September 2022 is Drug-Free Pain Management Awareness Month

Opioid pain medications work in the nervous system or in specific receptors in the brain to reduce the intensity of pain. More than 191 million opioid prescriptions were dispensed to American patients in 2017, and the most common drugs involved in prescription opioid overdose deaths include Methadone, Oxycodone, and Hydrocodone [1].

Up to 25% of patients receiving long-term opioid therapy struggle with opioid addiction [2]. In 2016, more than 11.5 million Americans reported misusing prescription opioids in the previous year [3].

Prescription opioid use and abuse leading to addiction and catastrophic outcomes remains a national crisis. The leading cause of injury death in the United States is drug overdose [4], and most of the deaths from drug overdose deaths involved an opioid. From 1999 to 2020, more than 263,000 Americans have lost their lives to overdoses involving prescription opioids [5].

Because many die prematurely, surviving family members and communities lose out on benefits from an individual’s lifetime earnings. Opioid use disorder also results in costs associated with added health care expenses, criminal justice, lost productivity, and reduced quality of life. In 2017, these costs totaled an estimated $1.02 trillion—54% was attributed to overdose deaths and 46% to opioid use disorder [6].

Overdose deaths involving prescription opioids nearly increased by five times from 1999 to 2020 [7]. We are losing 187 people a day from opioid overdoses and 68,630 [8] people died from opioid overdoses in the U.S. in 2020 (74.8% of all drug overdose deaths).

Prescription opioids are often recommended for low back, neck, and musculoskeletal pain management, as well as for patients suffering from peripheral neuropathy. More than 100 million suffer with chronic pain and an estimated 80 percent of all Americans will experience some form of back pain during their lifetime.

On October 24, 2018, President Donald Trump signed the Opioid Crisis Response Act (OCRA) into law. OCRA received overwhelming bi-partisan support in both Chambers. HR6, which is now Public Law 115-271, broke new ground in being the first legislation to mandate aggressive development and adoption of alternative pain treatments that include “innovative medical technologies for pain management”. On October 11, Congress held its first ever briefing on ending opioid use through “innovative medical technologies for pain management”. Photobiomodulation (PBM) was the featured technology [9].

Summus Medical Laser devices are class 4 therapeutic lasers, FDA-cleared as adjunctive devices for the temporary relief of pain [10]. Photobiomodulation (PBM) utilizes non-ionizing red and infrared laser light and is a non-thermal process involving endogenous chromophores eliciting photochemical events at various biological scales.

PBM treatments are shown to resolve inflammation, improve peripheral circulation, modulate pain, and enhance tissue healing. [11]

PBM treatments delivered with a class 4 therapeutic laser are shown to significantly reduce symptoms in patients with chemotherapy-induced peripheral neuropathy [12] and significantly reduce pain and improve the quality of life of older patients with painful diabetic peripheral neuropathy [13].

Summus Medical Laser treatments are non-invasive, pain-free, have no side effects yet are proven to be effective for both superficial wounds and deep neurological conditions.

SUMMARY

Photobiomodulation treatments delivered with a Summus Medical Laser class 4 therapeutic laser are a proven non-invasive opioid-free solution for pain management, with concomitant societal improvement and health care savings.

[1] https://www.cdc.gov/opioids/basics/prescribed.html

[2] Banta-Green CJ, Merrill JO, Doyle SR, Boudreau DM, Calsyn DA. Opioid use behaviors, mental health and pain—development of a typology of chronic pain patients. Drug Alcohol Depend 2009;104:34–42

[3] Centers for Disease Control and Prevention. 2018 Annual Surveillance Report of Drug-Related Risks and Outcomes — United States. Surveillance Special Report 2pdf icon. Centers for Disease Control and Prevention, U.S. Department of Health and Human Services.

[4] https://health.gov/healthypeople/objectives-and-data/browse-objectives/injury-prevention

[5] https://www.cdc.gov/drugoverdose/deaths/prescription/overview.html

[6] Curtis Florence, Feijun Luo, Ketra Rice. The economic burden of opioid use disorder and fatal opioid overdose in the United States, 2017. Drug and Alcohol Dependence, 2021-01-01, Volume 218, Article 108350.

