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Archive for the ‘Chiropractor’ Category

Arm Coventry,Arm Pain,Injuries,Coventry,Healing,Pain Relief,Nuneaton.

Wednesday, May 19th, 2010

Specific lists of injuries,conditions, disorders, treatment and research, this page includes;  Upper arm pain, Trapped nerve  in the neck and arm, Carpal Tunnel syndrome, is Surgery Effective at Treating Carpal Tunnel? Tennis Elbow, Golfers Elbow, Bicep Tendonitis, Fractures of both bones in the forearm, Scaphoid Fractures, Colles Fracture, Torus fracture, (“buckle” fracture), Metaphyseal fracture, Greenstick fracture, Galeazzi fracture, Monteggia fracture, Growth plate fracture, (physeal fracture), Wrist Sprains  injuries and strained muscles,  Arm Diseases, Heart Problems, Cold laser also known as Low level laser therapy, this includes low level laser research for healing,  ligament,and bone repair.

A research review published in The Lancet, for Cold/ Low Level Laser treatment for neck pain.  Research and the successful management of “Repetitive stress injury” or “Carpal tunnel syndrome” by a new treatment modality- application of Cold/ low level lasers,  for Tendonitis , Burstis, Fractures, conditions and disorders, and  pain relief and accelerating the  healing process.

The human arm has many uses, so when an arm hurts, productivity is affected and concern arises. When you have pain in the arm, the reasons can be varied.  Some may be obvious, while others are hidden.  Most often, arm pain is caused by injuries or falls. Continued stress can also injure arms, causing upper arm and wrist pain. Arm pain can be a symptom of a more serious problem such as a heart attack. Whenever you experience arm pain it’s vital to get immediate medical attention.

Injuries and Strained Muscles

Pain caused by arm injuries is usually in the lower arm. Any trauma or injury involving the arm can cause pain. Common examples include sprains and fractures, which are the most visible arm injuries. Overusing your arm, resulting in strained muscles, is one of the most common causes of arm pain. For example, excessive swimming, throwing, swinging such as in tennis and other repetitive activities, usually involved with sports, can result in arm pain.

Trapped or Pinched Nerves in the Neck

Pinched nerves in the neck cause numbness, weakness and pain in arms or hands. Neck pain due to muscle strain can cause stiffness and aches spreading to the upper arm. If you experience shooting pain spreading to the hand and fingers, you may have a pinched nerve. When this occurs in both arms and hands the pain is more severe. Pinched nerves can be the result of joint irritation, swelling or injuries.

Causes of Upper Arm Pain

Because the upper arm has plenty of muscles, it’s harder to injure it. However, one condition causing upper arm pain is bicipital tendonitis, involving a torn or frayed tendon near the shoulder. This triggers pain in the upper arm biceps. Lifting heavy weights can cause upper arm pain because it inflames shoulder tendons. Other causes of upper arm pain may include diabetes, a chemical burn, heartburn, brachial plexus injury, peripheral neuropathy or upper arm injury.

Heart Problems 

There is a strong link with tingling feelings or pain in the left arm and the possibility of either angina or a heart attack. Angina describes chest pain that’s related to the heart. This symptom is found more in males than in females. It’s rare that left arm pain is the only sign. If you do have pain in the left arm, it’s important to be diagnosed and treated as soon as possible.

Diseases

Diseases affecting other body organs can cause arm pain. A few examples include arthritis or peripheral vascular disease. Degrees of arm pain may range from mild to severe. In some cases the pain can even be life-threatening e.g. pain resulting from myocardial infarction. Treatments for the pain depend on the root cause

Poor Posture

Poor posture can cause shoulder and neck muscular tension. Just by sitting with your head and shoulders forward can place extra weight on your neck, causing arm pain. Considering the average-sized head is as heavy as a bowling ball, it’s not surprising how poor posture can result in muscular tension to the arms, causing pain.

Fractures of bones in the forearm.

The bones of the forearm are the radius and the ulna. If you hold your arm naturally by your side, the ulna is the bone closer to you and the radius is farther away.

Fractures of the forearm can occur near the wrist at the farthest (distal) end of the bone, in the middle of the forearm, or near the elbow at the top (proximal) end of the bone.

A child’s bones are also subject to a unique injury called a growth plate fracture. Growth plates are made of cartilage near the ends of children’s bones. They help determine the length and shape of the mature bone. 

Fractures of both bones in the forearm.

Fractures in a child’s bones begin to heal much more quickly than an adult’s bones. If you suspect a fracture, you should obtain prompt medical attention for the child so that the bones can be set for proper healing.

  • Torus fracture. This is also called a “buckle” fracture. The topmost layer of bone on one side of the bone is compressed, causing the other side to bend away from the growth plate. This is a stable fracture and the broken pieces of bone have not separated apart (displaced).
  • Metaphyseal fracture. The fracture is across the upper, or lower, portion of the shaft of the bone and does not affect the growth plate.
  • Greenstick fracture. The fracture extends through a portion of the bone, causing it to bend on the other side.
  • Galeazzi fracture. The injury affects both bones of the forearm. There is usually a displaced fracture in the radius and a dislocation of the ulna at the wrist, where the radius and ulna come together.
  • Monteggia fracture. The injury affects both bones of the forearm. There is usually a fracture in the ulna and the top (head) of the radius is dislocated. This is a very severe injury and requires urgent care.
  • Growth plate fracture. Also called a physeal fracture, this fracture occurs at or across the growth plate. Usually these fractures affect the growth plate of the radius near the wrist.

Symptoms

In most cases, a broken forearm causes severe pain to the forearm and hand may also feel numb.

Examination, Signs

 Any type of deformity about the elbow, forearm, or wrist

  • Tenderness
  • Swelling
  • An inability to rotate or turn the forearm

A doctor will also test to make sure that the nerves and circulation in your child’s hand and fingers have not been affected.

Investigation, Tests

The hand, wrist, arm, and elbow can all be injured during a fall on an outstretched arm. To determine exactly what injuries have occurred, a doctor will probably want to see x-rays of the elbow and wrist, as well as the forearm.

Wrist Fractures

In women, the number of wrist fractures increases at menopause and plateaus after age 55. This is most likely related to the rapid loss of bone in the years following menopause. Since men don’t experience menopause, the incidence of wrist fracture in men remains fairly constant.

A wrist Fracture occurs most often in women who are relatively healthy and active and have good reflexes. In fact, the majority of wrist fractures occur outdoors during the winter months when snow and ice make walking treacherous, and falls are common.

The wrist is made up of two bones in the lower arm, the radius and ulna, plus the small bones of the hand. The most common wrist fracture occurs when a person extends an arm to break a fall. The hand and forearm take all the weight and force from the fall, and one of the wrist bones breaks.

Colles Fracture

Colles fracture is the most frequent type of wrist fracture, which can occur when a patient falls on an outstretched hand. Pain accompanies wrist flexion, and there is usually tenderness, swelling, and bruising over the injury site. Some fractures are denoted by deformity of the bone. X-rays are needed to confirm the fracture.

Treatment includes a splint or cast for four to six weeks followed by range-of-motion and forearm strengthening exercises. Surgery may be needed if the bone does not heal correctly.

Prevention of wrist fractures includes wearing wrist guards during activities such as inline skating, skiing, and skateboarding, where falling on an outstretched hand has a higher possibility.

Scaphoid Fractures.

Scaphoid fractures occur when a person falls on an outstretched arm and the palm of the hand hits the ground, causing pain on the thumb side of the wrist, and pain with subsequent wrist motions. Digital-X-rays must be taken to diagnose this condition. Treatment includes a splint or cast for four to six weeks, unless the fracture occurred in the middle portion of the bone, in which case surgical intervention may be needed to stabilize the fracture. The blood normally supplied to the inner structure of the bone is not good enough to help heal the bone, because of this the bone may then require surgery.

There are no specific risk factors or diseases that increase one’s chance of a wrist fracture. Wearing wrist guards during biking, in line skating and snowboarding will decrease the risk of wrist fracture. After cast removal, avoid heavy lifting and activities with a high risk of wrist impaction. Sometimes hand therapy is prescribed to increase strength and range of motion if the patient has been in the cast for an extended period of time.

Diagnosis of Wrist Fractures.

Following a fall, you may be bruised and sore. Sometimes, a fracture may be misdiagnosed as a bad sprain (an injury to the ligaments), and the pain, limited movement, and weak hand grasp in the affected arm is ignored. Your wrist is probably fractured rather than sprained if you have:

  • persistent pain
  • swelling near the wrist
  • changes in finger movement
  • numbness

Usually, an X-ray can confirm the diagnosis. Once the fracture is diagnosed, appropriate treatment begins.

A wrist fracture may also be a sign of underlying problems such as:

  • low bone density
  • poor balance
  • vision/hearing problems

Wrist Sprains

Wrist sprains occur when the wrist is forcefully bent backwards, tearing the ligament that connects the bones of the wrist. Symptoms include pain with motion, swelling, bruising, and tenderness over the injury site. X-rays should be taken to rule out a fracture. In some cases, an MRI or CT scan is done to determine the extent of the ligament injury.

Treatment includes splinting, ice, and rest. Prevention includes being careful on wet floors that may cause slipping.

Thumb Sprains — Gamekeeper’s Thumb

Gamekeeper’s thumb occurs when the thumb is forcefully pushed backwards, thus stretching or tearing the ligament. Activities such as catching a ball can cause this injury; football and netball are the most common sports in which it occurs. Symptoms include pain with thumb movement, swelling and tenderness over the injured joint, and the inability to hold objects between the thumb and fingers.

Treatment includes splinting, rest, and ice. X-rays may be taken to rule out any fractures. Surgery may be needed if the joint is unstable. Prevention includes applying proper techniques when catching a ball, and avoiding falling on an outstretched hand.

Finger Injuries

Finger injuries are common and range from simple cuts to bone, tendon, or ligament damage. If not properly treated, finger injuries can lead to deformity and permanent loss

Carpal Tunnel Syndrome

Carpal Tunnel Syndrome affects the wrists and can prevent people from working due to the wrists and hands being very painful. This is a wrist condition that can result in chronic wrist and hand pain.

Carpal: Across the back of the wrist, eight small irregular bones (called carpals) are aligned in 2 rows forming a letter “C.” There is a tough ligament attaching across the inner side of the wrist, thus forming the Carpal Tunnel.

Tunnel: An opening through which something passes through. Nine tendons of the muscles of the forearm that move the fingers along with the soft median nerve pass through this narrow tunnel. This tunnel is about the size of your little finger.

In carpal tunnel syndrome the median nerve becomes either compressed, irritated or swollen resulting in pain.

Carpal Tunnel Syndrome is a condition in which the median nerve becomes irritated and swells. During the swelling the pressure in the canal increases leading to further irritation and compression of the nerve. This leads to more swelling and nerve irritation.

What are Carpal Tunnel Syndrome symptoms?

Typical symptoms of Carpal Tunnel Syndrome include parenthesis (abnormal sensations) such as tingling and numbness in the thumb and index and middle fingers on the palm side, night pain, weakness in grasping, thumb and index finger pinching, and other thumb movements’ clumsiness, such as awkward hand movements and dropping things with increased weakness.

Is Surgery Effective at Treating Carpal Tunnel Syndrome?

Surgical procedures have been developed over the years to “release” the pressure on the nerves at the carpal tunnel by permanently severing the ligament that holds the tunnel together. Unfortunately, these procedures are rarely successful over the long term and almost never address the cause of the nerve irritation. Common sense would tell us that it is unlikely that the carpal tunnel would simply “shrink” without warning. Therefore, increasing the size of the tunnel will only provide temporary benefit especially if the tendons within the tunnel continue to thicken. Also, post-surgical scar tissue can also interfere with proper wrist and nerve function contributing to more pressure on the nerve.

What treatment is available for Carpal Tunnel Syndrome?

Before commencing the treatment patient should be evaluated for the cause of the nerve swelling. Some systemic conditions such as under active thyroid can lead to the swelling of the tendons, thus putting pressure onto the median nerve.

Patients should also be evaluated for possible compression of the nerves at the neck, shoulder and elbow levels that can also present itself as a pain and weakness in the wrist. In majority of cases of wrist and hand pain and weakness the primarily cause is compression of the nerve root at the neck level that forms nerves of the arm and hand. That’s why some patients still experience symptoms of carpal tunnel even after the surgery or cortisone injections were performed.

Cold/low level laser therapy applied over the carpal tunnel has proven to be very effective in reduction of swelling and pain management. Please contact us if you require further information. Cold/Low Level Laser Therapy Section).

Cold/Low Level Laser Research for Carpal Tunnel Syndrome.

Successful management of “Repetitive stress injury” or “Carpal tunnel syndrome” by a new treatment modality- application of Cold/ low level lasers for pain Relief.

E. Wong G LEE J. Zu CHERMAN and D. P. MASON

Western Heart Institute and St. Mary’s Spine Center St. Mary’s Medical Center. San Francisco. CA. USA and Head and Neck Pain Center,  Honolulu HL. USA

 Abstract

Female office workers with desk jobs who are incapacitated by pain and tingling in the hands and fingers are often diagnosed by physicians as “repetitive stress injury” (RSI) or “Carpal tunnel syndrome” (CTS). These patients usually have poor posture with their head and neck stooped forward and shoulders rounded; upon palpation. They have pain and tenderness at the spinous processes C5 – T1 and the medial angle of the scapula. In 35 such patients we focused the treatment primarily at the posterior neck area and not the wrists and hands. A low level laser (100 mW) was used and directed at the tips of the spinous processes C5 – Tl.

The laser rapidly alleviated the pain and tingling in the arms, hands and fingers, and diminished tenderness at the involved spinous processes. Thereby, it has become apparent that many patients labelled as having RSI or CTS have predominantly cervical radicular dysfunction resulting in pain to the upper extremities which can be managed by low level laser.

Successful long-term management involves treating the soft tissue lesions in the neck combined with correcting the abnormal head, neck and shoulder posture by taping. Cervical collars, and clavicle harnesses as well as improved work ergonomics.

LASER THERAPY, 1997:9: 131- 136 09/97

© 1997 by LT Publishers, U.K., Ltd.

Carpal Tunnel Study Results Released

 Laser Focus World

 A physician at UMDNJ-Robert Wood Johnson Medical School is evaluating a “cold” laser to treat patients with carpal tunnel syndrome, a debilitating nerve condition that causes severe pain and numbness in the hand.

Clinical results of a double-blind study of 11 patients afflicted with carpal tunnel syndrome who were treated with a diode-laser device manufactured by Lasermedics (Missouri City, TX) showed that after six to 15 treatments, nine of the 11 patients experienced relief of pain and other associated symptoms as well as normalization of abnormal latencies.

The study was conducted by Michael L. Weintraub, a neurologist from Briarcliff, NY, and reported in the February 1996 issue of Neurology.

The patients all used a 30mW 830nm, a hand-held, battery-operated, nonsurgical laser device that employs the process of photo-biostimulation.

Dr. Weintraub concluded that the results of his study support the efficacy and safety of laser-light treatment in carpal tunnel syndrome.

Research Published in the Lancet, for Cold/ Low Level Laser treatment for neck pain

Neck Pain is common, often persistent, and responds poorly to medication. So it is encouraging to read that a relatively novel, non-invasive treatment shows evidence of effectiveness. A systematic review and meta-analysis of 16 randomised controlled trials of low-level laser therapy (LLLT)’ yielded 820 patients, for whom data was pooled. LLLT was found to reduce pain immediately after treatment in acute neck pain and up to 22 weeks after completion of treatment in patients with chronic neck pain. Low-level laser – or cold laser – is yet to be established as a medical treatment but, according to Wikipedia, papers are appearing at the rate of around 25 per month, mainly investigating treatment of musculoskeletal disorders. We will be watching.

1. Chow RT, Johnson Ml, Lopes-Martins RA, Bjordal JM. Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials. Lancet 2009 Dec 5;374(9705):1897-908.

X Tennis Elbow or Lateral Epicondylitis.

Tennis elbow, or lateral epicondylitis, takes its name from a common injury that originally appeared in a high proportion of tennis players. However this condition manifests in a vast proportion of people who never play tennis at all. Lateral epicondylitis is a painful condition involving the tendons that attach or anchor muscles to the bone on the outside (lateral) part of the elbow. The muscle involved in this condition, the extensor carpi radialis brevis, helps to extend and stabilize the wrist. With lateral epicondylitis, there is degeneration or deformity of the collagen of the tendon’s attachment, weakening the anchor site and placing greater stress on the area. This can then lead to pain associated with activities in which this muscle is involved, such as lifting, gripping, and/or grasping. The majority of people who suffer from tennis elbow are between 30 and 60 years old although condition can affect much younger athletes as well. Both men and women are also equally affected.

Causes of Tennis Elbow.

Tennis elbow may occur as a result of repeated extension or overuse of the wrist against resistance such example is using a hammer in the work place and from sporting activities such as tennis, badminton, squash and cricket. Tennis elbow is equally likely to appear in work related activities such as brick laying, carpentry and from the excessive typing on a computer keyboard.

