Life Extension Magazine October 2008
Breakthrough in the Relief of Chronic Pain Without Drugs!
By Julius Goepp, MD
Neck and Back Pain
Chronic neck and lower back pain trouble millions of adults, and are notoriously difficult to conquer using traditional medical or surgical techniques. LLLT is showing tremendous promise in this challenging group of patients.
For instance, Australian pain researchers treated 90 subjects with chronic neck pain, randomly assigning them to receive either an active laser or a “sham” (placebo) light source.26 The mean pain scores dropped by approximately 50% in the treated group while actually increasing slightly in the placebo group, and measures of quality of life showed substantial improvements in the LLLT group as well. Pain relief in this very difficult-to-treat group of patients lasted at least three months (the researchers did not follow the patients longer, so we don’t know how much longer the effects actually lasted).
Iranian researchers have now found similarly encouraging results in people with chronic low back pain.27 They treated 61 adults with pain that had lasted at least 12 weeks, providing a third of the patients with LLLT alone, a third with LLLT plus exercise, and a third with placebo laser plus exercise. The people treated with both low-level laser and exercise experienced significant improvements in pain scores, range of movement, and overall disability compared with the exercise-only group. This is a remarkable finding in patients who are typically resistant to almost any form of pain relief! Turkish researchers studying acute herniated disk pain have also found that LLLT is an effective non-surgical option for people with this debilitating condition that has often required surgical interventions.28
Wrist and Elbow Pain
Upper extremity pain plagues virtually everyone from time to time, and an unfortunate large minority of people suffers from such pain more or less constantly. Two of the biggest culprits, carpal tunnel syndrome and lateral epicondylitis (“tennis elbow”) both arise from overuse of the wrist or arm, and both can cause not just pain but loss of grip strength along with paresthesias (numbness and tingling). Traditional management of both conditions has included use of oral pain and anti-inflammatory medications and sometimes painful steroid injections. Carpal tunnel syndrome may ultimately require surgery to release pressure built up by inflamed tendons passing through the narrow bony channel at the wrist. Both of these maddening conditions are now yielding to management with LLLT, with studies from around the world demonstrating decreases in pain scores and functional status, including in many cases improvements in grip strength.15,29-31 At least one study has also found LLLT to be superior to traditional bracing for tennis elbow sufferers.32
Knee and Ankle Pain
In addition to Dr. Nordquist’s own extensive experience with pain in the lower extremities, there’s good evidence from other researchers around the world that LLLT is effective in reducing pain in the knees.5,33 Astonishingly, some orthopedists and anesthesiologists are now reporting success of LLLT in treating acute joint and tissue injuries such as ankle sprains as well as accelerating functional recovery.34
Summary of Studies
In addition to the many individual studies demonstrating the potency of LLLT at treating chronic pain, there are now dozens of “systematic reviews” that summarize the results of smaller studies. Scientists and practicing physicians alike often rely on these powerful articles to help them distinguish between truly effective forms of treatment, and those that may look good in small individual studies but fall short on closer analysis. LLLT passes this rigorous test with flying colors, with favorable systematic reviews now available on its benefits in treating chronic pain in the TMJ area, neck pain, and pain in all major joints in the extremities.12,13,22,35-41
A “Virtual” Experience in Dr. Nordquist’s LLLT Center
With this tremendous collection of positive information about LLLT in hand, we asked Dr. Nordquist to describe a typical first experience in his treatment center. What, we wondered, could patients expect as they come through the door?
“It’s a very non-threatening experience,” Dr. Nordquist explained. “The first thing we do is a thorough physical examination by a board-certified internist who is also skilled in integrative medicine. We do that mainly to be sure the patient’s pain isn’t a sign of a more troubling condition such as a tumor or fracture—the LLLT treatment itself is so safe that there really aren’t any medical conditions that would be contraindications. We do see LLLT as part of a comprehensive approach to healthy lifestyles, of course, and the Bahamas Anti-Aging Institute encourages and supports the use of nutritional and hormonal treatments as well—that’s one of the reasons why we think we are such a good fit for the Institute.