[7] https://www.cdc.gov/drugoverdose/deaths/prescription/overview.html

[8] https://www.cdc.gov/drugoverdose/deaths/index.html

[9] https://citizenoversight.blogspot.com/2018/11/ending-opioid-use.html

[10] https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfPCD/classification.cfm?ID=ILY

[11] https://journals.sagepub.com/doi/abs/10.1258/ebm.2012.012180

[12] https://pubmed.ncbi.nlm.nih.gov/27887804/

[13] https://pubmed.ncbi.nlm.nih.gov/31405365/

3 Biggest mistakes doctors make when buying a therapy laser

3 Biggest mistakes doctors make when buying a therapy laser

Therapeutic lasers are arguably the greatest modality introduced in healthcare in the last 20 years. Some would argue that they should not simply be called a modality.

Photobiomodulation treatments performed with a Class IV therapeutic laser can deliver infrared photons of laser light deep into the body where they are absorbed, and the light energy is converted into chemical energy thus initiating healing processes.

Doctors of all healthcare disciplines treating both human and animal patients are realizing the benefits that Class IV therapeutic laser treatments can have for their patients. An important point to remember is that laser therapy treatments do not target specific conditions in the body. Rather, they initiate healing processes in the body.

The three biggest mistakes that doctors make when buying a therapy laser are buying outdated equipment, being misled by experts, and ignoring training and support. Laser therapy equipment is a significant investment, so to achieve a return on investment, avoid making these three mistakes.

The first mistake is buying outdated equipment. And the first part of that is to buy a laser with enough power. Early in the development of laser therapy devices most of them were Class 3 devices with power under 1/2 a Watt. But now scientists, researchers, clinicians, and laser experts agree that in order to deliver a significant dosage to targets deep inside of the body a Class IV therapeutic laser is required.

A letter written by four top photobiomodulation and laser experts in the world stated, “…an important advance in photobiomodulation treatments was the recognition that optimization of transcutaneous therapeutic parameters should be based on the photonic dose reaching the target tissue and that often requires higher doses of light at the skin surface to reach deeper tissues.”[i]

When therapeutic laser light is shined on the skin surface it will penetrate the body. As photons of light are absorbed along the path, the light will become dimmer and dimmer. The experts are saying that to deliver an appropriate dose deep into the body, a higher dose at the skin surface is required.

Therefore, do not make the mistake of buying underpowered equipment- stick with Class IV.

The second part of this first mistake has to do with antiquated equipment. For example, there are two types of laser diodes used in Class IV therapy lasers. One is called a pigtailed diode which was developed in the 1970s and was current technology in the 1980s. Many Class 4 therapeutic laser devices being sold today still use pigtail diodes.

In addition, some manufacturer’s will use multiple low-powered diodes, and add up their power to state the total power. Three five-watt diodes are not the same as one fifteen-watt diode. This strategy lowers their cost of production, but it is less effective clinically.

The more advanced type of diode is a semiconductor diode. With a gallium aluminum arsenide (GaAlAs) semiconductor diode there can be one diode for each therapeutic wavelength. The semiconductor diode can be cooled more efficiently which keeps it within its operating power output parameters more efficiently. Semiconductor diodes are sturdier and more dependable. Don’t buy multiple old-fashioned pigtailed diodes - buy a Class IV therapy laser that uses semiconductor diodes, and one diode per wavelength.

There are other aspects of laser equipment and technology. Without going into the specifics, it is suggested to simply look at the laser equipment. Look at it today and look at what it looked like 10 years ago. Is it any different? Does it look different on the shell and the case only? Were any advances made in the internal electronics, display, diodes, or optical connections? So the bottom line is, buy the latest equipment - do not buy antiquated technology.

The second mistake that a doctor can make when buying a therapeutic laser is to rely on the “experts”, with emphasis on the air-quotes. Sadly, there are many laser promoters who are given the “expert” tag - or should we say they give it to themselves, and the statements that they make cannot be supported scientifically, by studies, or by clinical experience. A few red flags to lookout for: claims that a red laser can be used for musculoskeletal photobiomodulation treatments; claims that super pulsed laser light penetrates deeper into the body; claims that Class IV therapeutic lasers injure patients; claims that a laser can be used for fat loss; and on and on.

As the adage says - always tell the truth that way your story never changes. Some laser manufacturers have difficulty telling the truth. Rely on people who can back up their statements with science, studies, and a track record of clinical outcomes.

The final mistake is to ignore support and service. Especially for the doctor new to laser therapy. Inevitably questions will arise regarding treatment. Can I treat a patient who's just received a steroid injection? Can I treat a patient who is on blood thinners? What's the best laser treatment protocol for diabetic peripheral neuropathy or plantar fasciitis? Can my assistant do the treatments? Buy your laser from a company that has laser experience and can answer all the questions above and more.