A poor grip or backhand technique with a tennis racquet can be a primary cause and commonly seen in an athlete who miss times or arrives ‘late’ for a backhand this means they cannot get their body fully behind the ball. And therefore the wrist has to compensate and in doing so injuries are caused to muscles and tendons which provide this movement. In addition the wrist needs to be firm and not bent when the ball is struck so the forces can be spread over the arm, shoulder and the body. A small racquet grip will mean the muscles in the elbow must work a harder leading to structural changes in the tendon.

Another possible cause of tennis elbow is direct trauma to the elbow which may result in swelling of the tendon that can lead to degeneration. A sudden extreme action, force, or activity could also injure the tendon.

Two types of onset are commonly seen

Sudden Onset:

Sudden onset of tennis elbow occurs in a single instance of forced exertion such as a late back hand where the extensors of the wrist become strained. This is thought to correspond to micro-tearing of the tendon.

Late Onset (most common):

This normally takes place within 24-72 hours after an intensive overuse of untrained wrist extension. Examples may be a tennis player using a new racket or even a person who’s spent a weekend doing DIY.

Symptoms of Tennis Elbow / Lateral Epicondylitis.

Severe burning pain from about 1-2 cm down from bony area at the outside of the elbow (lateral epicondyle) -Weakness in the wrist associated with pain on the outside of the elbow or radiating into the forearm which causes difficulty when performing simple tasks such as opening the door handles or using a screwdriver. Lifting even very light objects (such as a small book or a cup of coffee) can lead to significant discomfort.

Pain on the outside of the elbow when the hand is bent back (extended) at the wrist against resistance.

Pain on the outside of the elbow when trying to straighten the fingers against resistance.

Pain when pressing just below the lateral bony prominence (epicondyle) on the outside of the elbow.

Non surgical treatment of Tennis elbow.

Tennis elbow treatment involves treatment not only in the elbow area but also treatment of possible pathologies in the neck or shoulder. Each individual will react differently to different treatments. Below are examples only- we always recommend seeing a qualified therapist before attempting any rehabilitation.

  • Ice to the elbow (15 min’s on up to six times a day). This will help reduce pain and inflammation if present.
  • Cold/low level laser therapy is shown to be extremely effective in settling down the inflammation and promoting healing of the soft tissues. Cold/low level laser therapy has a five star rating in the treatment of Tennis elbow
  • Rest – an extremely important component in the healing of this injury.
  • A brace or support will help to protect the tendon whilst healing and will provide strengthening, particularly when returning to playing sport or work equivalent. The brace should not be put on the painful area but rather approximately 10cm down the forearm.

 What can a chiropractor do?

Assess the integrity of the neurological supply the elbow from the neck and shoulder and address these areas if necessary by use of manual therapy.

  • Correctly diagnose the condition: This may be done by carrying out Mills’ test- resisted wrist extension with the palm facing the floor (pronated) and moving the hand sideways in the direction of the thumb. If pain is elicited then this is a positive sign for the test. Another test is to resist extension of the middle finger-pain is also a strong indicator.
  • Apply Cold /low level laser treatment has a five star rating in the treatment of tennis elbow, which helps to reduce pain and inflammation as well as stimulate healing.
  • Advice on pain control-such as NSAID’s like Ibuprofen.
  • Apply myofacial release and/or transverse friction techniques across the tendon as well as utilize the dry needling techniques
  • Identify and correct any predisposing factors which lead to the onset of tennis elbow. Your tennis coach should also be able to provide some advice with regards your backhand technique.
  • If the conservative treatments have failed for about a year then referral to the orthopaedic surgeon may be considered.

 How long will Tennis elbow take to get better?

Sometimes tennis elbow may heal quickly within two weeks but some people can suffer with this problem for up to two years. When the pain has settled down it is essential to provide full rehabilitation and strengthening of the elbow.

Few tips on preventing Tennis Elbow.

 Work on the correct technique – play the backhand with the -whole body not just the wrist!

  • Use a forearm brace or heat retainer if you have a weak wrist or elbow
  • Use a light racket if you do not play very often
  • Do not play with wet, heavy balls
  • Make sure that racquet strings are not too tight

Rehabilitation includes forearm stretches and strengthening of the wrist extensors and flexors, biceps, and triceps.

Golfer’s Elbow

Golfer’s elbow is pain or inflammation of the muscle on the inside of the elbow causing pain emanating from the bony prominence, and extending into the forearm. It is also known as “Little Leaguer elbow” when caused by excessive throwing. Golfers elbow does not occur only in golfers; it can be caused by activities that include repetitive forearm movement, such as using a screwdriver or painting. (View tennis elbow for diagnosis, treatment and prevention.)

Biceps Tendonitis

Biceps tendonitis refers to inflammation or degeneration of connecting muscle fibres on the front of the arm due to overhead repetitive activities such as throwing or tennis. The biceps are used to accelerate and decelerate the arm during overhead throwing-type motions. Symptoms include tenderness of the involved tendon and pain with overheard movements. Diagnosis is determined by going over a thorough history of activities with a health professional.

Treatment includes modifying activity, such as reducing overhead movements or switching activities to eliminate pain with movement. Physical therapy will include range of motion activities and gradual strengthening of the biceps and surrounding muscle of the shoulder and forearm. Prevention of biceps tendinitis includes a gradual increase in overhead activities, maintaining adequate strength of the biceps and surrounding shoulder musculature, and getting adequate rest between activities. 

Reasearch

Research on Low level laser therapy (LLLT) of tendonitis and myofacial pains a randomized, double-blind, controlled study.

Mimmi Logdberg-Anderssont (1), Sture Mutzell (2), and Ake Hazel (3)

  1: Akersberga Health Care Centre,

  2: Danderyd University Hospital, Danderyd, and

  3: Vaxholm Health Care Centre, Stockholm, Sweden.

The purpose of this randomised, double-blind study was to examine the effect of GaAs laser therapy for tendonitis and myofascial pain in a sample from the general population of Akersberga in the northern part of Greater Stockholm.

176 patients (of an original group of 200) completed the scheduled course of treatment. The patients were assigned randomly to either a laser group (92 patients, of whom 74 had tendonitis, completed the study) or a placebo group (84 patients, of whom 68 had tendonitis, completed the study). All 176 patients received six treatments during a period of 3-4 weeks. Their pain was estimated objectively using a pain threshold meter, and subjectively with a visual analogue scale before, at the end of, and four weeks after the end of treatment.

Laser therapy had a significant, positive effect compared with placebo measured from the first assessment to the third assessment, four weeks after the end of treatment. Laser treatment was most effective on acute tendonitis.

Address for Correspondence

Sture Mutzell, Danderyd University Hospital 5-182 87 Danderyd, Sweden.

03/07 Rep US 10-12-14, 1997 By LT Publishers, U.K., Ltd.

LASER THERAPY, 1997:9: 79-86   Wave- length Power Energy Density Power Density Energy per point Pulses 904nm 8mW av (10Wpeak) 0.5-1.0 J/Cm2 (not given) 1J 4KHz x 180nS 

Cold/Low Level laser Therapy (LLLT) 

Low Level Laser Therapy (LLLT) also so known as Cold Laser Therapy has been tested in over 200 clinical trials (RCTs) and published in the world’s top medical journals including a review by The Lancet, a clinical study in the journal PAIN and is acknowledged by the World Health Organisation Bone and Joint Task Force, and published in the journal Spine.

The lasers used are certified as low level laser therapy  (LLLT).  For the past 30 years the technology of low level laser therapy (also known as Cold/low level Laser Therapy has been formally accepted in North America and in many other parts of the world such as Europe, Russia and Japan.  In all this time there have been no recorded long-term adverse effects from low level laser therapy.  It is considered to be non-invasive, painless and safe.

Cold/Low Level Laser Therapy (LLLT) uses laser light energy to stimulate cells to function optimally.  In the body, light sensitive chromophores and other elements within the cell absorb energy, initiating a series of important photochemical changes such as increased production of ATP. The mitochondria and Kreb’s Cycle stimulation initiates the production of ATP, providing the cell with the extra energy needed to accelerate the healing process and positively influence pain.  These activities can occur in all types of cells and includes ligament, nerves, cartilage and muscle.

Cold/Low Level Laser Therapy (LLLT) is a treatment where by a low level laser is utilized to treat chronic and acute pain. Cold/ Low level laser therapy may be used for patients suffering from tennis elbow, frozen shoulder, sciatica, back and neck, hip, knee, ankle, foot pain and conditions a, musculoskeletal pain, joint pain associated with arthritis, fibromyalgia, tendonitis, bursitis, neuropathy, Achilles tendonitis, migraine headaches, sprains and strains, trapped nerves, carpal tunnel syndrome , back, neck, shoulder pain and other associated pains.Cold/ Low Level laser therapy also treats conditions such as TMJ, reflex sympathetic dystrophy (RSD) and other inflammatory and scarring conditions. By increasing serotonin levels, low level laser therapy contributes to the body’s own healing process. Non-thermal and non-invasive, low level laser therapy involves a combination of low level laser and electric stimulation and is one of the most effective healing therapies. Completed in ten to twelve sessions, Cold/ low level laser therapy (LLLT) can significantly reduce treatment time and costs.

Cold/Low Level Laser Therapy for Carpal Tunnel syndrome,Tennis Elbow, and Fractures including  other injuries, conditions, syndromes,

Soft tissue injuries, Ligaments, Tendons and muscles. Tendonitis, Bursitis, Plantar fasciitis, Back and Lower back pain. Neck, Shoulder, Arm, and Wrist pain. Hip knee ankle pain injuries.

The lasers used at Central Chiropractic Clinic are certified as Cold Laser.  For the past 30 years the technology of Cold Laser Therapy (also known as Low Level Laser Therapy) has been formally accepted in North America and in many other parts of the world such as Europe, Russia and Japan.  In all this time there have been no recorded long-term adverse effects from low level laser therapy.  It is considered to be non-invasive, painless and safe.

Cold/low level Laser Therapy uses laser light energy to stimulate cells to function optimally.  In the body, light sensitive chromophores and other elements within the cell absorb energy, initiating a series of important photochemical changes such as increased production of ATP. The mitochondria and Kreb’s Cycle stimulation initiates the production of ATP, providing the cell with the extra energy needed to accelerate the healing process and positively influence pain.  These activities can occur in all types of cells and includes ligament, nerves, cartilage and muscle.

Cold/Low Level Laser Therapy (LLLT) is a Handheld, non-invasive, light-emitting medical device which is used over different areas of the body. It provides an unmatched advantage in the treatment of conditions such as;

Carpal Tunnel Syndrome.

Chronic Neck and Back Pain.

 “Whiplash injuries” Neck Pain, Cervical Disc injury.

Back pain, Lower Back Pain, Sciatica.

“Slipped disc”, Prolapsed disc, Herniated disc, Bulging disc.

Trapped Nerves. 

Hip Pain Sacroiliac joint inflammation 

Athletic and Sports Injuries. Ligaments. Tendons. and Tendonitis.

Lower Back Pain
Knee and Foot Pain and injury
Shoulder Injury
Carpal Tunnel Syndrome
Arthritic Pain Relief, Muscle Spasm
Relief of Muscle and Joint Pain
Skin infections, 

Wound Management; including Skin Ulcers, Pressure Sores and Burns

Soft Tissue Injuries including; Sprains and Strains, Tendonitis and Haematomas 

Joint Disorders; including  Arthritic Pain Relief, and Tenosynovitis

Chronic Pain   such as Trigeminal Neuralgia and Chronic Neck and Back

 Pain. “Whiplash’ (WAD) injuries”, Neck Pain and injuries.

CONNECTIVE TISSUE / CARTILAGE / LIGAMENT / BONE REPAIR RESEARCH STUDIES

CONNECTIVE TISSUE REPAIR

THE BIOLOGICAL EFFECTS OF LASER THERAPY AND OTHER PHYSICAL MODALITIES ON CONNECTIVE TISSUE REPAIR PROCESSES

Chukuka S. Enwemeka, P.T., Ph.D., FACSM, G. Kesava Reddy, Ph.D.,
Department of Physical Therapy and Rehabilitation Sciences,
University of Kansas Medical Center,
Kansas City, KS 66160-7601, USA
Laser Therapy Vol. 12 Special Millennium Edition, 2000.

Connective tissue injuries, such as tendon rupture and ligamentous strains, are common. Unlike most soft tissues that require 7-10 days to heal, primary healing of tendons and other dense connective tissues take as much as 6 – 8 weeks during which they are inevitably protected in immobilization casts to avoid re-injury. Such long periods of immobilization impair functional rehabilitation and predispose a multitude of complications that could be minimized if healing is quickened and the duration of cast immobilization reduced.

In separate studies, we tested the hypothesis that early function, ultrasound, 632.8 nm He-Ne laser, and 904 nm Ga-As laser, when used singly or in combination, promote healing of experimentally severed and repaired rabbit Achilles tendons as evidenced by biochemical, biomechanical, and morphological indices of healing. Our results demonstrate that: (1) appropriate doses of each modality, i.e., early functional activities, ultrasound, He-Ne and Ga-As laser therapy augment collagen synthesis, modulate maturation of newly synthesized collagen, and overall, enhance the biomechanical characteristics of the repaired tendons. (2) Combinations of either of the two lasers with early function and either ultrasound or electrical stimulation further promote collagen synthesis when compared to functional activities alone. However, the biomechanical effects measured in tendons receiving the multi-therapy were similar, i.e., not better than the earlier single modality trials.

Although tissue repair processes in humans may differ from that of rabbits, these findings suggest that human cases of connective tissue injuries, e.g., Achilles tendon rupture, may benefit from appropriate doses of He-Ne laser, Ga-As laser, and other therapeutic modalities, when used singly or in combination. Our recent meta-analysis of the laser therapy literature further corroborates these findings.

BONE REPAIR

EFFECT OF LOW-LEVEL LASER ON CALVARIAL BONE DEFECT

M. KHADRA1, N. KASEM2, H.R. HAANÆS1, and S.P. LYNGSTADAAS1
1Oslo University, Norway, 2Karolinska Institute, Stockholm, Sweden

Objective: The purpose of the present study was to evaluate by animal means the effect of laser therapy with GaAlAs diode laser device on bone healing and growth in rat calvarial bone defects.

Methods: The study was performed as an animal trial of 4 weeks duration with blinded, placebocontrolled design. 20 rats had a standardised round osseous defect 2,7 mm in diameter made in each parietal bone (2 defects). The animals were then randomly divided into two equal groups. A GaAlAs diode laser (wavelength 830 nm, output power 75 mw and energy density 23 J/cm2) was used immediately after surgery and carried out daily for 7 consecutive days. The rats were thereafter sacrificed at day 14 and 28 after surgery. Levels of calcium, phosphorous and protein were determined in 20 bone defects, while the histological analyses were performed in the other 20 defects. Statistical analyses between the test and control were performed using Student’s t-test.

Results: The results indicate that calcium, phosphorous and protein contents were significantly higher in the laser-irradiated healing tissues than in the sham group on both time-points. The histological analyses showed that proliferation of fibroblasts, osteoid tissue and bone were more prominent in the irradiated group.

Conclusion: The findings suggest that Laser Therapy may promote metabolism and/or mineralisation in bone forming tissues during the healing of bone defects.

BONE REPAIR OF THE PERIAPICAL LESIONS TREATED OR NOT WITH LOW INTENSITY LASER (WAVELENGHT=904 NM). 

Laser Surg Med. Abstract Issue 2002. abstract 303.
Sousa G R, Ribeiro M S, Groth E B.

The effect of bone repair in periapical lesions has been studied by Sousa. 15 patients with atotal of 18 periapical lesions were divided into two groups. One group received endodontic treatment and/or periapical surgery. The patients in the other group were submitted to the same procedure and in addition the lesions were irradiated by GaAs laser, 11 mW, 9 J/cm2. This therapy was performed during 10 sessions with an interval of 72 hours. Bone regeneration was evaluated through X-ray examination. The results showed a significant difference between the laser and the control group in favour of the laser group. 

THE INFLUENCE OF LOW LEVEL INFRA RED LASER THERAPY ON THE
REGENERATION OF CARTILAGE TISSUE.

P.Lievens , Ph.van der Veen

This study concerns the influence of Laser treatment on the regeneration process of cartilage tissue. There is no need saying that the regeneration of cartilage tissue is a very big problem in rheumatic diseases for example. The lack of blood supply is one of the most important factors involved. Lots of previous publications give us proof of the regeneration capacities of Laser therapy (in wound healing, bone repair etc.)

In this study we have chosen to experiment on cartilage tissue of the ear of mice. We are aware of the fact that the elastic cartilage tissue of the ear is not totally comparable with the hyaline cartilage of articulations. For technical reasons however and because of the fact that the chondrocytes are comparable, we decided to use mice ears in our experiment. A 0,4 mm hole was drilled in both ears on 30 mice. The right ears remain untreated, while the left ears were treated daily with IR-Laser (904 nm) for 3 minutes. Macroscopical as well as histological evaluations were performed on the cartilage regeneration of both ears.

Our results show that after one day post-surgery no differences were found between the irradiated and the non-irradiated group. After the second day, only in the irradiated group there is a clear activation of the perichondrium. After four days, there is a significant in-growth of the perichondrium into the drill hole in the experimental group and there is only an active perichondrium zone in our control group. 