“After the initial physical exam, patients receive an actual prescription for 10 individualized treatment sessions with LLLT,” Dr. Nordquist continued. “That way patients can be certain that every treatment is done only under a physician’s supervision. Patients then complete a comprehensive form (we can help them with that), so that we can understand exactly where their pain is, what it feels like, what makes it better and worse, and so on. We enter all of that information into our custom-built computer program, which produces an individualized treatment plan specifying the specific target zones for treatment, the duration for each zone, and the laser energy that is best-suited for that person’s condition.”
We asked about duration of treatments, and how long people could expect the results to last. “Treatment at each specific zone lasts only about a minute,” Dr. Nordquist said. “So even though we target many different zones at each painful site, we can typically complete one treatment session within 30 minutes.” Patients receive one complete treatment session daily for 10 days, usually experiencing considerable relief immediately. “Most of our patients have reported excellent control of their pain for at least two to three years,” Dr. Nordquist pointed out with justifiable pride.
What’s the recommendation for activity during and after the treatments? “We ask them to take it easy during their treatment period,” replied Dr. Nordquist. “After the entire course of therapy is finished, we do remind them that we’ve controlled their pain, but that they need to use ordinary common sense about strenuous activity, in order to avoid exacerbating the underlying condition. But when people are able to move about with ease again, we often see that they lose weight, and that by itself can often help reduce further joint damage.”
What about prescription medications and painkillers? Can people reduce their dependence on these drugs? “Let me tell you about my most rewarding experience with LLLT,” was Dr. Nordquist’s reply. “And this is not an unusual story in this field. A young woman on crutches was assisted into my clinic by her husband and child—she’d been terribly overweight and had undergone gastric bypass surgery, but she was left with severe degenerative arthritis of the knees. She was on heavy doses of prescription narcotics, was having sleep disturbances, and her employer and family were concerned that she was addicted to the medications. By the eighth or ninth treatment session, she’d stopped all of her medications—and she came to her 10th session unassisted, walking like a child again!”
The astonishing ability of human tissue to interact with low-intensity, non-destructive laser light has opened a new world of possibilities for those who suffer from chronic pain.
Dr. Nordquist is now able to bring that healing power to a larger group of patients, thanks to the partnership that he’s spearheaded with the Bahamas Anti-Aging Institute, where his new LLLT center is now open. There are no known ill effects to the use of these very low-powered lasers. This treatment modality may be covered by several private insurers, though many patients will have to pay out of pocket.
Scientists from around the world have contributed to the massive evidence base for the effectiveness of LLLT—and the relief of human suffering as a result is truly staggering to consider.
Dr. Nordquist along with Norman Gay, MD and his colleagues have opened a center for LLLT at the Bahamas Anti-Aging Medical Institute.
According to Dr. Nordquist, “The Institute specializes in chronic pain management, creating integrative programs that incorporate the most cutting edge therapies with standard therapies to assist the patient with management of their chronic pain.”
If you have any questions on the scientific content of this article, please call a Life Extension Health Advisor at 1-800-226-2370.
1. Walker J. Relief from chronic pain by low power laser irradiation. Neurosci Lett. 1983 Dec 30;43(2-3):339-44.
2. Bjordal JM, Couppe C, Chow RT, Tuner J, Ljunggren EA. A systematic review of low level laser therapy with location-specific doses for pain from chronic joint disorders. Aust J Physiother. 2003;49(2):107-16.
3. Whittaker P. Laser acupuncture: past, present, and future. Lasers Med Sci. 2004;19(2):69-80.
4. Aigner N, Fialka C, Radda C, Vecsei V. Adjuvant laser acupuncture in the treatment of whiplash injuries: a prospective, randomized placebo-controlled trial. Wien Klin Wochenschr. 2006 Mar;118(3-4):95-9.
5. Yurtkuran M, Alp A, Konur S, Ozcakir S, Bingol U. Laser acupuncture in knee osteoarthritis: a double-blind, randomized controlled study. Photomed Laser Surg. 2007 Feb;25(1):14-20.