In addition, make sure that your company can give rapid equipment support. If you ever have a breakdown or need help with the equipment you want rapid turnaround. Once laser therapy is added to your clinic it will be an integral modality and patients will not want to go without it. Make sure your laser manufacturer can either repair your equipment rapidly and get it back to you or else supply a loaner.

The doctor of the future will use a Class IV therapeutic laser. If you have not yet purchased a Class IV therapy laser for your clinic, consider the three points discussed in this post and ask more questions. Your patients will love you for it!

 

[i] https://www.liebertpub.com/doi/full/10.1089/photob.2018.4600

Analysis of the Therapy Laser: Features, Benefits, and Common Mistakes

Therapeutic lasers are no longer considered a ‘novel’ modality. There will be a number of practices that never offer photobiomodulation (PBM) as an option because it does not interest them and/or they can refer it to someone with more knowledge and experience.  However, some are still deciding or have it on their wish list but don’t know how to make an informed decision. The biggest pitfall would be to make a decision based solely on price and clever marketing tactics vs. clinically relevant features. With plenty of foreign terminologies such as wavelengths, joules, nanometers, and Hertz, it can be challenging for veterinarians to recognize what is essential to produce consistent results. Lasers are not an inexpensive purchase, but they are a long-term investment. And with proper consideration, they will significantly enhance clinical results and generate a healthy revenue stream.

The biggest takeaway from this discussion is to help veterinarians make a decision that works best for them, their patients, and their bottom line.

The Features and Benefits of the Class IV Laser

When considering a therapeutic laser and reviewing the features one of the most important points and easiest to remember is that the more you can get for your buck, the better! Again, we are not talking about just the pretty colors and the fancy buttons. There's plenty of marketing out there that tries to distract you from what's important. The focus should be on the following clinically relevant elements of the unit.

Clinical Features of Class IV Lasers

Finally, and probably one of the most critical components of a laser purchase is the company behind the product. Sadly, there have already been some laser therapy companies that have dropped out of the industry. Look for a company with a long history and a primary focus on PBM. You want one that provides one-on-one training and education. Availability of and direct access to experienced clinical support should be included. The company should demonstrate a commitment to on-going innovation and growth based on the evolving scientific data. There should be an obvious enthusiasm and dedication to making your practice a successful laser therapy facility. If they seem more interested in just ‘closing the deal’, introducing other products, or bundling a package, they may not be there for laser support next month or next year when you need them.

And if you can get good results and good support, you're going to use it more. And if you use it more, you're going to get a better return on investment.

Why Choose a Class IV Therapy Laser Despite the Cost?

An effective, versatile Class IV therapy laser will consistently enhance clinical outcomes on a wide variety of patients and conditions. Having the right product along with the proper training will give you the confidence to prescribe the laser more frequently. Ultimately, this translates into a better investment. It is not uncommon, even in the smallest, rural practices, for a therapeutic laser to produce enough revenue to ‘pay-off’ the laser in 12-18 months.

So, don't focus on price. Focus on the clinical benefits. Don't focus on marketing, but instead look at the studies. Do your research, and you're going to be very satisfied, as are thousands of your colleagues that have already made the right decision!

Have Patients With Plantar Fasciitis? Learn About A New Solution For Their Pain.

Plantar fasciitis is the most common cause of inferior heel pain in adults. The patient typically complains of gradual onset pain along the medial side of the heel, with pain worse when first standing in the morning which lessens after walking a few steps.[i]

The plantar fascia has a fundamental role in the biomechanics of the foot, supporting the medial longitudinal arch and in the mechanisms of propulsion, as it can dissipate the forces and stresses involving the foot during gait.[ii] It was recently shown that it can store strain energy and convert this energy into propulsive force, behaving like a quasi-elastic tissue.[iii]

Plantar fasciitis is an irritation and swelling of the band of tissue that extends from the heel to the toes and can cause both heel pain as well as pain in the bottom of the foot. It is a common condition in people of middle age but can occur in all age groups.

Plantar fasciitis accounts for about 10% of injuries in runners, and about 15% the general population seeking medical care for foot problems. 83% patients are active working adults between the ages of 25 and 65 years old. Presentation is typically unilateral; however, it may present bilaterally in a third of the cases. The average plantar heel pain episode lasts longer than 6 months.[iv]

Approximately 90% of cases are treated successfully with conservative care. In the United States, plantar fasciitis generates up to 2 million patient visits per year, and accounts for 1% of all visits to orthopedic clinics.[v] Plantar fasciitis is diagnosed on clinical grounds, sometimes with the support of imaging to rule out other diseases and confirm a thickening of the fascia. The presence of heel spurs in patients with plantar fasciitis is still debated, as it is not settled whether they cause or co-exist with plantar fasciitis.[vi]