LOW-POWER DIODE LASER STIMULATION OF SURGICAL OSTEOCHONDRAL DEFECTS: RESULTS AFTER 24 WEEKS. 

Artificial cells, blood substitutes, and immobilization biotechnology. 2001.29 (3): 235-44.
Guzzardella G A, Tigani D, Torricelli P, Fini M, Martini L, Morrone G, Giardino R.

The purpose of this study was to evaluate osteochondral lesions of the knee, treated intraoperatively with low-power laser stimulation, and assess results at 24 weeks. Surgery was performed under general anesthesia on six rabbits; a bilateral osteochondral lesion was created in the femoral medial condyles with a drill. All of the left lesions underwent immediate stimulation using the diode Ga-Al-As laser (780nm), whereas the right knees were left untreated as control group. After 24 weeks, the explants from the femoral condyles, either treated employing laser energy or left untreated, were examined histomorphometrically. Results obtained on the lased condyles showed good cell morphology and a regular aspect of the repaired osteocartilaginous tissue. 

ASSESSMENT OF LASER BIOSTIMULATION ON CHONDRAL LESIONS: AN “IN VIVO”: EXPERIMENTAL STUDY. 

Artificial cells, blood substitutes, amd immobilization biotechnology.
2000;28 (5): 441-449.
Guzzardella-G-A, Morrone-G, Torricelli-P et al.

The purpose of this study was to evaluate whether intraoperative laser biostimulation can enhance healing of cartilaginous lesions of the knee. Surgery was performed on eighteen rabbits: a bilateral chondral lesion of 1.25 +/- 0.2 mm in length and 0.8 +/- 0.2 mm in width was created in the femoral media l condyle with a scalpel. The lesion in the left knee of each animal was treated intraoperatively using the diode Ga-Al-As 780nm. laser (300 Joules/cm2, 1 Watt, 300 Hertz, 10 minutes), while the right knee was left untreated, as control group. The animals were divided into three groups, A, B and C, according to the survival time after surgery, two, six and twelve weeks, respectively. The explants from the femoral condyles, both treated employing laser energy and left untreated, were examined histologically. Results showed a progressive filling with fibrous tissue of the cartilaginous lesion treated with laser irradiation, while no changes in the original lesion of the untreated group were observed at the end of the study.

LIGAMENT REPAIR

THERAPEUTIC LOW ENERGY LASER IMPROVES THE MECHANICAL STRENGTH OF REPAIRING MEDIAL COLLATERAL LIGAMENT. 

Fung DT, Ng GY, Leung MC, Tay DK. Lasers Surg Med. 2002; 31:91-96.
Twenty-four rats received surgical transection to their right MCL and eight received sham operation. After surgery, 16 received a single dose of gallium aluminum arsenide laser to their transected MCL for 7.5 minutes (n = 8) or 15 minutes (n = 8) and eight served as control with placebo laser, while the sham group didn’t receive any treatment. The MCLs were biomechanically tested at either 3 or 6 weeks post-operation. The normalized ultimate tensile strength (UTS) and stiffness of laser and sham groups were larger than control (P < 0.001). The UTS of laser and sham groups were comparable. Laser and sham groups had improved in stiffness from 3 to 6 weeks (P < 0.001). A single dose of low energy laser therapy improves the UTS and stiffness of repairing MCL at 3 and 6 weeks after injury.

Pain Relief,Rheumatoid Arthritis,Cold/Low Level Laser.

Sunday, May 9th, 2010

Pain Relief for Rheumatoid Arthritis, Cervical  Spine Osteoarthritis, Injuries and Inflammatory  Conditions. Low Level Laser Therapy (LLLT) also known as Cold Laser therapy,   Research on the Clinical application of GaAIAs 830 NM diode laser in treatment of Rheumatoid Arthritis, Cervical Spine Osteoarthritis,  including  LLLT Research  on Pain Relief  for other Inflammatory  Conditions, and  Injuries.

Cold/Low level laser, a review on research published by The Lancet shows that Low Level Laser Therapy (LLLT) also so known as Cold Laser Therapy has been tested in over 200 clinical trials (RCTs) and published in the world’s top medical journals including a review by The Lancet, a clinical study in the journal PAIN and is acknowledged by the World Health Organisation Bone and Joint Task Force, and published in the journal Spine. There are 26 research papers on low level laser therapy, for Musculoskeletal pain and syndromes, both chronic and acute, Rheumatoid Arthritis, Cervical Spine Osteoarthritis, lateral and medial epicondylitis,(Tennis, Golfers Elbow).Achilles Tendonitis, Carpal Tunnel, TMJ, Tendonitis, Bursitis, soft tissue injuries, fractures, neck, shoulder, back,lower back pain,disc injuries, hip, joints knee, and ankle injuries, conditions and disorders, and research on low level laser therapy are included on this page, scroll down.

Cold/Low Level Laser Therapy (LLLT) Clinical application of GaAIAs 830 NM diode laser in treatment of Rheumatoid Arthritis. Department of Orthopaedic Surgery, Osaka City University Medical School, Japan

The authors have been involved in the treatment of rheumatoid arthritis (RA), in particular chronic poly-arthritis and the associated pain complaints. The biggest problem facing such patients is joint contracture, leading to bony ankylosis. This in turn severely restricts the range of motion (ROM) of the RA-affected joints, thereby seriously restricting the patient’s quality of life (QOL). The authors have determined that in these cases, daily rehabilitation practice is necessary to maintain the patient’s QOL at a reasonable level.

The greatest problem in the rehabilitation practice is the severe pain associated with RA-affected joints, which inhibits restoration of mobility and improved ROM. LLLT or low reactive level laser therapy has been recognized in the literature as having been effective in pain removal and attenuation. The authors accordingly designed a clinical trial to assess the effectiveness of LLLT in RA related pain (subjective self-assessment) and ROM improvement (objective documented data).

From July 1988 to June 1990, 170 patients with a total of 411 affected joints were treated using a GaAlAs diode laser system (830 nm, 60 mW C/W). Patients mean age was 61 years, with a ratio of males: females of 1: 5.25 (16%: 84%). Effectiveness was graded under three categories: excellent (remarkable improvement), good (clearly apparent improvement), and unchanged (little or no improvement).

For pain attenuation, scores were: excellent – 59.6%; good – 30.4%; unchanged – 10%.

For ROM improvement the scores were: excellent – 12.6%; good – 43.7%; unchanged – 43.7%. This gave a total effective rating for pain attenuation of 90%, and for ROM improvement of 56.3%.

Kanji Asada, Yasutaka Yutani, Akira Sakawa and Akira Shimazu

0898-5901/91/020077-06 $05.00  © 1991 by John Wiley & Sons, Ltd.

Low Level Laser Therapy for Osteoarthritis and Rheumatoid Arthritis: A Metaanalysis

ABSTRACT.Osteoarthritis (OA) and rheumatoid arthritis (RA) affect a large proportion of the population. Low level laser therapy (LLLT) was introduced as an alternative non-invasive treatment for RA and OA about 10 years ago, but its effectiveness is still controversial. We assessed the effectiveness of LLLT in the treatment of RA and OA.

Objective.

Methods.A systematic review was conducted, following an a priori protocol, according to the methods recommended by the Cochrane Collaboration. Trials were identified by a literature search of Medline, Embase, and the Cochrane Controlled Trials Register. Only randomized controlled trials of LLLT for the treatment of patients with a clinical diagnosis of RA or OA were eligible. Thirteen trials were included, with 212 patients randomized to laser and 174 patients to placebo laser, and 68 patients received active laser on one hand and placebo on the opposite hand. Treatment duration ranged from 4 to 10 weeks. Follow-up was reported by only 2 trials for up to 3 months.

Results. In patients with RA, relative to a separate control group, LLLT reduced pain by 70% relative to placebo and reduced morning stiffness by 27.5 min (95% CI –52.0 to –2.9), and increased tip to palm flexibility by 1.3 cm (95% CI –1.7 to –0.8). Other outcomes such as functional assessment, range of motion, and local swelling were not different between groups. There were no significant differences between subgroups based on LLLT dosage, wavelength, site of application, or treatment length. In RA, relative to a control group using the opposite hand, there was no difference between control and treatment hand, but all hands were improved in terms of pain relief and disease activity. For OA, a total of 197 patients were randomized. Pain was assessed by 3 trials. The pooled estimate (random effects) showed no effect on pain (standardized mean difference –0.2, 95% CI –1.0 to +0.6), but there was statistically significant heterogeneity (p > 0.05). Other outcomes of joint tenderness, joint mobility, and strength were not significant.

Conclusion.LLLT should be considered for Pain relief and morning stiffness in RA, particularly since it has few side effects. For OA, the results are conflicting in different studies and may depend on the method of application and other features of the LLLT. Clinicians and researchers should consistently report the characteristics of the LLLT device and the application techniques. New trials on LLLT should make use of standardized, validated outcomes. Despite some positive findings, this metaanalysis lacked data on how effectiveness of LLLT is affected by 4 factors: wavelength, treatment duration of LLLT, dosage, and site of application over nerves instead of joints. There is a need to investigate the effects of these factors on effectiveness of LLLT for RA and OA in randomized controlled clinical trials. (J Rheumatol 2000;27:1961–9)

LUCIE BROSSEAU, VIVIAN WELCH, GEORGE WELLS, PETER TUGWELL, ROBERT de BIE, ARNE GAM, KATHERINE HARMAN, BEVERLEY SHEA, and MICHELLE MORIN

Key Indexing Terms:

Leaders of International laser organizations met during the third Congress of the World Association for Laser Therapy held in  Athens, Greece, to explore ways of advancing research, education and practice world-wide. Photo was taken immediately after the special session in May, 2000

Cold /Low Level Laser (LLLT)

Low Level laser Therapy (LLLT) also known as Cold Laser Therapy/Treatment

The lasers used  are certified as  low level laser therapy  (LLLT).  For the past 30 years the technology of low level laser therapy (also known as Cold Laser Therapy has been formally accepted in North America and in many other parts of the world such as Europe, Russia and Japan.  In all this time there have been no recorded long-term adverse effects from low level laser therapy.  It is considered to be non-invasive, painless and safe.

Low Level Laser Therapy (LLLT) uses laser light energy to stimulate cells to function optimally.  In the body, light sensitive chromophores and other elements within the cell absorb energy, initiating a series of important photochemical changes such as increased production of ATP. The mitochondria and Kreb’s Cycle stimulation initiates the production of ATP, providing the cell with the extra energy needed to accelerate the healing process and positively influence pain.  These activities can occur in all types of cells and includes ligament, nerves, cartilage and muscle.

Low Level Laser Therapy (LLLT) is a treatment where by a low level laser is utilized to treat chronic and acute pain.  Low level laser therapy may be used for patients suffering from Sciatica, back and neck, hip, knee, ankle, foot pain and conditions a, musculoskeletal pain, joint pain associated with arthritis, fibromyalgia, tendonitis, bursitis, neuropathy, Achilles tendonitis, migraine headaches, sprains and strains, trapped nerves, carpal tunnel syndrome , back, neck, shoulder pain and other associated pains. Low Level laser therapy also treats conditions such as TMJ, reflex sympathetic dystrophy (RSD) and other inflammatory and scarring conditions. By increasing serotonin levels, low level laser therapy contributes to the body’s own healing process. Non-thermal and non-invasive, low level laser therapy involves a combination of low level laser and electric stimulation and is one of the most effective healing therapies. Completed in ten to twelve sessions, low level laser therapy(LLLT) can significantly reduce treatment time and costs.

Low Laser Therapy(LLLT) has been tested in over 200 clinical trials (RCTs) and published in the world’s top medical journals including a review by The Lancet, a clinical study in the journal PAIN and is acknowledged by the World Health Organisation Bone and Joint Task Force  and published in the journal Spine.

A Review on research published by The Lancet, for the treatment of neck pain with Cold/Low Laser Therapy (LLLT)

Low level Laser treatment for neck pain.

Neck pain is common, often persistent, and responds poorly to medication. So it is encouraging to read that a relatively novel, non-invasive treatment shows evidence of effectiveness. A systematic review and meta-analysis of 16 randomised controlled trials of low-level laser therapy (LLLT)’ yielded 820 patients, for whom data was pooled. LLLT was found to reduce pain immediately after treatment in acute neck pain and up to 22 weeks after completion of treatment in patients with chronic neck pain. Low-level laser – or cold laser is yet to be established as a medical treatment but, according to Wikipedia, papers are appearing at the rate of around 25 per month, mainly investigating treatment of musculoskeletal disorders.

1. Chow RT, Johnson Ml, Lopes-Martins RA, Bjordal JM. Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials. Lancet 2009 Dec 5;374(9705):1897-908.

Lower Back Pain, Low Level Laser Therapy (LLLT) Research.

Abstract

Objective:

The aim of this study was to investigate the clinical effects of low-level laser therapy (LLLT) in patients with acute low back pain (LBP) with radiculopathy.

Background Data:

Acute LBP with radiculopathy is associated with pain and disability and the important pathogenic role of inflammation. LLLT has shown significant anti-inflammatory effects in many studies.

Materials and Methods:

A randomized, double-blind, placebo-controlled trial was performed on 546 patients. Group A (182 patients) was treated with nimesulide 200 mg/day and additionally with active LLLT; group B (182 patients) was treated only with nimesulide; and group C (182 patients) was treated with nimesulide and placebo LLLT. LLLT was applied behind the involved spine segment using a stationary skin-contact method. Patients were treated 5 times weekly, for a total of 15 treatments, with the following parameters: wavelength 904 nm; frequency 5000 Hz; 100-mW average diode power; power density of 20 mW/cm2 and dose of 3 J/cm2; treatment time 150 sec at whole doses of 12 J/cm2. The outcomes were pain intensity measured with a visual analog scale (VAS); lumbar movement, with a modified Schober test; pain disability, with Oswestry disability score; and quality of life, with a 12-item short-form health survey questionnaire (SF-12). Subjects were evaluated before and after treatment. Statistical analyses were done with SPSS 11.5.

 Results:

Statistically significant differences were found in all outcomes measured (p < 0.001), but were larger in group A than in B (p < 0.0005) and C (p < 0.0005). The results in group C were better than in group B (p < 0.0005).

Conclusions: The results of this study show significant improvement in acute LBP treated with LLLT used as additional therapy.

Ljubica M. Konstantinovic, Ph.D.,1Zeljko M. Kanjuh, M.S.,1Andjela N. Milovanovic, M.S.,2Milisav R. Cutovic, Ph.D.,1Aleksandar G. Djurovic, Ph.D.,3Viktorija G. Savic, M.S.,4Aleksandra S. Dragin, M.S.,1and Nesa D. Milovanovic, M.S.1

1Clinic for Rehabilitation, Medical School, Belgrade, Serbia 2Center for Physical Medicine, Clinical Center of Serbia, Belgrade, Serbia.3Clinic for Rehabilitation, Military Medical Academy, Belgrade, Serbia.4Department for Physical Medicine, Institute for Rheumatology, Belgrade, Serbia.

Address correspondence to: Ljubica Konstantinovic, Ph.D. Clinic for Rehabilitation dr Miroslav ZotovicMedical School, University of Belgrade Sokobanjska 13, Belgrade

Low Level Laser Therapy (LLLT)

Low Level  Laser Therapy (LLLT) has a 5 star rating for soft tissue injuries,conditions and inflammation.  Low Level Laser Therapy is a handheld, non-invasive, light-emitting medical device which is used over different areas of the body. It provides an unmatched advantage in the treatment of conditions such as;

Athletic and sports Injuries, Soft tissue injuries including Sprains and Strains, Tendonitis and Haematomas

Lower leg (calf pain) inflammation, Shin splints, Hamstring, Achilles tendonitis, Bursitis, conditions and disorders

Ankle sprains, injury, and fractures, inflammation conditions and disorders

Heel and foot injury, pain, Bursitis, Achilles Tendonitis, Plantar fasciitis, conditions and disorders

Knee pain, injuries, tears, ligament, Tendon injury, ruptures, Runners Knee, inflammation, Bursitis, conditions and disorders

Shoulder injury, pain, Shoulder tears, fractures inflammation, Tenosynovitis ,Tendonitis, Bursitis, conditions such as frozen shoulder, and disorders

Neck injury, Neck Pain, Neck sprain, Whiplash injury.

Back Injury,   Lower back pain, Sciatica, slipped discs, prolapsed disc, herniated / bulging discs, Trapped nerves and inflammation.

Elbow, Wrist and Hand injury, Tendonitis, inflammation, fractures, conditions and disorders, such as Tennis Elbow,(Golfers Elbow) Carpal Tunnel Syndrome,

Hip injury and pain, Sacroiliac Joint inflammation, groin and thigh strain (pull), sports hernia, Hip Bursitis/Tendonitis, Trochanteric Bursitis, conditions and disorders

Muscle sprain and spasms, Cramps, Joint Pain and stiff Joints.

Pain Relief, including Arthritic pain relief.

Wound Management including Skin Ulcers, Pressure Sores and Burns, Skin infections

Chronic pain such as Trigeminal Neuralgia and Chronic Neck and Back pain.