6. Urek R, Crncevic-Urek M, Cubrilo-Turek M. Obesity—a global public health problem. Acta Med Croatica. 2007 Apr;61(2):161-4.
7. Pearson-Ceol J. Literature review on the effects of obesity on knee osteoarthritis. Orthop Nurs. 2007 Sep;26(5):289-92.
8. Bierma-Zeinstra SM, Koes BW. Risk factors and prognostic factors of hip and knee osteoarthritis. Nat Clin Pract Rheumatol. 2007 Feb;3(2):78-85.
9. Christensen R, Bartels EM, Astrup A, Bliddal H. Effect of weight reduction in obese patients diagnosed with knee osteoarthritis: a systematic review and meta-analysis. Ann Rheum Dis. 2007 Apr;66(4):433-9.
10. Brosseau L, Robinson V, Wells G, et al. WITHDRAWN: Low level laser therapy (Classes III) for treating osteoarthritis. Cochrane Database Syst Rev. 2007;(1):CD002046.
11. Yousefi-Nooraie R, Schonstein E, Heidari K, et al. Low level laser therapy for nonspecific low-back pain. Cochrane Database Syst Rev. 2008;(2):CD005107.
12. Chow RT, Barnsley L. Systematic review of the literature of low-level laser therapy (LLLT) in the management of neck pain. Lasers Surg Med. 2005 Jul;37(1):46-52.
13. Bjordal JM, Lopes-Martins RA, Joensen J, et al. A systematic review with procedural assessments and meta-analysis of low level laser therapy in lateral elbow tendinopathy (tennis elbow). BMC Musculoskelet Disord. 2008;975.
14. Cetiner S, Kahraman SA, Yucetas S. Evaluation of low-level laser therapy in the treatment of temporomandibular disorders. Photomed Laser Surg. 2006 Oct;24(5):637-41.
15. Ekim A, Armagan O, Tascioglu F, Oner C, Colak M. Effect of low level laser therapy in rheumatoid arthritis patients with carpal tunnel syndrome. Swiss Med Wkly. 2007 Jun 16;137(23-24):347-52.
16. Fujiyama K, Deguchi T, Murakami T, et al. Clinical effect of CO(2) laser in reducing pain in orthodontics. Angle Orthod. 2008 Mar;78(2):299-303.
17. Wilden L, Karthein R. Import of radiation phenomena of electrons and therapeutic low-level laser in regard to the mitochondrial energy transfer. J Clin Laser Med Surg. 1998 Jun;16(3):159-65.
18. Vladimirov I, Klebanov GI, Borisenko GG, Osipov AN. Molecular and cellular mechanisms of the low intensity laser radiation effect. Biofizika. 2004 Mar;49(2):339-50.
19. Gavish L, Asher Y, Becker Y, Kleinman Y. Low level laser irradiation stimulates mitochondrial membrane potential and disperses subnuclear promyelocytic leukemia protein. Lasers Surg Med. 2004;35(5):369-76.
20. Chow RT, David MA, Armati PJ. 830 nm laser irradiation induces varicosity formation, reduces mitochondrial membrane potential and blocks fast axonal flow in small and medium diameter rat dorsal root ganglion neurons: implications for the analgesic effects of 830 nm laser. J Peripher Nerv Syst. 2007 Mar;12(1):28-39.
21. Buescher JJ. Temporomandibular joint disorders. Am Fam Physician. 2007 Nov 15;76(10):1477-82.
22. Atsu SS, Ayhan-Ardic F. Temporomandibular disorders seen in rheumatology practices: A review. Rheumatol Int. 2006 Jul;26(9):781-7.
23. Fikackova H, Dostalova T, Navratil L, Klaschka J. Effectiveness of low-level laser therapy in temporomandibular joint disorders: a placebo-controlled study. Photomed Laser Surg. 2007 Aug;25(4):297-303.