Plantar fasciitis care historically has consisted of the following, in order from non-invasive to invasive: rest (which can be a challenge for the active runner); application of ice, either via ice pack or ice cup massage; anti-inflammatory agents and non-steroidal anti-inflammatory drugs (NSAIDS); stretching; foot orthotics; extra-corporeal shock wave therapy (ESWT); a walking boot and/or night splints; autologous platelet rich plasma injection (PRP); steroid injections and finally, surgery.[vii]

The application of ice, especially on acute injuries is falling out of favor. “Inflammation is an essential mechanism in human health and disease.”[viii] The healing response, with its stages of inflammation, proliferation, remodeling, and maturation in necessary for proper repair of injured and damaged tissues. It is now recognized that anything that reduces or suppresses inflammation (including ice, NSAIDs, and corticosteroids) will delay healing.[ix]

One study recommended treating plantar fasciitis with radial extracorporeal shockwave therapy. But it also indicated laser therapy (defined later in this article) may potentially be a better alternative.[x]

PRP has been shown to provide better pain relief and improved function compared to steroid injection.[xi] Steroid injections compared may slightly reduce heel pain for up to one month but not thereafter. And steroids are falling into disfavor with their inherent side effects and related tissue damage.[xii]

Laser therapy, more formally known as photobiomodulation (PBM) is a treatment that utilizes nonionizing lasers (red and infrared) and is a nonthermal process by which endogenous chromophores absorb photons of light, eliciting photochemical events at various biological scales. This treatment results in beneficial therapeutic outcomes including, but not limited to, the alleviation of pain or inflammation, immunomodulation, and promotion of wound healing and tissue regeneration.[xiii]

Photobiomodulation has been used in both human and veterinary medicine for more than 30 years. The last decade has seen a significant increase in its use, as a better understanding of mechanisms of action has guided laser therapy equipment manufacturers to build more clinically effective devices. Early therapeutic lasers were simply too low in power, and today both scholars and clinicians agree that class 4 therapeutic laser devices are necessary for significant and dependable outcomes.[xiv]

The evidence suggests that PBM resolves and does not inhibit inflammation, as it can reduce or inhibit production of important inflammatory mediators such as IL-1, IL-6, PGE2, and MMPs and significantly reduce leukocyte infiltration in different inflammatory conditions.[xv] In addition, PBM has been shown to preserve mechanical behavior of inflamed tendons, whereas NSAIDs did not.[xvi]

Patients with myofascial trigger points in the gastrocnemius and soleus muscles will experience chronic shortening of those muscles, which will either cause or contribute to the problem of plantar fasciitis. Laser therapy is clinically indicated for myofascial trigger points and should be a part of the treatment plan for plantar fasciitis patients.[xvii]

Photobiomodulation treatments with a class 4 therapy laser are inherently safe, due to the non-ionizing (red and infrared) wavelengths being used. Treatments are non-invasive and there is no pain during treatment so patients do not need a local anesthetic or sedative as can be the case with shockwave therapy.

Patients are drawn to the high-tech nature of laser therapy treatments. Any health care provider caring for patients suffering from plantar fasciitis should consider adding photobiomodulation with a class 4 therapy laser to their treatment services.

[i] Stecco, et al. Plantar fascia anatomy and its relationship with Achilles tendon and paratenon,  J Anat. 2013 Dec; 223(6): 665–676.

[ii] Hicks, JH. The mechanics of the foot; The plantar aponeurosis and the arch. J Anat. 1954 Jan; 88(1):25-30

[iii] Natali AN, Pavan PG, Stecco C. A constitutive model for the mechanical characterization of the plantar fascia. Connect Tissue Res. 2010 Oct; 51(5):337-46.

[iv] Plantar Fasciitis. https://www.ncbi.nlm.nih.gov/books/NBK431073/

[v] Ibid

[vi] Onwuanyi ON. Calcaneal spurs and plantar heel pad pain. The Foot. 2000;4:182–185.

[vii] Ibid

[viii] Freire and Van Dyke. Natural resolution of inflammation. Periodontol 2000. 2013 Oct; 63(1): 149–164.

[ix] Mirkin. Why Ice Delays Recovery. https://www.drmirkin.com/fitness/why-ice-delays-recovery.html

[x] Xian Li, et al. Comparative effectiveness of extracorporeal shock wave, ultrasound, low-level laser therapy, noninvasive interactive neurostimulation, and pulsed radiofrequency treatment for treating plantar fasciitis. Medicine (Baltimore). 2018 Oct; 97(43): e12819.