Safety

Low level laser therapy(LLLT) is not harmful. Lasers used for tissue stimulation have insufficient strength to damage cells. 30 years of clinical studies and clinical use have shown no adverse effects whatsoever.

The Advantages of Low Intensity Laser Therapy

  • Non-invasive
  • Non-toxic
  • Easily applied
  • Highly effective
  • Cure rate > 95%
  • No known negative side effects

Mechanism of Action

Therapeutic lasers work by supplying energy to the body in the form of photons of light. The tissues and cells then absorb this energy, where it is used to accelerate the normal rate of tissue healing.

Therapeutic Benefits of Laser Therapy:

  • Anti-inflammatory Action: Laser light reduces swelling, leading to decreased pain, less stiffness, and a faster return to normal joint and muscle function.
  • Rapid Cell Growth: Laser light accelerates cellular reproduction and growth.
  • Faster Wound Healing: Laser light stimulates fibroblast development and accelerates collagen synthesis in damaged tissue.
  • Reduced Fibrous Tissue Formation: Laser light reduces formation of scar tissue, leading to more complete healing, with less chance of weakness and re-injury later.
  • Increased Vascular Activity: Laser light increases blood flow to the injured area.
  • Stimulated Nerve Function: Laser light speeds nerve cell processes which may decrease pain and numbness associated with nerve-related conditions.

Frequency of Treatments

While some patients get immediate results, others require 6-12 treatments before seeing a lasting effect. Less severe or acute injuries will require fewer treatments than chronic or severe conditions.

Low Level Laser Therapy (LLLT) Applications, Case Studies and Low Level Laser Research with 26 Worldwide Clinical Studies is presented below:

Musculoskeletal pain syndromes, both chronic and acute.Cold/Low level laser therapy (LLLT)has been shown to be effective in a variety of musculoskeletal conditions and associated pain presentations.In Rheumatoid Arthritis, LLLT can benefit not only the pain of acute small joint inflammation but also the chronic pain.In a review article on rheumatology (3), some 18 papers were considered. All studies involved double-blind trials with LLLT in chronic rheumatoid, and reported significant improvement in pain (80% success rate in relieving pain). Upon comparing LLLT to a similar rate of pain attenuation using anti-inflammatory drugs (NSAIDs), the LLLT was free of any side-effects while 20% of patients treated with NSAIDs suffered unacceptable side-effects of medication . In another study of 170 patients with rheumatoid arthritis using LLLT (4), pain attenuation of up to 90% was noted.Trellis et al (6) used LLLT for osteoarthritis of the knee in 40 patients. He reported a significant reduction of 82% of the patients with improved joint mobility. Among 36 randomized patients, with pain caused by cervical osteoarthritis, those who received Infra-Red and Low Level Laser treatment improved 75% compared with the group receiving mock treatment (31%) . Similarly, a study of 60 patients with Cervical Osteoarthritis, Low Pulsed Laser was successful in relieving pain and in improving function.
The results of a study show that cervical myofascial pain is significantly improved at 3-month with Diode laser . A similar successful LLLT treatment has been described for whiplash injuries.In a randomized study with 30 patients with supraspinatus or bicipital tendonitis, the results demonstrated the effectiveness of laser therapy in tendonitis of the shoulder . Another study with a patient population (n = 324), with either medial epicondylitis (Golfer’s elbow; n = 50) or lateral epicondylitis (Tennis elbow; n = 274), and randomly allocated, provides further evidence of the efficacy of LLLT in the management of lateral and medial epicondylitis .

Treatment with low-level laser therapy (LLLT) was shown effective in treating Carpal Tunnel Syndrome pain. Another study, significant decreases in McGill Pain Questionnaire scores, median nerve sensory latency, and Phalen and Tinel signs were observed after treatment series with Low Level Laser Therapy. Patients could perform their previous work  .

In acute trauma there is a soft tissue injury comprising swelling, haematoma, pain and reduced mobility. Sporting injuries and domestic accidents usually involve damage to muscles, joint ligaments and tenclass. In the absence of bone fracture or other injury demanding priority treatment, LLLT should be instituted at the earliest opportunity. Kumar reported a comparative study in 50 patients with inversion injuries of the ankle. He found that compared to conventional physiotherapy, the LLLT treated patients showed a more rapid resolution of symptoms and an earlier return to full weight-bearing .

Fibromyaliga (FM) is characterized by widespread pain in the body, associated with particular tender points. It is often accompanied by disturbed sleep patterns, fatigue, headaches, irritable bowel and bladder syndrome, morning stiffness, anxiety and depression. FM can cause a high level of functional disability and have a significantly negative effect on quality of life. One study suggests that “Laser Therapy is effective on pain, muscle spasm, morning stiffness, fatigue, depression and total tender point number in Fibromyalgia”.

A randomized controlled study with 63 with non-radiating low back pain showed that LLLT significantly improved pain and function.

In summary, the bulk of published work to date supports the use of LLLT for treatment of a variety of musculoskeletal conditions and associated pain. Moreover, the LLLT proved to be not only more effective than conventional methods, but more economical as well. The added advantage of absence of side effects, non-invasive nature of therapy and the ease of application, ensures good patient acceptance of the treatment modality.

Low Intensity Laser Therapy(LILT) for Head, Neck and Facial Pain.

Prof P.F. Bradley

The clinical application of low incident power density laser radiation for the treatment of acute and chronic pain is now a well established procedure. This paper reviews the currently available English speaking literature and summarises a selection of serious scientific papers which report a beneficial effect following the treatment of a wide variety of acute and chronic syndromes whose main presenting symptom is pain.

Head and Neck Clinical Applications of LILT

LILT is proving useful in a wide variety of painful conditions in the Head and Neck but the following are particular applications:

  1. TM Joint Pain Dysfunction

  2. Post Herpetic Neuralgia

  3. Trigeminal Neuralgia

  4. Painful Ulcerative Conditions

  5. Pain of Advanced Oro Facial Cancer

 The above information has been suppled by Quantum Healing Lasers .Com

  The Ability of Low Level Laser Therapy (LLLT) to Mitigate Fibromyalgic Pain.

  The CFIDS Chronicle Physicians’ Forum Fall 1993

  Douglas Ashendorf, MD, FAAPMR Newark, New Jersey

Physiotherapist Shows Lasers Relieve Pain.

A physiotherapist at Royal Brisbane Hospital (Australia) recently received a PhD from the University of Queensland for demonstrating that laser treatment prompts the release of endorphins into the bloodstream. Endorphins are a type of natural morphine that dulls pain. Physiotherapist Liisa Laakso studied the effects of lasers on 56 people who suffered myofascial pain syndrome, a chronic hypersensitivity often secondary to a person’s primary painful affliction, such as arthritis. Previous experiments linking endorphin release and lasers have only been done on rats.

In the study, Laakso applied different doses and wavelengths of a laser diode to “trigger points” on the body and took blood samples measuring endorphin levels in these subjects and a control group. The control group reported some pain relief – most likely a placebo effect – but endorphins were present. Those patients that underwent laser treatment reported pain reduction of up to 78%, and endorphins were present in their blood.

THERMOGRAPHIC STUDY OF LOW LEVEL LASER      THERAPY FOR ACUTE-PHASE INJURY.

 Yoshimi Asagai, M.D.1, Atsuhiro Imakiire, M.D.2, Toshio Ohshiro, M.D.3,  1. Shinano Handicapped Children`s Hospital Shimosuwa, Nagano, Japan    2. Department of Orthopaedic Surgery, Tokyo Medical University Shinjuku, Tokyo, Japan     3. Japan Medical Laser Laboratory, Shinanomachi, Tokyo, Japan. 

Acute-phase injury is generally treated by localized cooling of the region, and rarely by theactive use of low level laser therapy (LLLT) in Japan. Thermographic studies of acutephase injury revealed that circulatory disturbances at the site of trauma occurred due to swelling and edema on the day following the injury, and that skin temperature was high at the site of the trauma and low at the periphery. Following LLLT, circulatory disturbances rapidly improved, while temperature in the high temperature zone around the site of trauma fell by 3 degrees on the average, but at the periphery the low temperature rose by 3 degrees on the average to nearly normal skin temperature. Clinically, swelling and edema improved. LLLT was also useful in treating necrosis of the skin in the wound area and in accelerating healing of surgical wounds of paralytic feet, which are prone to delayed, wound healing and also wounds due to spoke injury. LLLT is useful in treating swelling and edema in acutephase injury and in accelerating healing of surgical wounds. 

Key words: Laser therapy, acute-phase injury, thermography, ankle joint sprain

Introduction

It has not been clearly defined to date if LLLT is indicated for acute-phase injury with swelling and calor. Yet it is frequently considered to be contraindicated in acute-phase injury. We have previously reported that, in patients with cerebral palsy with reduced peripheral skin temperature, the skin surface temperature was elevated to normal after LLLT

(1). in this study, we used thermography to examine changes in skin temperature following LLLT chie fly inacute-phase injury. 

Patients and Methods

Subjects were 7 patients with sprains of the ankle joint, two patients with fractures of the tibial shaft, and one patient with dislocation of the elbow joint. LLLT was also used in orthopedic surgery for disorders of the distal lower extremity such as talipes varus, which is frequently followed by postoperative necrosis of the skin in the wound area as well as delayed wound healing, and pre- and postoperative treatment of paralytic feet with circulatory disturbances. The procedure was as follows. Room temperature was maintained at 25oC. After acclimatization for 20 minutes, continuous irradiation with a GaAlAr semiconductor laser (JQ305, Minato Medical Science Co., Ltd., Japan) with the wavelength adjusted to 810 nm and the output to 100mW was applied using the contact method.

The spot size on the tissue was 0.56cm2 with a power density of 17.86W/cm2 at 100mW, the energy density per point being 107.5J/cm2. The area surrounding the site of trauma was irradiated for 3 to 5 minutes in total, one minute per spot, and changes in the skin surface temperature were followed using Thermotracer TH1106. The test was performed from immediately after injury till 5 days post-trauma, an average of two days after injury. 

Results 

Immediately after injury, the skin surface temperature was elevated to about 34 degrees at and around the site of trauma (Fig. 1). On the day following the injury, skin temperature remained elevated around the site of trauma to the same degree as immediately after injury, but was markedly reduced to about 29 degrees at its periphery (Fig. 2). Skin temperature began to fall in the high temperature zone and began to rise in the peripheral low temperature zone immediately following LLLT, and the peripheral skin temperature reached a peak or became almost normal at about 40 minutes after the initiation of irradiation (Fig. 3). Changes in post-LLLT skin temperature in all patients 

a b c

 1. Sprain of the right ankle joint immediately after injury: 

a) Before irradiation, a high temperature zone extends over the trauma site  and a wide area around it.

 b) At 10 minutes after LLLT,skin temperature fell at the trauma site, and rose in the toes at the periphery.

 c) At 20 minutes after LLLT,skin temperature was re-elevated at the trauma site.

31 Laser Therapy Vol. 12 Official Journal of the World Association for Laser Therapy (WALT) showed that skin temperature fell by an average of 3degrees in the high temperature zone around the site of trauma, and rose by an average of 3 degrees in the peripheral low temperature zone, both to approximately normal skin temperature. Clinically, swelling and edema were diminished and repeated irradiation suppressed exacerbation of swelling and edema.Patients receiving pre- and post-operative

application of LLLT for such conditions as talipes varus, in which postoperative necrosis of skin in the wound area and delayed wound healing are frequent, spoke injury produced when the foot is caught in a bicycle’s spokes (Fig. 4), and paralytic feet with distal circulatory failure due to spin bifida or cerebral palsy, we have not seen any necrosis of the skin in the wound area or delayed wound healing.

Discussion 

There have been many reports on wound healing (2, 3).Currently, the site of trauma is cooled to reduce swelling in acute-phase injury. An important problem in the healing

of wounds and associated fractures is how to suppress swelling and edema, and improvement of local swelling and edema is also crucial for the healing of ligament injury in sprained ankles. However, the use of LLLT for sprained ankles is controversial (4). Thermography has been used for evaluating the effect of LLLT (5). In the present thermographic evaluation, the surface temperature was high around the trauma site and low in the periphery, which indicated that local blood and lymph flow were impaired by swelling and edema, thus raising temperature. When LLLT was applied to these areas, it was found that skin temperature fell in the high temperature zone but

rose in the low temperature zone to approximately the normal temperature in both zones, suggesting improved  blood and lymphatic circulation. Clinically, reduction of local swelling and edema was considered to have led to the improvement of blood and lymph flow. 

Conclusions 

1: In acute-phase injury, skin temperature was elevated around the site of trauma, and reduced in the periphery on the day following the injury. 

2: Immediately after irradiation, skin temperature fell by 3oC on the average in the high temperature zone around the trauma site, and rose by 3oC on the average reaching normal temperature in the low temperature zone at the periphery of the injury.

3: LLLT rapidly improved blood and lymphatic flow, which had been impaired by injury, and alleviated swelling and edema. LLLT was also useful in accelerating healing

of the surgical wound.

Address for Correspondence:  Yoshimi Asagai MD, Director, Shinano Handicapped  Children`s Hospital, 6525-1 Shimosuwa, Suwagun, Nagano, Japan 393 

a b c

2. Contusion of the right tibial shaft 1 day after injury: a) before irradiation,

a) Skin temperature is high at the trauma site, and low at the periphery.

b) At 10 minutes after LLLT:skin temperature fell at the trauma site, and rose slightly at the periphery. c) At 40 minutes after LLLT: skin temperature at the periphery reached a peak and nearly normal skin temperature

a b c

 3. Fracture of the right tibia 2 days after removal of nailing: a) Before irradiation, skin temperature was high in the surgical wound, and low at the periphery. b) Immediately after LLLT, skin temperature was reduced in the high temperature zone, and elevated in the low temperature zone. c) At 40 minutes after LLLT, skin temperature at the periphery reached a peak.

a b

4. Spoke injury:

a) At 6 days after injury the left foot had been caught in the rear wheel of a bicycle, and this left a large skin defect on the back of the foot and a contusion, with marked swelling and edema.

 b) After daily LLLT, epithelialization was observed and the wound healed at 23 days after injury.

http://www.walt.nu Laser Therapy Vol. 12 32 

References

1. Asagai,Y.,Ueno,R.,Miura,Y.,Ohshiro,T.(1995):Application of low reactive-level laser therapy(LLLT) in patients with cerebral palsy of the adult tension athetosis type. Laser Therapy,7:113-118. 

2. asaki, K., Ohshiro, T. (1997): Assessment in the rat model of the effects of 830nm diode laser irradiation in a diachronic wound hearing study. Laser Therapy,

9:25-32.

3. ubota, J., Ohshiro, T. (1996): The effects of diode laser LLLT on flap survival: Measurement of flap microcirculation with laser speckle flowmetry. Laser Therapy, 8:241-246.

4. Robert A. Henrica C.W., Ton F, Lenssen, Frans, A.J.M., Gauke, K., Paul G.(1998): Low-level laser therapy in ankle sprains: A randomized clinical trial.

Arch. Phys. Med. Rehabil, 79:1415-1420.

5. Ohshiro, T. (1988): Thermographic analysis and evaluationof pain attenuation with the GaAlAs LLLT laser system. In Ohshiro T and Calderhead RG: ‘Low Lever Laser Therapy: A Practical Introduction’. John Wiley & Sons, Chichester, UK. pp.56-62. 33 Laser Therapy Vol. 12 Official Journal of the World Association for Laser Therapy (WALT)

Results have suggested that the pain relieving properties of LLLT have been the most consistent benefit. The duration of benefit has varied from one hour to one week, and seems to increase as treatment progresses.

Other areas of improvement were not as clear. Improvement in sleep was observed with some regularity although this was undoubtedly due in part to decreased pain. The “non-restorative” sleep complaints were less regularly improved. Improvement with regard to abnormal sensations in the limbs (paresthesia and subjective swelling) appears to be fairly consistent. Improvements in fatigue, mood and headache.

Although the pilot study is incomplete, I believe that these early findings warrant the further investigation of laser therapy for patients with fibromyalgia. This is further supported by the relatively few and harmless side effects of this therapy, the fact that equipment and operating costs are reasonable, and the reality that there are few effective alternative treatments for fibromyalgia patients.

Carpal Tunnel Study Results Released

Laser Focus World

A physician at UMDNJ-Robert Wood Johnson Medical School is evaluating a “cold” laser to treat patients with carpal tunnel syndrome, a debilitating nerve condition that causes severe pain and numbness in the hand.

Clinical results of a double-blind study of 11 patients afflicted with carpal tunnel syndrome who were treated with a diode-laser device manufactured by Lasermedics (Missouri City, TX) showed that after six to 15 treatments, nine of the 11 patients experienced relief of pain and other associated symptoms as well as normalization of abnormal latencies.

The study was conducted by Michael L. Weintraub, a neurologist from Briarcliff, NY, and reported in the February 1996 issue of Neurology.

The patients all used a 30mW 830nm, a hand-held, battery-operated, nonsurgical laser device that employs the process of photo-biostimulation.

Dr. Weintraub concluded that the results of his study support the efficacy and safety of laser-light treatment in carpal tunnel syndrome.