24. Mazzetto MO, Carrasco TG, Bidinelo EF, de Andrade Pizzo RC, Mazzetto RG. Low intensity laser application in temporomandibular disorders: a phase I double-blind study. Cranio. 2007 Jul;25(3):186-92.
25. Turhani D, Scheriau M, Kapral D, et al. Pain relief by single low-level laser irradiation in orthodontic patients undergoing fixed appliance therapy. Am J Orthod Dentofacial Orthop. 2006 Sep;130(3):371-7.
26. Chow RT, Heller GZ, Barnsley L. The effect of 300 mW, 830 nm laser on chronic neck pain: a double-blind, randomized, placebo-controlled study. Pain. 2006 Sep;124(1-2):201-10.
27. Djavid GE, Mehrdad R, Ghasemi M, et al. In chronic low back pain, low level laser therapy combined with exercise is more beneficial than exercise alone in the long term: a randomised trial. Aust J Physiother. 2007;53(3):155-60.
28. Unlu Z, Tasci S, Tarhan S, Pabuscu Y, Islak S. Comparison of 3 physical therapy modalities for acute pain in lumbar disc herniation measured by clinical evaluation and magnetic resonance imaging. J Manipulative Physiol Ther. 2008 Mar;31(3):191-8.
29. Evcik D, Kavuncu V, Cakir T, Subasi V, Yaman M. Laser therapy in the treatment of carpal tunnel syndrome: a randomized controlled trial. Photomed Laser Surg. 2007 Feb;25(1):34-9.
30. Lam LK, Cheing GL. Effects of 904-nm low-level laser therapy in the management of lateral epicondylitis: a randomized controlled trial. Photomed Laser Surg. 2007 Apr;25(2):65-71.
31. Stergioulas A. Effects of low-level laser and plyometric exercises in the treatment of lateral epicondylitis. Photomed Laser Surg. 2007 Jun;25(3):205-13.
32. Oken O, Kahraman Y, Ayhan F, et al. The short-term efficacy of laser, brace, and ultrasound treatment in lateral epicondylitis: a prospective, randomized, controlled trial. J Hand Ther. 2008 Jan;21(1):63-7.
33. Gur A, Cosut A, Sarac AJ, et al. Efficacy of different therapy regimes of low-power laser in painful osteoarthritis of the knee: a double-blind and randomized-controlled trial. Lasers Surg Med. 2003;33(5):330-8.
34. Simunovic Z, Ivankovich AD, Depolo A. Wound healing of animal and human body sport and traffic accident injuries using low-level laser therapy treatment: a randomized clinical study of seventy-four patients with control group. J Clin Laser Med Surg. 2000 Apr;18(2):67-73.
35. Sun G, Tuner J. Low-level laser therapy in dentistry. Dent Clin North Am. 2004 Oct;48(4):1061-76, viii.
36. Brosseau L, Robinson V, Wells G, et al. Low level laser therapy (Classes I, II and III) for treating rheumatoid arthritis. Cochrane Database Syst Rev. 2005;(4):CD002049.
37. McNeely ML, Armijo OS, Magee DJ. A systematic review of the effectiveness of physical therapy interventions for temporomandibular disorders. Phys Ther. 2006 May;86(5):710-25.
38. Naeser MA. Photobiomodulation of pain in carpal tunnel syndrome: review of seven laser therapy studies. Photomed Laser Surg. 2006 Apr;24(2):101-10.
39. Bjordal JM, Johnson MI, Lopes-Martins RA, et al. Short-term efficacy of physical interventions in osteoarthritic knee pain. A systematic review and meta-analysis of randomised placebo-controlled trials. BMC Musculoskelet Disord. 2007;851.
40. Gross AR, Goldsmith C, Hoving JL, et al. Conservative management of mechanical neck disorders: a systematic review. J Rheumatol. 2007 May;34(5):1083-102.
41. Jensen I, Harms-Ringdahl K. Strategies for prevention and management of musculoskeletal conditions. Neck pain. Best Pract Res Clin Rheumatol. 2007 Feb;21(1):93-108.