[xi] Khurana, et al. Comparison of midterm results of Platelet Rich Plasma (PRP) versus Steroid for plantar fasciitis: A randomized control trial of 118 patients. J Clin Orthop Trauma. 2021 Feb; 13: 9–14.

[xii] David, et al. Injected corticosteroids for treating plantar heel pain in adults. Cochrane Database Syst Rev. 2017 Jun; 2017(6): CD009348.

[xiii] WALT/NAALT. Photobiomodulation: mainstream medicine and beyond. September 9–12 2014; WALT Biennial Congress and NAALT Annual Conference; Arlington Virginia USA.

[xiv] Anders, Arany, Baxter, Lanzafame. Light-Emitting Diode Therapy and Low-Level Light Therapy Are Photobiomodulation Therapy. Photobiomodulation,  Photomedicine and Laser Surgery. 2019 Feb;37(2):63-65.

[xv] Lopes, et al. Photobiomodulation: Inhibition or Resolution of the Inflammatory Process?. Photobiomodulation, Photomedicine, and Laser Surgery, 2020 Aug;38(8):453-454.

[xvi] Ibid.

[xvii] CCGPP. Chiropractic Management of Myofascial Trigger Points and Myofascial Pain Syndrome: Summary of Clinical Practice Recommendations. https://clinicalcompass.org/clinical-guidelines/chiropractic-management-of-myofascial-trigger-points-and-myofascial-pain-syndrome-summary-of-clinical-practice/

Treating Plantar Fasciitis Pain With Class IV Laser Therapy

Plantar fasciitis is the most common cause of heel pain in adults. It causes a stabbing pain in the bottom of your foot near your heel, most notably with the first step out of bed in the morning. Ouch! As you stand up and walk around, the pain may subside, but it will often return after long periods of standing, or when you stand up after sitting for a while.

‘Plantar’ refers to the sole, or bottom of your foot. ‘Fasciitis’ is inflammation of the thick band of tissue that connects the heel to your toes. The plantar fascia also connects to the tissues that run down your leg and Achilles’ tendon. Sometimes problems such as trigger points in the muscles in your leg (called the soleus and gastrocnemius) can cause or contribute to the problem of plantar fasciitis. If that is the case, treatment may be needed in the leg – but more on that later.

Plantar fasciitis is more common in runners but is also seen in the very active dancers, the overweight and those who wear shoes with inadequate support. Your foot mechanics can also increase chances of developing plantar fasciitis. A flat foot, a high arch, or an abnormal pattern of walking can put added stress of the plantar tissues.

It most commonly affects patients between ages 40 and 60, and certain occupations that require long periods of standing such as factory workers, teachers, and store clerks can be at increased risk. Standing on a hard surface increases the risk, so someone forced to stand for a long time should use a cushioned pad or carpet.

Diagnosis of plantar fasciitis usually does not require diagnostic imaging, but occasionally an x-ray may be taken to determine whether a heel spur is present. Heel spurs are bony projections from the bottom of the heel along the course of the plantar fascia. Spurs usually require invasive procedures, such as surgery to correct. Whereas since plantar fasciitis is an inflammatory condition, surgery is not recommended.

In the past, treatment for plantar fasciitis consisted of the following: icing, foot orthotics, heel pads and cushions, anti-inflammatory drugs, and steroid injections. But there is a new solution that is giving patients across the country relief from plantar fasciitis – regenerative, non-invasive pain management with a class 4 therapy laser.

Class 4 therapeutic lasers deliver red and infrared photons of laser light into the tissues. The red photons are absorbed by more superficial tissues, while the infrared photons penetrate deeper into the body. The treatment is non-invasive and painless, to the contrary you would only feel a mild warming sensation during the treatment.

The photons of light are absorbed by different components (water, oxygenated hemoglobin, various enzymes) in your body, resulting in enhanced blood flow, improved tissue oxygenation and resolution of inflammation. For someone suffering from plantar fasciitis, the pain relief can sometimes be noticed after just the first treatment.

Treatment times are about five minutes, or maybe a little longer if treatment is also required in the leg. Remember how we said that sometimes trigger points in your leg muscles can cause or contribute to plantar fasciitis? Those trigger points cause a chronic shortening of the muscles, essentially pulling on the plantar fascia 24 hours a day, making your plantar fasciitis pain even worse.