Physiotherapist Shows Lasers Relieve Pain.

A physiotherapist at Royal Brisbane Hospital (Australia) recently received a PhD from the University of Queensland for demonstrating that laser treatment prompts the release of endorphins into the bloodstream. Endorphins are a type of natural morphine that dulls pain. Physiotherapist Liisa Laakso studied the effects of lasers on 56 people who suffered myofascial pain syndrome, a chronic hypersensitivity often secondary to a person’s primary painful affliction, such as arthritis. Previous experiments linking endorphin release and lasers have only been done on rats.

In the study, Laakso applied different doses and wavelengths of a laser diode to “trigger points” on the body and took blood samples measuring endorphin levels in these subjects and a control group. The control group reported some pain relief – most likely a placebo effect – but endorphins were present. Those patients that underwent laser treatment reported pain reduction of up to 78%, and endorphins were present in their blood.

The effect of infra-red laser irradiation on the duration and severity of postoperative pain: a double blind trial.

Kevin C. Moore, Naru Hira, Ian J. Broome* and John A. Cruikshank, Departments of Anaesthesia and General Surgery, The Royal Oldham Hospital, Oldham, U.K *Department of Anaesthesia, The Royal Hallamshire Hospital, Sheffield, U.K.,General Practitioner, Pennymeadow Clinic, Ashton-under-Lyne, U.K.

This trial was designed to test the hypothesis that LLLT reduces the extent and duration of post-operative pain. Twenty consecutive patients for elective cholecystectomy were randomly allocated for either LLLT or as controls. The trial was double blind. Patients for LLLT received 6-8-min treatment (GaAlAs: 830 nm: 60 mW CW: CM) to the wound area immediately following skin closure prior to emergence from GA. All patients were prescribed on demand post-operative analgesia (IM or oral according to pain severity). Recordings of pain scores (0-10) and analgesic requirements were noted by an independent assessor. There was a significant difference in the number of doses of narcotic analgesic (IM) required between the two groups.

Controls n = 5.5: LLLT n = 2.5.

No patient in the LLLT group required IM analgesia after 24 h. Similarly the requirement for oral analgesia was reduced in the LLLT group.

 Controls n = 9: LLLT n = 4.

 Control patients assessed their overall pain as moderate to severe compared with mild to moderate in the LLLT group.

 The results justify further evaluation on a larger trial population.

 Address for correspondence:

 Dr K. C. Moore, Department of Anaesthesia, The Royal Oldham Hospital, Rochdale Road, Oldham OL1 2JH, U.K.

 0898-5901/92/040145-05 $07.50   ©1992 by John Wiley & Sons, Ltd.

Efficacy of laser irradiation on the area near the stellate ganglion is dose-dependent:    A double-blind crossover placebo-controlled study.

Toshikazu Hashimoto, Osamu Kemmotsu, Hiroshi Otsuka, Rie Numazawa, and Yoshihiro Ohta, Department of Anaesthesia, Hokkaido University Hospital, Sapporo, Japan

In the present study we evaluate the effects of laser irradiation on the area near the stellate ganglion on regional skin temperature and pain intensity in patients with postherpetic neuralgia. A double blind, crossover and placebo-controlled study was designed to deny the placebo effect of laser irradiation.

 Eight inpatients (male 6, female 2) receiving laser therapy for pain attenuation were enrolled in the study after institutional approval and informed consent. Each patient received three sessions of treatment on a separate day in a randomised fashion. Three minutes irradiation with a 150 mW laser (session 1), 3 minutes irradiation with a 60 mW laser (session 2), and 3 minutes placebo treatment without laser irradiation. Neither the patient nor the therapist was aware which session type was being applied until the end of the study. Regional skin temperature was evaluated by thermography of the forehead, and pain intensity was recorded using a visual analogue scale (VAS). Measurements were performed before treatment, immediately after (0 minutes) then 5, 10, 15, and 30 min after treatment. Regional skin temperature increased following both 150 mW and 60mW laser irradiation, whereas no changes were obtained by placebo treatment. VAS decreased following both 150 mW and 60 mW laser treatments, but no changes in

VAS were obtained by placebo treatment. These changes in the temperature and VAS were further dependent on the energy density, i.e. the dose.

Results demonstrate that laser irradiation near the stellate ganglion produces effects similar to stellate ganglion block. Our results clearly indicate that they are not placebo effects but true effects of laser irradiation.

Address for Correspondence:   Toshikazu Hashimoto MD, Department of Anaesthesia, I Hokkaido University I Hospital N15, W7, Kita-ku Sapporo, Japan 060.

LASER THERAPY 1997:9:7-12  ©1997 by LT Publishers l.K., Ltd.

Successful management of female office workers with “repetitive stress injury” or”carpal tunnel syndrome” by a new treatment modality- application of low level lasers for pain

E. Wong G LEE J. Zu CHERMAN and D. P. MASON

Western Heart Institute and St. Mary’s Spine Center St. Mary’s Medical Center. San Francisco. CA. USA and Head and Neck Pain Center, Honolulu HL. USA

Abstract

Female office workers with desk jobs who are incapacitated by pain and tingling in the hands and fingers are often diagnosed by physicians as “repetitive stress injury” (RSI) or “carpal tunnel syndrome” (CTS). These patients usually have poor posture with their head and neck stooped forward and shoulders rounded; upon palpation. they have pain and tenderness at the spinous processes C5 – T1 and the medial angle of the scapula. In 35 such patients we focused the treatment primarily at the posterior neck area and not the wrists and hands. A low level laser (100 mW) was used and directed at the tips of the spinous processes C5 – Tl.

The laser rapidly alleviated the pain and tingling in the arms, hands and fingers, and diminished tenderness at the involved spinous processes. Thereby, it has become apparent that many patients labelled as having RSI or CTS have predominantly cervical radicular dysfunction resulting in pain to the upper extremities which can be managed by low level laser.

Successful long-term management involves treating the soft tissue lesions in the neck combined with correcting the abnormal head, neck and shoulder posture by taping. Cervical collars, and clavicle harnesses as well as improved work ergonomics.

LASER THERAPY, 1997:9: 131- 136 09/97 © 1997 by LT Publishers, U.K., Ltd  Physiological responses in chronic pain patients. LLLT protocol.  Scott D. Fender and David Diffee

Pain Research Group, Arvada, Colorado, U.S.A.

Use of Low Reactive Level Laser Therapy (LLLT) utilising helium-neon lasers has increased lately especially in pain control. New protocols are being developed aimed at a complex of primary and secondary symptomologies. One of these protocols Stellate Ganglion Stimulation has shown in our research a unique set of developments. Targeting the area of the stellate ganglion is showing great promise in the rehabilitation of patients with a history of chronic musculoskeletal pain syndromes, but several patients with pre-existing psychological symptomology have exacerbated during the initial stages of utilization of this protocol.

Patients with a history of psychological diagnosis for dysthymia, anxiety, post traumatic stress disorder or minor diffuse brain injury have shown an exacerbation of these symptomologies during the initial phases of stimulation treatment. Overall, response to this form of therapy seems to be positive but some patients require dermatomal and/or site-specific therapy to maximize outcome. With specific psychological treatment combined with a more conservative amount of stimulation initially the increase in these symptoms shows a tendency to remit with the pain response. Our continued research is currently focusing on the mechanisms for this type of response as well as protocol refinement to maximize its effectiveness.

 Address for correspondence:

Scott D. Fender DDS DAPM, 5275 Marshall Street, Suite 203, Arvada, CO 80002, U.S.A. 0898-5901/92/040169-05$07.50nn© 1992 by John Wiley & Sons, Ltd.

Mechanisms of the analgesic effects of therapeutic lasers in vivo.

L Navratil (1)and I Dylevsky(2)

  1: Outpatient Department of Radiobiology, Institute of Biophysics, First Medical Faculty, and

  2: Department of Functional Anatomy, Second Medical Faculty and Faculty of Physical Education Charles University, Prague, Czech Republic

The analgesic effects in the course of application of therapeutic lasers to affected tissue have been described in a number of works in the literature. Although a few scientific-based reports have appeared, those on laser-induced analgesia are mainly clinical works describing the effect of the therapy which, however, do not study the mechanism of the laser action. There are several different possible responses induced by non-invasive low level laser therapy (LLLT).

The purpose of the present communication is to review the arrangement and characterisation of these responses. By being aware of these effects, the laser therapist can acquire a physiological and morphological scheme making possible the appropriate choice of the site of application of LLLT, choice of the irradiation technique, and selection of appropriate doses.

Address for Correspondence:

Leos Navratil MD PhD, Department of Clinical Radiahiology, Institute of Biophysics, First Medical Faculty, Charles University Saln1ovska 3, CZ 120 00, Prague 2, Czech Republic. 03/97 Rep. US 5 10 12 14 © 1997 by LT Publishers U.K, Ltd.   LASER THERAPY 1997:9:33-40   Experimental Physiology (1994) 79. 227-234 Printed in Great Britain

Can low reactive-level laser therapy be used in the treatment of neurogenic facial pain?   A double-blind, placebo controlled investigation of patients with trigeminal neuralgia.

ArneEckerdal and Lehmann Bastian. Department of Oral and Maxillofacial Surgery and Oral Medicine, Odense University Hospital, Denmark

Neurogenic facial pain has been one of the more difficult conditions to treat, but the introduction of laser therapy now permits a residual group of patients hitherto untreatable to achieve a life free from or with less pain. The present investigation was designed as a double-blind, placebo controlled study to determine whether low reactive-level laser therapy (LLLT) is effective for the treatment of trigeminal neuralgia. Two groups of patients (14 and 16) were treated with two probes. Neither the patients nor the dental surgeon were aware of which was the laser probe until the investigation had been completed. Each patient was treated weekly for five weeks.

The results demonstrate that of 16 patients treated with the laser probe, 10 were free from pain after completing treatment and 2 had noticeably less pain, while in 4 there was little or no change. After a one year follow-up, 6 patients were still entirely free from pain. In the group treated with the placebo system, i.e. the non-laser probe, one was free from pain, 4 had less pain, and the remaining 9 patients had little or no recovery. After one year only one patient was still completely free from pain. The use of analgesics was recorded and the figures confirmed the fact that LLLT is effective in the treatment of trigeminal neuralgia. It is concluded that the present study clearly shows that LLLT treatment, given as described, is an effective method and an excellent supplement to conventional therapies used in the treatment of trigeminal neuralgia.

Address for Correspondence:

Arne Eckerdal DDS DOS Consultant, Department of Oral and Maxillofacial Surgery & Oral Medicine, Odense University Hospital, DK-5000 Odense, Denmark.  12/96 Rep. US X 8-10-12  LASER THERAPY, 1996: 8: 247-252

Double-blind crossover trial of low level laser therapy in the treatment of post-herpetic neuralgia.

Kevin C Moore, Naru Hira. Parswanath S. Kramer, Copparam S. Jayakumar and Toshio Ohshiro

Post herpetic neuralgia can he an extremely painful condition which in many cases proves resistant to all the accepted forms of treatment. It is frequently most severe in the elderly and may persist for years with no predictable course.

This trial was designed as a double blind assessment of the efficacy of low level laser therapy in the relief of the pain of post herpetic neuralgia with patients acting as their own controls. Admission to the trial was limited to patients with established post herpetic neuralgia of at least six months duration and who had shown little or no response to conventional methods of treatment. Measurements of pain intensity and distribution were noted over a period of eight treatments in two groups of patients each of which received four consecutive laser treatments.

The results demonstrate a significant reduction in both pain intensity and distribution following a course of low level laser therapy.    John Wiley & Sons. Ltd.

Efficacy of low-level laser therapy for pain attenuation of post-herpetic neuralgia.

Osamu Kemmotsu, Kenichi Sato,Hitoshi Furumido, Koji Harada, Chizuko Takigawa, Shigeo Kaseno, Sho Yokota, Yukari Hanaoka and Takeyasu Yamamura

Department of Anaesthesiology, Hokkaido University School of Medicine, N-15. W-7, Kita-ku. Sapporo 060, Japan.

The efficacy of low reactive-level laser therapy (LLLT) for pain attenuation in patients with postherpetic neuralgia (PHN) was evaluated in 63 patients (25 males. 38 females with an average age of 69 years) managed at our pain clinic over the past four years. A double blind assessment of LLLT was also performed in 12 PHN patients. The LLLT system is a gallium aluminium arsenide (GaAlAs) diode laser (830 nm, 60 mW continuous wave). Pain scores (PS) were obtained using a linear analogue scale (1 to 10) before and after LLLT.

The immediate effect after the initial LLLT was very good (PS: <3) in 26, and good (PS: 7-4) in 30 patients. The long-term effect at the end of LLLT (the average number of treatments 36 + 12) resulted in no pain (PS: 0) in 12 patients and slight pain (PS: 1-4) in 46 patients. No complications attributable to LLLT occurred. Although a placebo effect was observed, decreases in pain scores and increases of the body surface temperature by LLLT were significantly greater than those that occurred with the placebo treatment. Our results indicate that LLLT is a useful modality for pain attenuation in PHN patients and because LLLT is a non-invasive, painless and safe method of therapy, it is well acceptable by patients.

Address for correspondence: Osamu Kemmotsu, Department of Anaesthesiology, Hokkaido University School of Medicine, N-15, W-7, Kita-ku, Sapporo 060, Japan. 0898-5901/91/020071-05 $05.00  © 1991 by John Wiley & Sons, Ltd.

Mechanistic approach to GaAIAs diode laser effects on production of reactive oxygen species  from human neutrophils as a model for therapeutic modality at cellular level.

Makoto Yamaya*, Chiyuki Shiroto’, Hiroki Kobayashi*, Shinji Naganuma*, Jyuichi Sakamoto*, Koh-Jun Suzuki*, Shigeyuki Nakaji*, Kazuo Sugawara* and Takashi Kumae *Department of’ Hygiene, Hirosaki University School of Medicine. Hirosaki; .-Shiroto Clinic Coshogawara, Aomori: Department of Industrial Health. The Institute of Public Health, Tokyo. Japan

There have been many reports on the applications of low reactive level laser (LLL) therapy for pain attenuation or pain removal. Our group has reported previously on the effects of in vitro irradiation of LLLT particularly on the phagocytic activity of human Neutrophils, using luminol-dependent chemiluminescence (LmCL) for measurement of reactive oxygen species (ROS) production from human Neutrophils. However, the mechanisms of the attenuation of phagocytic activity of NEUTROPHILS by LLL irradiation is not yet fully understood.

In this study. we used luminol-dependent and lucigenin-dependent chemiluminescence (LgCL) for detection of affected ROS producing process of human Neutrophils by LLL irradiation. Two soluble action stimuli, N-formyl-Met-Leu-Phc (fMLP) and phorbol myristate acetate (PMA) were used to avoid the possible influence of lag-time from recognition to uptake of particles at the ROS production.

In case of using fMLP as a stimulus, the maximum luminescence intensity of LULL was increased hut LgCL luminescence was decreased by LLL irradiation. When PMA was used as a stimulus, the times to reach the maximum luminescence intensity of LmCL and LgCL were shortened by LLL irradiation, but there was no effect on the maximum luminescence intensity of both.

These results suggest that LLL irradiation enhances the ROS production activity of human Neutrophils by the activation of the superoxide converting system, the active clement in which is mainly myeloperoxidase. LLL irradiation enabled a more rapid activation of the superoxide production system, NADPH -oxidase.

0898-5901/93/03011 1-06 $08.00   © 1993 by John Wiley & Sons. Ltd  LASER THERAPY 1993: 5: 111-116

Laser therapy takes pain, discomfort out of post-cancer condition

LOW-LEVEL laser therapy promises to be a valuable weapon in the fight against  lymphoedema, the painful and permanent swelling of an arm which frequently follows breast cancer operations. Doctors at Adelaide’s Flinders University (FU) have conducted trials which have produced the first clinical evidence that infra-red laser can improve tissue conditions rapidly in the affected area.

Associate professor Neil Piller told the university magazine, Flinders Journal that loosening the tissue encouraged the regrowth of lymph vessels. The results are very exciting,” Dr Piller said. “This is the first time anyone specifically has set out to trial lasers in this way. Previously, information about the possible efficacy of lasers has come as a by-product of research into such areas as wound treatment and arthritic conditions, and even then there has been very little work done.”

Lymphoedema results from deliberate or accidental removal of lymph nodes or vessels. It affects about 15 per cent of women sometime after a breast cancer operation. In the FU trials, 15 women with prolonged or severe lymphoedema were given 16 half-hour laser treatments over 10 weeks. “All had arms swollen to between 140 and 180 per cent of normal volume. A scanning laser, focusing 2-4 joules of power to each square centimetre, was applied to the entire arm.

In all cases, the treatment reduced the amount of oedema, the volume of fluid and the circumference of the arm above the elbow. Tissues in the upper and lower arm were softened and patients reported less pain, tightness and heaviness, and far greater mobility. “Giving them 16 treatments actually was overkill,” Dr Piller said. “Since the trial ended, we have achieved significant results from just three or four treatments, or in some cases one or two.”

