Lancet Systematic Review on Neck pain and the MASCC “recommendation” statements, also brushed aside by BCBS.