Treatments are usually delivered three times a week for four to six weeks – but your clinician will determine the schedule and number of treatments that is best for you. A very high percentage of patients will get relief from the pain, discomfort and disability caused by plantar fasciitis within six weeks once they receive the class 4 therapy laser treatments

Residual Limb and Phantom Pain

Are you looking for a new solution? Don’t you wish there were another way? Wouldn’t it be great if there was a possible answer for your pain – an answer that was not invasive and did not have side-effects?

Read on - there is a possible solution used by doctors across the country, and they are helping patients with pain, just like you. That solution is known as laser therapy, specifically delivered with a higher-powered class 4 therapeutic laser device such as the Summus Medical Laser. The fancy official word for this procedure is ‘photobiomodulation’ or PBM, but we will just call it ‘laser therapy’.

Laser therapy uses red and near infrared laser light to induce photochemical reactions in the body on the molecular and cellular levels. Summus Medical Laser protocols combine wavelengths, pulsing and power to achieve unparalleled therapeutic effects including modulation of inflammation, reduction in pain, accelerated tissue healing and increased circulation.

Studies show that laser therapy treatments have neuro-protective effects, meaning that laser therapy treatments can help to keep nerve cells alive and functioning normally. When nerve cells function normally, pain is resolved. Pain is reduced by relieving chronic inflammation and reducing painful sensitivity to light touch, called allodynia.

To deliver adequate laser dosages to target tissues deep inside the body, much higher power levels need to be used at the skin surface. This is why your doctor will use a class 4 therapy laser, such as the Summus Medical Laser for your treatments.

There are nearly 2 million people living with limb loss in the United States. Approximately 185,000 amputations occur in the United States each year. Nearly 80 percent of amputees experience phantom limb pain.

Phantom limb pain is pain that seems to be originating from the missing limb. The experience of phantom limb pain can be mild – or it can be excruciating and constant. There could be no pain sensations to mild cases where pain is felt occasionally for a few minutes to constant debilitating pain that prevents normal daily activities. About 20% suffer from excruciating pain, which strongly affects their quality of life and can lead to suicide.

Non-invasive treatments that have relieved phantom limb pain for some include the following: hot and cold packs; manual manipulation, such as chiropractic adjustments; transcutaneous electrical nerve stimulation (TENS); mirror therapy and visualization.

Invasive treatments, or those with significant side-effects include anesthetic injections, nerve blocks, opioid pain medications, and surgery.

People suffering from phantom limb pain can be reluctant to tell anyone about their painful experience, for fear that they will be considered “crazy.” But it is very important to report pain as soon as they are experienced so treatment can be started.

There was a time when it was presumed phantom limb pain was a psychological problem related to post-amputation emotional stress. The cause is still not clear, but experts believe it is a response to mixed signals from the brain and may also be caused by damaged nerve endings.

Today there is a safe, non-invasive treatment modality – class 4 laser therapy such as those delivered by a Summus Medical Laser. Laser therapy treatments are pain-free and have helped many patients suffering from phantom limb pain. Laser therapy treatments can help those damaged nerves repair and start working normally again – removing your pain and improving your quality of life.

[i] The Mechanistic Basis for Photobiomodulation Therapy of Neuropathic Pain by Near Infrared Laser Light; Holanda, Chavantes, Wu, Anders. Lasers in Surgery and Medicine, 2017 Jul;49(5):516-524.

[ii] Ziegler‐Graham K, MacKenzie EJ, Ephraim PL, Travison TG, Brookmeyer R. Estimating the Prevalence of Limb Loss in the United States: 2005 to 2050. Archives of Physical Medicine and Rehabilitation2008;89(3):422‐9.

[iii] Owings M, Kozak LJ, National Center for Health S. Ambulatory and Inpatient Procedures in the United States, 1996. Hyattsville, Md.: U.S. Dept. of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics; 1998.

Treating Peripheral Neuropathy

By Dr. Phil Harrington

Sharp, stabbing pains. Feeling like you are wearing a glove or a sock. Numbness in the hands or feet. Regularly dropping things, like your book or coffee cup. Tingling in your feet or hands. A weak, heavy feeling in your arms or legs. Muscle weakness, even in your facial muscles.

Do one or more of those describe you? Then you may have peripheral neuropathy.

Peripheral neuropathy is a general term for a series of disorders that result from damage to the body’s peripheral nervous system. What’s that, you ask?

The body’s nervous system has two parts: the central nervous system (CNS) which is your brain and the spinal cord; and the peripheral nervous system (PNS) which sends nerves from the CNS out to your arms, hands, legs, feet, joints and even your mouth, eyes, ears, nose, and skin.