Diode Laser in Cervical Myofascial Pain: A Double-Blind Study versus Placebo

* F. Ceccherelli, * L. Altafini, * G. Lo Castro, * A. Avila, *F. Ambrosio, and * G. P. Giron

*Institute of Anesthesiology and Intensive Care, University of Padua, and the Associazione Italiana per la Ricerca e, l’Aggiornamento Scientif co, Padua, Italy

Summary

We present a double-blind trial in which a pulsed infrared beam was compared with a placebo in the treatment of myofascial pain in the cervical region. The patients were submitted to 12 sessions on alternate days to a total energy dose of 5 J each. At each session, the four most painful muscular trigger points and five bilateral homometameric acupuncture points were irradiated. Those in the placebo group submitted to the same number of sessions following an identical procedure, the only difference being that the laser apparatus was nonoperational. Pain was monitored using the Italian version of the McGill pain questionnaire and the Scott Huskisson visual analogue scale.

The results show a pain attenuation in the treated group and a statistically significant difference between the two groups of patients, both at the end of therapy and at the 3-month follow-up examination.

Address correspondence and repent requests to:  Dr. F. Ceccherelli at the Istituto di Anestesiologiae Rianimazione, via C. Battisti 267, 35121 Padova, Italia.

 The Clinical journal of Pain 5:301-304

copyright 1989 Raven Press, Ltd., New York   Wave- length Power Energy Density Power Density Energy per point Pulses 904nm 5mW av (25Wpeak) (not given) (not given) 1 J 1KHz x 200nS

Pain scores and side effects in response to low level laser therapy (LLLT) for physical trigger points.

E Liisa Laakso Carolyn Richardson, and Tess Cramond

1: Physiotherapy Department, Royal Brisbane Hospital, Brisbane; 2: Physiotherapy Department, University of Queensland, Brisbane; and 3: Pain Clinic, Royal Brisbane Hospital, Brisbane, Queensland, Australia.

Clinically, Low Level Laser Therapy – LLLT has been used successfully in the treatment of chronic pain but many have questioned the scientific basis for its use. Many studies have been poorly designed or poorly controlled.

A double-blind, placebo-controlled, random allocation study was designed to analyse the effect of second daily infrared (JR) laser (820 nm, 25 mW) and visible red laser (670 nm, 10 mW) at 1 J/cm2 and 5 J/cm2 on chronic pain. Forty-one consenting subjects with chronic pain conditions exhibiting myofascial trigger points in the neck and upper trunk region underwent five treatment sessions over a two week period. To assess progress, pain scores were measured using visual analogue scales before and after each treatment. The incidence of side effects was recorded.

All groups demonstrated significant reductions in pain over the duration of the study with those groups which received infrared (820 nm) laser at I J/cm2 and 5 J/cm2. Demonstrating   the most significant effects (p < 0.001). Only those subjects who had active laser treatment experienced side effects.

Results indicated that responses to LLLT at the parameters used in this study are subject to placebo and may be dependent on power output, dose and/or wavelength.

Addressee for Correspondence: E Liisa Laakso BPhty PhD, Physiotherapy Department, Royal Brisbane Hospital, Herston, (Queensland, Australia, 4029.   6/97 Rep. US $8-10-12 Copyright 1997 by LT Publishers, U.K. Ltd. LASER THERAPY. 9: 67-72 67

Two wavelengths studied.

Best results with the higher powered infrared laser compared with the lower powered red laser   Wave- length   Average Power Energy Density Power Density Energy Pulses Time Beam Spot size 820 25mW 5 J/Cm2 0.89 W/Cm2 0.14 J 5,000Hz 5.62 secs 0.89Cm2

Low level laser therapy (LLLT) of tendinitis and myofacial pains a randomized, double-blind, controlled study.Mimmi Logdberg-Anderssont (1), Sture Mutzell (2), and Ake Hazel (3) 1: Akersberga Health Care Centre, 2: Danderyd University Hospital, Danderyd, and   3: Vaxholm Health Care Centre, Stockholm, Sweden.

The purpose of this randomised, double-blind study was to examine the effect of GaAs laser therapy for tendonitis and myofascial pain in a sample from the general population of Akersberga in the northern part of Greater Stockholm.

176 patients (of an original group of 200) completed the scheduled course of treatment. The patients were assigned randomly to either a laser group (92 patients, of whom 74 had tendonitis, completed the study) or a placebo group (84 patients, of whom 68 had tendonitis, completed the study). All 176 patients received six treatments during a period of 3-4 weeks. Their pain was estimated objectively using a pain threshold meter, and subjectively with a visual analogue scale before, at the end of, and four weeks after the end of treatment.

  Laser therapy had a significant, positive effect compared with placebo measured from the first assessment to the third assessment, four weeks after the end of treatment. Laser treatment was most effective on acute tendonitis.

 Address for Correspondence   Sture Mutzell, Danderyd University Hospital 5-182 87 Danderyd, Sweden.  03/07 Rep US 10-12-14, 1997 By LT Publishers, U.K., Ltd.

 LASER THERAPY, 1997:9: 79-86   Wave- length Power Energy Density Power Density Energy per point Pulses 904nm 8mW av (10Wpeak) 0.5-1.0 J/Cm2 (not given) 1J 4KHz x 180nS

The efficady of laser therapy for musculoskeletal and skin disorders: a criteria-based meta-analysis of randomized clinical trials.

Beckerman H, de Bie RA, Bouter LM, et al.

The efficacy of laser therapy for musculoskeletal and skin disorders has been assessed on the basis of the results of 36 randomized clinical trials (RCTs) involving 1,704 patients. For this purpose, a criteria-based meta-analysis that took into account the methodological quality of the individual trials was used. The studies with a positive outcome were generally of a better quality than the studies with a negative outcome. No clear relationship could be demonstrated between the laser dosage applied and the efficacy of laser therapy, or between the dosage and the methodological score.

In general, the methodological quality of these studies appeared to be rather low. Consequently, no definite conclusions can be drawn about the efficacy of laser therapy for skin disorders. The efficacy of laser therapy for musculoskeletal disorders seems, on average, to be larger than the efficacy of a placebo treatment. More specifically, for rheumatoid arthritis, post-traumatic joint disorders, and myofascial pain, laser therapy seems to have a substantial specific therapeutic effect.

Further RCTs, avoiding the most prevalent methodological errors, are needed in order to enable the benefits of laser therapy to be more precisely and validly evaluated.

Physical Therapy. 72(7):483-91, 1992 Jul. (60 ref)

LLLT using a diode laser in successful treatment of a herniated lumbar/sacral disc, with magnetic resonance imaging (MRI) assessment: a case report.

Tatsuhide Abe

Abe Orthopaedic Clinic Futuoka City Fukuoka Prefecture Japan X12′ A 40-year-old woman presented at the Abe Orthopedic Clinic with a 2-year history of lower hack pain and pain in the left hip and leg diagnosed as a ruptured disc between the 5th lumbar/lst sacral vertebrae. The condition had failed to respond to conventional treatment methods including pelvic traction, nonsteroid anti-inflammatory drugs and aural block anesthetic injections.

MRI scans were made of the affected disc, showing it protruding on the left side through the aural membrane. The gallium aluminum arsenide (GaAlAs) diode laser (830 nm, 60 mW) was used in outpatient therapy and after 7 months, the patient’s condition had dramatically improved demonstrated by motility exercises. This improvement was confirmed by further MRI scans, which showed clearly the normal condition of the previously herniated L5/SI disc.

O898-5901/89/020093-03 $05.00   © 1989 by John Wiley & Sons. Ltd.

Physiological responses in chronic pain patients LLLT protocol.

Scott D. Fender and David Diffee, Pain Research Group, Arvada, Colorado, U.S.A.

Use of Low Reactive Level Laser Therapy (LLLT) utilising helium-neon lasers has increased lately especially in pain control. New protocols are being developed aimed at a complex of primary and secondary symptomologies. One of these protocols, Stellate Ganglion Stimulation, has shown in our research a unique set of developments.

Targeting the area of the stellate ganglion is showing great promise in the rehabilitation of patients with a history of chronic musculoskeletal pain syndromes, but several patients with preexisting psychological symptomology have exacerbated during the initial stages of utilization of this protocol. Patients with a history of psychological diagnosis for dysthymia, anxiety, post traumatic stress disorder or minor diffuse brain injury have shown an exacerbation of these symptomologies during the initial phases of stimulation treatment.

Overall, response to this form of therapy seems to be positive but some patients require dermatomal and/or site-specific therapy to maximize outcome. With specific psychological treatment combined with a more conservative amount of stimulation initially the increase in these symptoms shows a tendency to remit with the pain response. Our continued research is currently focusing on the mechanisms for this type of response as well as protocol refinement to maximize its effectiveness.

Address for correspondence:  Scott D. Fender DDS DAPM, 5275 Marshall Street, Suite 203, Arvada, CO 80002, U.S.A.  0898-5901/92/040169-05 $07.50  © 1992 by John Wiley & Sons, Ltd.

Clinical application of GaAIAs 830 NM diode, low level laser therapy  in treatment of Rheumatoid Arthritis.

Kanji Asada, Yasutaka Yutani, Akira Sakawa and Akira Shimazu

Department of Orthopaedic Surgery, Osaka City University Medical School, Japan

The authors have been involved in the treatment of rheumatoid arthritis (RA), in particular chronic poly-arthritis and the associated pain complaints. The biggest problem facing such patients is joint contracture, leading to bony ankylosis. This in turn severely restricts the range of motion (ROM) of the RA-affected joints, thereby seriously restricting the patient’s quality of life (QOL). The authors have determined that in these cases, daily rehabilitation practice is necessary to maintain the patient’s QOL at a reasonable level.

The greatest problem in the rehabilitation practice is the severe pain associated with RA-affected joints, which inhibits restoration of mobility and improved ROM. LLLT or low reactive level laser therapy has been recognized in the literature as having been effective in pain removal and attenuation. The authors accordingly designed a clinical trial to assess the effectiveness of LLLT in RA related pain (subjective self-assessment) and ROM improvement (objective documented data).

From July 1988 to June 1990, 170 patients with a total of 411 affected joints were treated using a GaAlAs diode laser system (830 nm, 60 mW C/W). Patients mean age was 61 years, with a ratio of males: females of 1: 5.25 (16%: 84%). Effectiveness was graded under three categories: excellent (remarkable improvement), good (clearly apparent improvement), and unchanged (little or no improvement).

For pain attenuation, scores were: excellent – 59.6%; good – 30.4%; unchanged – 10%.

For ROM improvement the scores were: excellent – 12.6%; good – 43.7%; unchanged – 43.7%. This gave a total effective rating for pain attenuation of 90%, and for ROM improvement of 56.3%.

0898-5901/91/020077-06 $05.00  

© 1991 by John Wiley & Sons, Ltd.

Mechanisms of the analgesic effect of therapeutic lasers in vivo.

  L Navratil (1) and I Dylevsky (2)

1: Outpatient Department of Radiobiology, Institute of Biophysics, First Medical Faculty, and 2: Department of Functional Anatomy, Second Medical Faculty and Faculty of Physical Education Charles University, Prague, Czech Republic

The analgesic effects in the course of application of therapeutic lasers to affected tissue have been described in a number of works in the literature. Although a few scientific-based reports have appeared, those on laser-induced analgesia are mainly clinical works describing the effect of the therapy which, however, do not study the mechanism of the laser action.

There are several different possible responses induced by non-invasive low level laser therapy (LLLT). The purpose of the present communication is to review the arrangement and characterisation of these responses. By being aware of these effects, the laser therapist can acquire a physiological and morphological scheme making possible the appropriate choice of the site of application of LLLT, choice of the irradiation technique, and selection of appropriate doses.

Address for Correspondence: Leos Navratil MD PhD, Department of Clinical Radiahiology, Institute of Biophysics, First Medical Faculty, Charles University Saln1ovska 3, CZ 120 00, Prague 2, Czech Republic.

© 1997 by LT Publishers U.K, Ltd.

LASER THERAPY 1997:9 : 33-40

Experimental Physiology (1994) 79. 227-234 Printed in Great Britain

Laser’s Effect on Bone and Cartilage Change Induced by Joint Immobilization An Experiment with Animal Model.

Masami Akai, MD,1* Mariko Usuba, RPT,1 Toru Maeshima, Yoshio Shirasaki,2 and Shozo Yasuaka, MD3 ‘Department of Physical Therapy Tsukuba College of Technology, Tsukuba, Ibaraki, Japan Mechanical Engineering Laboratory, Agency of Industrial Science and Technology, TsuPuba, Ibaraki Japan. Yasuoka Orthopaedic Clinic, Mitaka, Tokyo, Japan

Objective:

Influence of low-level (810nm, Ga-Al-As semiconductor) laser on bone and cartilage during joint immobilization was examined with rats’ knee model.

Materials and Methods:

The hind limbs of 42 young Wistar rats were operated on in order to immobilise the knee joint. One week after operation they were assigned to three groups; irradiance 3.9W/cm2, 5.8W/cm2, and sham treatment. After 6 times of treatment for another 2 weeks both hind legs were prepared for 1) indentation of the articular surface of the knee (stiffness and loss tangent), and for 2) dual energy X-ray absorptiometry (bone mineral density) of the focused regions.

Results and Conclusions:

The indentation test revealed preservation of articular cartilage stiffness with 3.9 and 5.8W/cm2 therapy. Soft laser treatment has a possibility for prevention of biomechanical changes by immobilisation.

Correspondence to:  Masami Akai, M.D., Department of Central Rehabilitation Service University Hospital, Faculty of Medicine, University of Tokyo 7-3-1 Hongo, Bunkyo-ku, Tokyo 113, Japan.

Lasers Surg. Med. 21:480-484, 1997.   © 1997 Wiley-Liss, Inc.

Histological and Clinical Responses of Articular Cartilage to Low-level Laser Therapy: Experimental Study.

I. RUIZ CALATRAVA, J.M.SANTISTEBAN VALENZUELA, R.J.G0MEZ-VILLAMANDOS J.I.REDONDO, J.C.G0MEZ-VILLAMANDOS, l.AVIGA JURADO

Department of Veterinary Clinical Pathology-Surgery, Faculty of Veterinary Medicine, University of Cordoba, Spain. Correspondence to 1. Ruiz Calatrava, Department of Veterinary Clinical Pathology-Surgery, Faculty of Veterinary Medicine, University of Cordoba, Avda. Medina Azahara, 9, 14005 Cordoba, Spain

Abstract

This study was carried out to evaluate the effects of low-level laser irradiation on experimental lesions of articular cartilage.

A standard lesion was practiced on the femoral trochlea of both hind limbs of 20 clinically normal Californian rabbits. These animals were divided into two groups of 10 individuals each, depending on the laser equipment used for treatment. One group was treated with HeNe laser (8 J cm – 2, 632.8 nm wavelength) and the other with infra-red (JR) laser (8 J cm – 2, 904 nm wavelength). In both groups, five points of irradiation to the right limb alone were irradiated per session for a total of 13 sessions, applied with an interval of 24 h between sessions. These points were the following: left and right femoral epicondyles, left and right tibial condyles and the centre of articulation. The distance between these points was approximately 1 cm. The untreated left limb was left as a control. During treatment, extension angle and periarticular thickness were considered. At the end of the treatment, samples were collected for histopathological study and stained with: Haematoxylin-Eosin, PAS and Done.

The results show a statistically higher anti-inflammatory capacity of the IR laser (p<0.0001). The functional recovery was statistically similar for both treatments (p<0.176). Histological study showed, at the end of the treatment, hyaline cartilage in the IR group, fibrocartilage in the HeNe group and granulation tissue in the control limbs. Clinical and histological results indicated that this laser treatment had a clear anti-inflammatory effect that provided a fast recuperation and regeneration of the articular cartilage.

Lasers in Medical Science 1997, 12:117-121

© 1997 W.B. Saunders Company Ltd

THERMOGRAPHIC STUDY OF LOW LEVEL LASER THERAPY FOR ACUTE-PHASE INJURY.

Yoshimi Asagai, M.D.1, Atsuhiro Imakiire, M.D.2, Toshio Ohshiro, M.D.3,    1. Shinano Handicapped Children`s Hospital Shimosuwa, Nagano, Japan  2. Department of Orthopaedic Surgery, Tokyo Medical University Shinjuku, Tokyo, Japan 3. Japan Medical Laser Laboratory, Shinanomachi, Tokyo, Japan.

Acute-phase injury is generally treated by localized cooling of the region, and rarely by theactive use of low level laser therapy (LLLT) in Japan. Thermographic studies of acutephase injury revealed that circulatory disturbances at the site of trauma occurred due to swelling and edema on the day following the injury, and that skin temperature was high at the site of the trauma and low at the periphery. Following LLLT, circulatory disturbances rapidly improved, while temperature in the high temperature zone around the site of trauma fell by 3 degrees on the average, but at the periphery the low temperature rose by 3 degrees on the average to nearly normal skin temperature. Clinically, swelling and edema improved. LLLT was also useful in treating necrosis of the skin in the wound area and in accelerating healing of surgical wounds of paralytic feet, which are prone to delayed, wound healing and also wounds due to spoke injury. LLLT is useful in treating swelling and edema in acutephase injury and in accelerating healing of surgical wounds.