Peripheral neuropathy occurs when nerves have a problem and can’t send messages from the brain and spinal cord out to your muscles, skin and other parts of your body. When problems occur, you may experience numbness, pain, and loss of function in these areas.

Problems with sensory nerves cause frequent pain, tingling and numbness, while motor nerve problems may cause difficulty walking or picking up items, and moving the arms. Autonomic nerve problems affect your involuntary functions, such as breathing, sweating, and blood pressure.

Mononeuropathy (affecting one nerve) is usually the result of trauma, injury, local compression, or inflammation. Examples include carpal tunnel syndrome and Bell’s palsy

However, most people suffer from polyneuropathy, with problems involving many nerves at the same time. The most common polyneuropathy is diabetic peripheral neuropathy, with residual limb pain and phantom limb sensation in this category.

Diabetes is the leading cause of neuropathy, with over 70% of diabetic patients developing symptoms such as those listed above.

Other causes include chemotherapy, traumatic injury, alcoholism, and exposure to toxins. When the cause cannot be determined, it is called ‘idiopathic neuropathy’.

Common medical solutions for peripheral neuropathies include over-the-counter pain medications (like Tylenol) and non-steroidal anti-inflammatory medications (NSAIDs); prescriptions of opioid pain medications, or various prescriptions such as Lyrica, Cymbalta or Neurontin.

But does it come as any surprise? None of those fix the problem, and they have several side effects such as drowsiness, dry mouth, difficulty speaking, anxiety, depression, and more.

By now you must be asking yourself – is there another way? Can anyone help me without all the harmful side effects of those drugs?

The answer is yes, and the solution is called photobiomodulation (PBM), also known as laser therapy. PBM treatments with a Summus Medical Laser shine safe red and infrared laser light over your damaged nerves and help them recover and repair. Laser therapy treatments are non-invasive and safe, and there really are no side effects.

Sounds too good to be true? No, it isn’t and you can find doctors providing Summus Medical Laser treatments by visiting https://summuslaser.com.

Patients who have received the recommended course of laser therapy treatments report reduced numbness and tingling, improved muscle function, normal sensations in their hands and feet, and more. Summus Medical Laser treatments have helped patients suffering from peripheral neuropathy of many types, including Bell’s Palsy, diabetic peripheral neuropathy, residual limb pain, and more.

As someone once said, ‘Modern medicine is not modern without laser therapy.’ Are you or a loved one suffering from peripheral neuropathy? Schedule Summus Medical Laser treatments today!

Class IV Laser Therapy for Acute Injuries

Sports injuries and acute injuries in general vary widely in terms of the mechanism of injury, how the individual presents, and how the injury should be managed. Acute injuries can affect bone, articular cartilage, ligaments, muscles, tendons, bursae, nerves, and the skin, with conditions presenting such as periosteal contusions, sprains and strains, nerve damage or abrasions.

Acute injuries occur due to sudden trauma, and the symptoms present almost immediately. The mechanism of injury is that the force exerted on the tissue (i.e. muscle, tendon, ligament, and bone) exceeds its strength.

Common acute injuries include ankle sprains, muscle strains especially the quadriceps and hamstrings, fractures of the clavicle or fingers and shoulder dislocation. In all types of acute injuries, the body will rapidly respond with inflammation. The anciently recognized five characteristic signs of inflammation are redness (rubor), swelling (tumour), heat (calor), pain (dolor) and loss of function (functio laesa).

Many treatment methods seek to suppress or counter-act these five signs, with ice packs frequently being applied to the injured site. But does that help? Is there a better solution?

Photobiomodulation (PBM), more commonly known as laser therapy delivers red and infrared wavelengths of light to both superficial and deep tissues to enhance blood circulation, increase tissue oxygenation and improve metabolic activity. In turn this helps the body progress through the healing stages of inflammation, proliferation, remodeling, and maturation.

Class 4 therapeutic lasers can deliver multiple wavelengths of laser light, which in turn get absorbed by chromophores in the tissues. This creates a healing environment for acute injuries.  Treatments with a class 4 therapeutic laser are safe and non-invasive. They can effectively treat the large volumes of tissue damaged in sports and acute injuries. Therapeutic lasers use light, there is no tissue heating in treatments for acute injuries.

Studies and clinical experience show that PBM treatments can and should be immediately after acute injury. The mechanism is to facilitate rather than suppress inflammation, leading to quicker reduction of pain and swelling while also contributing to growth of healthy collagen fibers.

Are you dealing with a sprained ankle, strained hamstring, or broken collarbone? Consider class 4 laser therapy as a new solution.

Laser Therapy and Ice

LASER AND ICE By Dr. Phil Harrington Your team is on a run, playing the best they have all year when suddenly the starting point guard drives hard to the basket, steps on an opponent’s foot and suffers a sprained ankle. Not bad enough to end his season, but it will disrupt team chemistry leading to the conference tournament. What do you do? For years, ice has been used to treat acute injuries under the premise that it alleviates pain, reduces tissue metabolism, and reduces swelling. It has been a standard treatment for injuries and sore muscles because it helps to relieve pain caused by injured tissue. Trainers have used the “RICE” (rest, ice, compression, elevation) guideline for decades, but now it appears that both ice and immobilization may delay healing. Dr. Gabe Mirkin who coined the term RICE in 1978, points out that healing requires inflammation; and anything that reduces or suppresses inflammation will also delays healing. This would include ice, along with cortisone injections, non-steroidal anti-inflammatories, and immune suppressants. “Applying ice to injured tissue causes blood vessels near the injury to constrict and shut off the blood flow that brings in the healing cells of inflammation”, wrote Dr. Mirkin. “When you damage tissue through trauma or develop muscle soreness by exercising very intensely, you heal by using your immunity, the same biological mechanisms that you use to kill germs. This is called inflammation.”[i] Normal injury healing progresses sequentially through the stages of inflammation, proliferation, remodeling and maturation. Interrupting the first stage – inflammation – will adversely affect the timing and effectiveness of the subsequent three stages. So, if you plunge the point guard’s foot and ankle into an ice bath, and then advise him to apply ice several times a day, you are making the injury worse, not better. Icing injured tissue causes constriction of blood vessels near the injury which shuts off the blood flow that brings in the healing cells of inflammation. What’s a better solution? Photobiomodulation (PBM), more commonly known as laser therapy. Therapeutic laser devices deliver red and infrared wavelengths of light to both superficial and deep tissues to enhance blood circulation, increase tissue oxygenation and improve metabolic activity. In turn this helps the body progress through the healing stages of inflammation, proliferation, remodeling and maturation. Treatments with a class 4 therapeutic laser are safe and non-invasive and can be applied immediately after injury. So instead of delaying your point guard’s recovery with ice, consider getting him back on the court more quickly with laser therapy. [i]https://www.drmirkin.com/fitness/why-ice-delays-recovery.html

Can Laser Therapy Help Chemotherapy Patients?

Chemotherapy is a treatment designed to destroy cancer cells, but it can also affect healthy cells. One of chemotherapy’s side effects is immunosuppression. It slows down healthy cell growth in the bone marrow, where defense cells are produced.   

The most challenging condition that may develop is oral mucositis. The pain and inflammation of this condition prevents eating, swallowing, and normal speech due to painful lesions in the mouth. Secondary infections, such as candida can further worsen symptoms. 

The inflammatory effects chemotherapy causes on mucous cells are intense. A week after chemotherapy begins, oral mucositis effects begin to be felt. Healthy cells are subjected to sudden apoptosis. The condition is challenging for providers to treat and for patients to endure, sometimes slowing or stopping cancer treatment altogether. 

Secondary conditions like thrush, salivary changes, dry mouth, changes in taste sensitivity, and difficulty eating may be experienced, depending on dose and type of chemotherapy being administered. The patient’s general health, age, and other factors also play a role.  

Laser treatment can prevent oral mucositis when applied prior to the start of chemotherapy. Laser Therapy is recommended by the Multinational Association of Supportive Care in Cancer (MASCC) as standard for cancer care. In many countries, laser is routinely covered by medical insurance and patient health plans.  

Laser therapy effectively treats oral mucositis when no other treatment can, preserving patient quality of life and the cancer regimen’s completion. Laser early intervention amplifies cell regeneration, protects cells from being destroyed, and modulates the inflammatory process in the first stages of mucositis. It saves the mucous cells, speeding up the healing response. 

The laser is applied immediately after chemotherapy. Laser dosage varies according to patient, but in all cases the dentist is the professional trained for the treatment. Diagnosis and management of the case should be managed by a dentist trained in laser therapy. 

If the patient did not start laser treatment prior to developing oral mucositis, several sessions will be necessary to reduce inflammatory response. Within 24 hours following laser therapy treatment, the patient can expect to have a significant decrease in pain. 

Doctors refer cancer patients to dentists for the prevention of oral mucositis. Dentists are increasingly involved in oncology teams. Informed patients are additionally seeking this care out for themselves. If you are a cancer patient, look for a dentist who practices with therapeutic laser! If you are an oncologist, remember to refer your patients to a laser therapy dental professional.