Key words: Laser therapy, acute-phase injury, thermography, ankle joint sprain

Introduction

It has not been clearly defined to date if LLLT is indicated for acute-phase injury with swelling and calor. Yet it is frequently considered to be contraindicated in acute-phase injury. We have previously reported that, in patients with cerebral palsy with reduced peripheral skin temperature, the skin surface temperature was elevated to normal after LLLT

(1). in this study, we used thermography to examine changes in skin temperature following LLLT chie fly inacute-phase injury. 

Patients and Methods

Subjects were 7 patients with sprains of the ankle joint, two patients with fractures of the tibial shaft, and one patient with dislocation of the elbow joint. LLLT was also used in orthopedic surgery for disorders of the distal lower extremity such as talipes varus, which is frequently followed by postoperative necrosis of the skin in the wound area as well as delayed wound healing, and pre- and postoperative treatment of paralytic feet with circulatory disturbances. The procedure was as follows. Room temperature was maintained at 25oC. After acclimatization for 20 minutes, continuous irradiation with a GaAlAr semiconductor laser (JQ305, Minato Medical Science Co., Ltd., Japan) with the wavelength adjusted to 810 nm and the output to 100mW was applied using the contact method.

The spot size on the tissue was 0.56cm2 with a power density of 17.86W/cm2 at 100mW, the energy density per point being 107.5J/cm2. The area surrounding the site of trauma was irradiated for 3 to 5 minutes in total, one minute per spot, and changes in the skin surface temperature were followed using Thermotracer TH1106. The test was performed from immediately after injury till 5 days post-trauma, an average of two days after injury. 

Results

Immediately after injury, the skin surface temperature was elevated to about 34 degrees at and around the site of trauma (Fig. 1). On the day following the injury, skin temperature remained elevated around the site of trauma to the same degree as immediately after injury, but was markedly reduced to about 29 degrees at its periphery (Fig. 2). Skin temperature began to fall in the high temperature zone and began to rise in the peripheral low temperature zone immediately following LLLT, and the peripheral skin temperature reached a peak or became almost normal at about 40 minutes after the initiation of irradiation (Fig. 3). Changes in post-LLLT skin temperature in all patients 

a b c

Fig. 1. Sprain of the right ankle joint immediately after injury: 

a) Before irradiation, a high temperature zone extends over the trauma site    and a wide area around it.

 b) At 10 minutes after LLLT,skin temperature fell at the trauma site, and rose in the toes at the periphery.

 c) At 20 minutes after LLLT,skin temperature was re-elevated at the trauma site.

31 Laser Therapy Vol. 12 Official Journal of the World Association for Laser Therapy (WALT) showed that skin temperature fell by an average of 3degrees in the high temperature zone around the site of trauma, and rose by an average of 3 degrees in the peripheral low temperature zone, both to approximately normal skin temperature. Clinically, swelling and edema were diminished and repeated irradiation suppressed exacerbation of swelling and edema.Patients receiving pre- and post-operative   application of LLLT for such conditions as talipes varus, in which postoperative necrosis of skin in the wound area and delayed wound healing are frequent, spoke injury produced when the foot is caught in a bicycle’s spokes (Fig. 4), and paralytic feet with distal circulatory failure due to spin bifida or cerebral palsy, we have not seen any necrosis of the skin in the wound area or delayed wound healing. 

Discussion

There have been many reports on wound healing (2, 3).Currently, the site of trauma is cooled to reduce swelling in acute-phase injury. An important problem in the healing

of wounds and associated fractures is how to suppress swelling and edema, and improvement of local swelling and edema is also crucial for the healing of ligament injury in sprained ankles. However, the use of LLLT for sprained ankles is controversial (4). Thermography has been used for evaluating the effect of LLLT (5). In the present thermographic evaluation, the surface temperature was high around the trauma site and low in the periphery, which indicated that local blood and lymph flow were impaired by swelling and edema, thus raising temperature. When LLLT was applied to these areas, it was found that skin temperature fell in the high temperature zone but

rose in the low temperature zone to approximately the normal temperature in both zones, suggesting improved  blood and lymphatic circulation. Clinically, reduction of local swelling and edema was considered to have led to the improvement of blood and lymph flow.

Conclusions

1: In acute-phase injury, skin temperature was elevated around the site of trauma, and reduced in the periphery on the day following the injury. 

2: Immediately after irradiation, skin temperature fell by 3oC on the average in the high temperature zone around the trauma site, and rose by 3oC on the average reaching normal temperature in the low temperature zone at the periphery of the injury.

3: LLLT rapidly improved blood and lymphatic flow, which had been impaired by injury, and alleviated swelling and edema. LLLT was also useful in accelerating healing  of the surgical wound. 

Address for Correspondence:  Yoshimi Asagai MD, Director, Shinano Handicapped Children`s Hospital, 6525-1 Shimosuwa, Suwagun,Nagano, Japan 393

a b c

Fig. 2. Contusion of the right tibial shaft 1 day after injury: a) before irradiation,

Skin temperature is high at the trauma site, and low at the periphery.

b) At 10 minutes after LLLT:skin temperature fell at the trauma site, and rose slightly at the periphery. c) At 40 minutes after LLLT: skin temperature at the periphery reached a peak and nearly normal skin temperature

a b c

3. Fracture of the right tibia 2 days after removal of nailing:

 a) Before irradiation, skin temperature was high in the surgical wound and low at the periphery.

 b) Immediately after LLLT, skin temperature was reduced in the high temperature zone, and elevated in the low temperature zone.

c) At 40 minutes after LLLT, skin temperature at the periphery reached a peak.

a b

 4. Spoke injury:

 a) At 6 days after injury the left foot had been caught in the rear wheel of a bicycle, and this left a large skin defect on the back of the foot and a contusion, with marked swelling and edema.

b) After daily LLLT, epithelialization was observed and the wound healed at 23 days after injury.

http://www.walt.nu Laser Therapy Vol. 12 32

References

1. Asagai,Y.,Ueno,R.,Miura,Y.,Ohshiro,T.(1995):Application of low reactive-level laser therapy(LLLT) in patients with cerebral palsy of the adult tension athetosis type. Laser Therapy,7:113-118.

2. asaki, K., Ohshiro, T. (1997): Assessment in the rat model of the effects of 830nm diode laser irradiation in a diachronic wound hearing study. Laser Therapy,

9:25-32.

3. ubota, J., Ohshiro, T. (1996): The effects of diode laser LLLT on flap survival: Measurement of flap microcirculation with laser speckle flowmetry. Laser Therapy, 8:241-246.

4. Robert A. Henrica C.W., Ton F, Lenssen, Frans, A.J.M., Gauke, K., Paul G.(1998): Low-level laser therapy in ankle sprains: A randomized clinical trial.

Arch. Phys. Med. Rehabil, 79:1415-1420.

5. Ohshiro, T. (1988): Thermographic analysis and evaluationof pain attenuation with the GaAlAs LLLT laser system. In Ohshiro T and Calderhead RG: ‘Low Lever Laser Therapy: A Practical Introduction’. John Wiley & Sons, Chichester, UK. pp.56-62. 33 Laser Therapy Vol. 12 Official Journal of the World Association for Laser Therapy (WALT)

Lower Back Pain, Low Level Laser Therapy (LLLT) Research.

Abstract

Objective:The aim of this study was to investigate the clinical effects of low-level laser therapy (LLLT) in patients with acute low back pain (LBP) with radiculopathy.

Background Data : Acute LBP with radiculopathy is associated with pain and disability and the important pathogenic role of inflammation. LLLT has shown significant anti-inflammatory effects in many studies.

 Materials and Methods: A randomized, double-blind, placebo-controlled trial was performed on 546 patients. Group A (182 patients) was treated with nimesulide 200 mg/day and additionally with active LLLT; group B (182 patients) was treated only with nimesulide; and group C (182 patients) was treated with nimesulide and placebo LLLT. LLLT was applied behind the involved spine segment using a stationary skin-contact method. Patients were treated 5 times weekly, for a total of 15 treatments, with the following parameters: wavelength 904 nm; frequency 5000 Hz; 100-mW average diode power; power density of 20 mW/cm2 and dose of 3 J/cm2; treatment time 150 sec at whole doses of 12 J/cm2. The outcomes were pain intensity measured with a visual analog scale (VAS); lumbar movement, with a modified Schober test; pain disability, with Oswestry disability score; and quality of life, with a 12-item short-form health survey questionnaire (SF-12). Subjects were evaluated before and after treatment. Statistical analyses were done with SPSS 11.5.

 Results: Statistically significant differences were found in all outcomes measured (p < 0.001), but were larger in group A than in B (p < 0.0005) and C (p < 0.0005). The results in group C were better than in group B (p < 0.0005). Conclusions: The results of this study show significant improvement in acute LBP treated with LLLT used as additional therapy.

Ljubica M. Konstantinovic, Ph.D.,1Zeljko M. Kanjuh, M.S.,1Andjela N. Milovanovic, M.S.,2Milisav R. Cutovic, Ph.D.,1Aleksandar G. Djurovic, Ph.D.,3Viktorija G. Savic, M.S.,4Aleksandra S. Dragin, M.S.,1and Nesa D. Milovanovic, M.S.1

1Clinic for Rehabilitation, Medical School, Belgrade, Serbia 2Center for Physical Medicine, Clinical Center of Serbia, Belgrade, Serbia.3Clinic for Rehabilitation, Military Medical Academy, Belgrade, Serbia.4Department for Physical Medicine, Institute for Rheumatology, Belgrade, Serbia.

Address correspondence to: Ljubica Konstantinovic, Ph.D. Clinic for Rehabilitation dr Miroslav ZotovicMedical School, University of Belgrade

Sokobanjska 13, Belgrade

 Chiropractic Treatment

Chiropractic addresses the function of central nervous system which is the “master system” of the body controlling ad regulating function of all other subsystems including musculoskeletal system. Properly aligned skeletal system would improve performance, reduce the risk of injury and improve healing of existing injuries.

Chiropractors specialize in the non-drug treatment of musculoskeletal problems, including joint sprains and disc injuries. To some extent, the chiropractic approach to sports injuries is similar to that of traditional medical care.

Usually chiropractor’s initial examination would include standard orthopaedic and neurological tests to diagnose whether a particular pain is due to a strain, sprain, or disc problem. X-ray examination is also performed to screen for fractures and other bone disorders, such as osteoporosis.  

Chiropractic management of sports injuries often includes widely used physical therapies such as ice, Low Level laser therapy (LLLT) to reduce swelling and inflammation, or electronic muscle stimulation for muscle strains and spasms. 

Importance of Restoring Structural Body Balance.

Chiropractic management of sport injuries has an emphasis on adjustment and improving function of spinal and other joints through manipulation as well as restoring overall structural balance of the body. Chiropractor assess the effect of the muscle injury on the rest of the body as it would cause tightening of other muscle and joints in order to maintain general balance. Chiropractic adjustments help to restore the natural balance that was present before the injury.

 

Low Level Laser Therapy,Pain Relief,

Friday, April 23rd, 2010

A review on reseach published by The Lancet shows that Low Level Laser Therapy(LLLT) also so known as Cold Laser Therapy has been tested in over 200 clinical trials (RCTs) and published in the world’s top medical journals including a review by The Lancet, a clinical study in the journal PAIN and is acknowledged by the World Health Organisation Bone and Joint Task Force , and published in the journal Spine.

Call 024 7622 2002.Registered with BUPA. AXA  PPP. HSA. AVIVA. Simplyhealth. Standard Life. Mercia health. BHSF. Pru health .Cigna Police health care scheme Medicare  Medisure. Medicash and all other healthcare insurers .

Low Level laser Therapy (LLLT)  also known as Cold Laser Therapy/Treatment

Low Level Laser Therapy(LLLT) also so known as Cold Laser Therapy has been tested in over 200 clinical trials (RCTs) and published in the world’s top medical journals including a review by The Lancet, a clinical study in the journal PAIN and is acknowledged by the World Health Organisation Bone and Joint Task Force , and published in the journal Spine.

The lasers used  are certified as  low level laser therapy  (LLLT).  For the past 30 years the technology of low level laser therapy (also known as Cold Laser Therapy has been formally accepted in North America and in many other parts of the world such as Europe, Russia and Japan.  In all this time there have been no recorded long-term adverse effects from low level laser therapy.  It is considered to be non-invasive, painless and safe.

Low Level Laser Therapy (LLLT) uses laser light energy to stimulate cells to function optimally.  In the body, light sensitive chromophores and other elements within the cell absorb energy, initiating a series of important photochemical changes such as increased production of ATP. The mitochondria and Kreb’s Cycle stimulation initiates the production of ATP, providing the cell with the extra energy needed to accelerate the healing process and positively influence pain.  These activities can occur in all types of cells and includes ligament, nerves, cartilage and muscle.

Low Level Laser Therapy(LLLT) is a treatment where by a low level laser is utilized to treat chronic and acute pain.  Low level laser therapy may be used for patients suffering from Sciatica, back and neck, hip, knee, ankle, foot pain and conditions a, musculoskeletal pain, joint pain associated with arthritis, fibromyalgia, tendonitis, bursitis, neuropathy, Achilles tendonitis, migraine headaches, sprains and strains,trapped nerves, carpal tunnel syndrome , back, neck, shoulder pain and other associated pains. Low Level laser therapy also treats conditions such as TMJ, reflex sympathetic dystrophy (RSD) and other inflammatory and scarring conditions. By increasing serotonin levels, low level laser therapy contributes to the body’s own healing process. Non-thermal and non-invasive, low level laser therapy involves a combination of low level laser and electric stimulation and is one of the most effective healing therapies. Completed in ten to twelve sessions,  low level laser therapy(LLLT) can significantly reduce treatment time and costs.

Low Laser Therapy(LLLT) has been tested in over 200 clinical trials (RCTs) and published in the world’s top medical journals including a review by The Lancet, a clinical study in the journal PAIN and is acknowledged by the World Health Organisation Bone and Joint Task Force  and published in the journal Spine.

A Review on research published by The Lancet, for the treatment of neck pain with Cold/Low Laser Therapy (LLLT)

Low level Laser treatment for neck pain.

Neck pain  is common, often persistent, and responds poorly to medication. So it is encouraging to read that a relatively novel, non-invasive treatment shows evidence of effectiveness. A systematic review and meta-analysis of 16 randomised controlled trials of low-level laser therapy (LLLT)’ yielded 820 patients, for whom data was pooled. LLLT was found to reduce pain immediately after treatment in acute neck pain and up to 22 weeks after completion of treatment in patients with chronic neck pain. Low-level laser – or cold laser – is yet to be established as a medical treatment but, according to Wikipedia, papers are appearing at the rate of around 25 per month, mainly investigating treatment of musculoskeletal disorders.

1. Chow RT, Johnson Ml, Lopes-Martins RA, Bjordal JM. Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials. Lancet 2009 Dec 5;374(9705):1897-908.

Low Level Laser Therapy (LLLT)

Low Level  Laser Therapy (LLLT) has a 5 star rating for soft tissue injuries,conditions and inflammation.  Low Level Laser Therapy is a handheld, non-invasive, light-emitting medical device which is used over different areas of the body. It provides an unmatched advantage in the treatment of conditions such as;

Athletic and sports Injuries, Soft tissue injuries including Sprains and Strains, Tendonitis and Haematomas

Lower leg (calf pain) inflammation, Shin splints, Hamstring, Achilles tendonitis, Bursitis, conditions and disorders

Ankle sprains, injury, and fractures, inflammation conditions and disorders

Heel and foot injury, pain, Bursitis, Achilles Tendonitis, Plantar fasciitis, conditions and disorders

Knee pain, injuries, tears, ligament, Tendon injury, ruptures, Runners Knee, inflammation, Bursitis, conditions and disorders

Shoulder injury, pain, Shoulder tears, fractures inflammation, Tenosynovitis ,Tendonitis, Bursitis, conditions such as frozen shoulder, and disorders

Neck injury, Neck Pain, Neck sprain, Whiplash injury.

Back Injury,   Lower back pain, Sciatica, slipped discs, prolapsed disc, herniated / bulging discs, Trapped nerves and inflammation.

Elbow, Wrist and Hand injury, Tendonitis, inflammation, fractures, conditions and disorders, such as Tennis Elbow,(Golfers Elbow) Carpal Tunnel Syndrome,

Hip injury and pain, Sacroiliac Joint inflammation, groin and thigh strain (pull), sports hernia, Hip Bursitis/Tendonitis, Trochanteric Bursitis, conditions and disorders

Muscle sprain and spasms, Cramps, Joint Pain and stiff Joints.

Pain Relief, including Arthritic pain relief.

Wound Management including Skin Ulcers, Pressure Sores and Burns, Skin infections

Chronic pain such as Trigeminal Neuralgia and Chronic Neck and Back pain.

Safety

Low level laser therapy(LLLT) is not harmful. Lasers used for tissue stimulation have insufficient strength to damage cells. 30 years of clinical studies and clinical use have shown no adverse effects whatsoever.

The Advantages of Low Intensity Laser Therapy

  • Non-invasive
  • Non-toxic
  • Easily applied
  • Highly effective
  • Cure rate > 95%
  • No known negative side effects

Mechanism of Action

Therapeutic lasers work by supplying energy to the body in the form of photons of light. The tissues and cells then absorb this energy, where it is used to accelerate the normal rate of tissue healing.

Therapeutic Benefits of Laser Therapy:

  • Anti-inflammatory Action: Laser light reduces swelling, leading to decreased pain, less stiffness, and a faster return to normal joint and muscle function.
  • Rapid Cell Growth: Laser light accelerates cellular reproduction and growth.
  • Faster Wound Healing: Laser light stimulates fibroblast development and accelerates collagen synthesis in damaged tissue.
  • Reduced Fibrous Tissue Formation: Laser light reduces formation of scar tissue, leading to more complete healing, with less chance of weakness and re-injury later.
  • Increased Vascular Activity: Laser light increases blood flow to the injured area.
  • Stimulated Nerve Function: Laser light speeds nerve cell processes which may decrease pain and numbness associated with nerve-related conditions.

Frequency of Treatments

While some patients get immediate results, others require 6-10 treatments before seeing a lasting effect. Less severe or acute injuries will require fewer treatments than chronic or severe conditions.

 Chiropractic Treatment

Chiropractic addresses the function of central nervous system which is the “master system” of the body controlling ad regulating function of all other subsystems including musculoskeletal system. Properly aligned skeletal system would improve performance, reduce the risk of injury and improve healing of existing injuries.

Chiropractors specialize in the non-drug treatment of musculoskeletal problems, including joint sprains and disc injuries. To some extent, the chiropractic approach to sports injuries is similar to that of traditional medical care.

Usually chiropractor’s initial examination would include standard orthopaedic and neurological tests to diagnose whether a particular pain is due to a strain, sprain, or disc problem. X-ray examination is also performed to screen for fractures and other bone disorders, such as osteoporosis.  

Chiropractic management of sports injuries often includes widely used physical therapies such as ice, Low Level laser therapy (LLLT) to reduce swelling and inflammation, or electronic muscle stimulation for muscle strains and spasms. 

Importance of Restoring Structural Body Balance.

Chiropractic management of sport injuries has an emphasis on adjustment and improving function of spinal and other joints through manipulation as well as restoring overall structural balance of the body. Chiropractor assess the effect of the muscle injury on the rest of the body as it would cause tightening of other muscle and joints in order to maintain general balance. Chiropractic adjustments help to restore the natural balance that was present before the injury.

 

Network Spinal Analysis,Somatopsychic Wave (Wave of Life), Northhamptonshire.

Monday, April 19th, 2010

Network Spinal Analysis and Research

Network Spinal Analysis is a gentle and extremely effective style of chiropractic care used to evaluate and adjust the spine. The purpose of NSA is to allow restoration of proper nerve function for full health and peak performance. 

Network Spinal Analysis is a chiropractic technique developed in America in the early 80’s by Dr Donald Epstein. Network Spinal Analysis utilises light touches, specific body contacts and body positioning to develop breathing and body oscillations (or waves) that dissipate stored tension. NSA allows your body to develop new strategies to release this tension on its own. This promotes the clarity and flexibility a body needs to adapt to the challenges of our busy lives. 

How Does NSA Work?  

The spinal cord, in addition to being an electrical system, also conducts information through oscillation, or wave-like motion. Like an overstretched rubber band, the spinal cord tissues oscillate at a higher frequency, or “phase”, when they are under tension. As every cell of the body is connected via an elaborate nerve network to the spinal cord, any change in tension of the spinal cord affects the function of every cell in the body… all 75-100 trillion of them!   

From this, we found that most tension in the vertebra of the spine was secondary to tension patterns from the spinal cord. The stress of having too much to do and not enough time to do it is epidemic in our culture. Consistently high stress levels freeze the body in a “fight or flight” mode, tightening muscles, rounding shoulders, making breathing shallow, and limiting blood and oxygen to the parts of your brain responsible for relaxation, revitalization, creativity, and growth.   We find that a busy life is typically not the problem. The problem is an inability to shift gears and “unhook” from the stress-causing factors that are overwhelming you.
That’s why, instead of trying to mechanically adjust or align the spine through manipulation of the vertebra, a Network Chiropractor seeks to understand the physical, emotional, and mental factors related to the tension pattern and then find the specific points on the spine that will help the body resolve its tension using the exact amount of pressure that cues the brain from stress into ease. No twisting, popping, or cracking is necessary. 

The Network Chiropractor is using the principle of leverage. This is when they make the light gentle adjustments. The idea is like moving huge boulder without having to use a great deal of force if you use the leverage of a tree branch.
Putting the lever in the exact right place, at the right time with the right amount of light force, you can easily move the boulder. Likewise, Network Chiropractors are trained during post-graduate courses on Network Spinal Analysis to know the exact leverage point and manoeuvres to utilise on the spine to release tension to allow the body to find equilibrium. 

What scientific evidence do you have that your method works? 

NSA is one of the most researched methods in chiropractic. Network Spinal Analysis™ has been the subject of academic study, research and publication for its unprecedented effect in wellness and quality of life, adaptability to stress, enhanced life enjoyment, facilitation of constructive lifestyle changes. Also studies are being conducted as to its influence on the advancement and evolution of the nervous system’s strategies for self-organization.
A retrospective study of nearly 3,000 people through the University of California Irvine Medical College documented significant improvements in quality of life in the majority of people receiving Network Chiropractic care. 

The wave patterns that occur during a Network entrainment are the focus of University of Southern California mathematician professor Edmund Jonckheere, who is currently studying the relationship between these wave patterns and the energy-efficiency and adaptability of the nervous system.   

The Journal of Alternative and Complementary Medicine featured the evolving paradigm that contains NSA and SRI, called Reorganizational Healing, in May ’09. 

NSA Sessions 

The adjustments are made along the spine and are as gentle as the pressure that you could comfortably apply to your closed eyelid. 

  • You keep your clothes on (except your shoes) during a session.
  • Sessions last about 30-40 minutes.
  • The therapy is not painful, although the bodily sensations can be surprising and emotional releases during sessions are common.
  • Practitioners evaluate the client’s progress based on his or her self-reported experience.

Benefits of NSA 

Research has shown that as a spine, body and nervous system becomes healthier, physical wellbeing improves to provide more spinal flexibility, diminished symptoms and a greater ability to cope, developing an internal sense of wellness regardless of circumstances.
Examples of further additional benefits reported include: 

  • Less physical pain
  • Less tension or stiffness of the spine
  • Greater flexibility
  • Reduced allergies, eczema, asthma
  • Fewer colds flu & headaches
  • Less menstrual discomfort
  • Improved response to stress
  • Improved mental/emotional state
  • Improved life enjoyment
  • Improved overall quality of life

Basic care typically lasts 6 to 8 weeks, with 2 to 3 sessions per week. At the end of this period, clients generally report better body awareness, stronger spinal movement, and relief from discomfort and more ease in releasing tension.
After basic care sessions, you can choose to continue with treatment and enjoy wellness 

Network Spinal Analysis Research

The following is a list of peer-reviewed publications involving Network Spinal Analysis Care. Further information regarding Network Spinal Analysis Research currently in process or programs where information on Network Spinal Analysis Research has been presented is available at www.associationfornetworkcare.com

Improvement in Attention in Patients Undergoing Network Spinal Analysis: A Case Series Using Objective Measures of Attention
Pauli Y. Journal of Vertebral Subluxation Research, August 23, 2007; 1-9

Objective: Anecdotal preliminary evidence suggests that chiropractic care may be of benefits for individuals suffering from ADHD. This case series presents the improvement in attention experienced by 9 adult patients undergoing Network Spinal Analysis.

Methods: Nine adult patients are presented (4 male, 5 female) with a mean age of 40.4 years (range 22 – 58 years old). All patients were evaluated with the Test of Variable of Attention (TOVA) before receiving Network Spinal Analysis (NSA) care and at 2 months into care. The nine patients received level 1 NSA care for two months, as taught by the Association for Network Care. Neurospinal integrity was evaluated with palpation, as well as surface electromyography. Cognitive process of attention was objectively evaluated using a continuous performance test, the Test of Variables of Attention (TOVA).

Results: We evaluated our patient cohort before and after Network care using sEMG and variables from the continuous performance test (TOVA). Before care, all patients had an abnormal ADHD score with a mean of -3.74 (range: – 8.54 to -1.89). After 2 months of care, all patients had a significant change in ADHD score (p=0.08) and 88% completely normalized the ADHD score. 77% and 66% of patients experienced significant change in reaction time and variability score, respectively. All patients experienced a significant reduction in sEMG pattern of activation (p=0.08). We discuss possible mechanisms by which spinal care may have enhanced the function of the prefrontal cortex, thereby resulting in improved attentional capacities

Conclusion: In this case series the nine adult patients experienced significant improvement in attention, as measured by objective outcomes, after receiving two months of Network Spinal Analysis. The progress documented in this report suggests that NSA care may positively affect the brain by creating plastic changes in the prefrontal cortex and other cortical and subcortical areas serving as neural substrate for the cognitive process of attention. These findings may be of importance for individuals suffering from attention deficit. Further research into this area is greatly needed.

Quality of Life Improvements and Spontaneous Lifestyle Changes in a Patient Undergoing Subluxation-Centered Chiropractic Care: A Case Study
Pauli Y. Journal of Vertebral Subluxation Research, October 11, 2006; 1-15

Purpose of Study: This case study is to report the improvement in quality of life experienced by a patient undergoing subluxation-centered chiropractic care.

Clinical Features: A 36 year old male presented with primary health concerns of stress, eye pain and left leg pain of 14 years duration radiating to the foot and secondary complaints of gastritis, ulcers, nervousness, depression, lack of concentration and general loss of interest in daily life. The patient also smokes, does not exercise, eats a sub-optimal diet and rated his family and friends support, as well as job satisfaction as sufficient.

Intervention and Outcome: We discuss the various analyses employed to evaluate vertebral subluxations, including paraspinal surface electromyography and thermography. Adjustive care included a combination of Network Spinal Analysis, Torque Release Technique and diversified structural adjustments to correct vertebral subluxations over a six month period. We used visual analog scales, open-ended questions and selected items from the Self-Rated Health and Wellness Instrument to monitor health changes, as well as the positive improvements in quality of life as perceived by the patient himself.

Conclusion: This case study demonstrates that the correction of vertebral subluxations over an 11 month period was associated with significant improvements in the quality of life of the patient.

Chiropractic Care of a Battered Woman: A Case Study
Bedell L. Journal of Vertebral Subluxation Research, July 20, 2006; 1-6

Objective: This case study documents the chiropractic care of battered woman struggling with Intimate Partner Violence (IPV). Chiropractic offers battered women a unique service, it is the only profession trained and licensed to detect and correct vertebral subluxations. The relationship between the stresses of abuse and vertebral subluxation, as well as the subsequent changes during chiropractic care, are described.

Clinical Features: A Caucasian, 23-year old female presented with headaches, neck pain, and upper back pain. The initial complaint noted sharp, knife-like pains into the medial scapular borders, worse on the right side. Tingling extended into the right hand, most severe in the 2nd, 3rd, and 4th fingers.

Chiropractic care and outcome: Protocols of both Torque Release and Activator techniques were utilized to evaluate vertebral subluxations. Subjective quality of life issues were evaluated through a Network Spinal Analysis (NSA) Health Status Questionnaire. After commencing chiropractic care, this woman suffered a cervical spine hyper-extension/hyper-flexion type injury from an automobile accident. For the first 30 days after, adjustments were applied twice weekly. Acute exacerbations of symptoms unrelated to the original complaints were displayed and progress became irregular. During the next 60 days, there were various unexplained falls and severe flare-ups of painful symptoms, and she finally admitted to being battered by her husband. Referrals to counselors and programs dealing with domestic violence were provided. Once the physical battering stopped, consistent progress was noted in both clinical symptoms and quality of life issues.

Conclusion: As a battered woman must receive emotional and social support to improve her situation, it is important for chiropractors to recognize the “red flags” of IPV. Chiropractors re-evaluate regularly for changes in vertebral subluxation patterns and can recognize inconsistent responses. They may also be the first caregivers to offer a vitalistic approach; considering a woman’s physical, chemical, and emotional quality of life; a perspective that offers significant connection and trust. This article serves as a foundation on the topic of IPV and chiropractic, for use in both communities.

Wellness lifestyles II: Modeling the dynamic of wellness, health lifestyle practices, and Network Spinal Analysis.
Schuster TL, Dobson M, Jauregui M, Blanks RH. Journal of Alternative and Complimentary Medicine. April 2004;10(2):357-67.
PMID: 15165417

OBJECTIVE: Empirical application of a theoretical framework linking use of Network Spinal Analysis (NSA; a holistic, wellness-oriented form of complementary and alternative medicine [CAM]), health lifestyle practices, and self-reported health and wellness. DESIGN: Cross-sectional self-administered survey study. RESPONDENTS: Two thousand five hundred and ninety-six (2596) patients from 156 offices of doctors who were members of the Association for Network Chiropractic (currently titled Association for Network Care); estimated response rate was 69%. MEASURES: Exogenous variables entered into the structural equation model include gender, age, education, income, marital status, ailments, life change, and trauma. A wellness construct consisted of calculated difference scores between two referents, “presently” and “before Network” care, for self-reported items representing wellness domains of physical state, mental-emotional state, stress evaluation, and life enjoyment. Positive reported change in nine items assembled into dietary practices, health practices, and health risk dimensions serve as indicators of the construct of changes in health lifestyle practices. The NSA care construct consisted of duration of care in months, awareness of energy and awareness of breathing since beginning Network care. RESULTS: Of the exogenous variables only gender, age, and education remain in the final parsimonious structural equation model in these data. Reported wellness benefits accrue to individuals along a direct path from both self-reported positive lifestyle change (0.22), and from NSA care (0.43). The path (0.65) from NSA care to positive health lifestyle changes indicates that NSA care also has an indirect effect on wellness through changes in health lifestyle practices.

CONCLUSIONS: The Structural Equation model tested in these analyses lends support to our theoretical framework linking wellness, health lifestyles, and CAM. This study provides further evidence that our measurements of health and wellness are particularly appropriate for investigating wellness-oriented CAM. There is a positive relationship between the experience of NSA care and self-reported improvements in wellness as well as self-reported changes in lifestyle practices. NSA care users tend toward the practice of a positive health lifestyle, which also has a direct effect on reported improvements in wellness. These empirical links are discussed relative to the sociodemographic characteristics of this population and show that use of NSA care is an aspect of a wellness lifestyle.

Wellness lifestyles I: A theoretical framework linking wellness, health lifestyles, and complementary and alternative medicine.
Schuster TL, Dobson M, Jauregui M, Blanks RH. Journal of Alternative and Complimentary Medicine. April 2004;10(2):349-56.
PMID: 15165416

Scholarship concerning complementary and alternative medicine (CAM) practices within the United States could benefit from incorporating sociological perspectives into the development of a comprehensive research agenda. We review the literature on health and wellness emphasizing definitions and distinctions, the health lifestyles literature emphasizing issues of both life choices and life chances, and studies of CAM suggesting utilization as an aspect of a wellness lifestyle. This review forms the foundation of a new theoretical framework for CAM research based on the interrelationship of CAM with health promotion, wellness, and health lifestyles. To date, few studies have sought to bring these various elements together into a single, comprehensive model that would enable an assessment of the complexity of individual health and wellness in the context of CAM. We argue that attention to literatures on health measurement and health lifestyles are essential for exploring the effectiveness and continuing use of CAM.

The Transition of Network Spinal Analysis Care: Hallmarks of a Client-Centered Wellness Education Multi-Component System of Health Care Delivery
Epstein D. Journal of Vertebral Subluxation Research, April 5, 2004; 1-7

Network Spinal Analysis TM (NSA) care has been transitioned from a health care system with the objective of correction of two types of vertebral subluxation, to a multi-component system of health care delivery with emphasis on wellness education for participating clients. NSA care is now delivered and communicated in discrete Levels of Care with emphasis on client participation through self-evaluation. Emphasis on wellness education will be introduced into NSA practice through training via a Certificate Program currently under development. This paper considers some hallmarks that delineate a wellness education, patient (client)-centered practice. The concepts presented relative to this wellness model of health care delivery are believed to be applicable to any approach with similar practice objectives. The perspective presented considers that the major aspects of a patient-centered, wellness education health care delivery system is multi-dimensional. Hallmarks include differentiating terms, and establishing a wellness mentality. Substantiation of the discipline must be established through credible published research regarding its efficacy and safety as well as a consistent and valid means of measuring progressive outcomes derived from the care received. The relationship of NSA to other disciplines is discussed.

Successful In Vitro Fertilization in a Poor Responder While Under Network Spinal Analysis Care: A Case Report
Senzon SA. Journal of Vertebral Subluxation Research, September 14, 2003; 1-6

Objective: This case report describes the successful in vitro fertilization (IVF) of a 34 year old female who had one previous aborted IVF attempt prior to Network Spinal Analysis (NSA) care. This case report is being presented to add to other case reports that show positive physiological changes in patients receiving NSA care.

Clinical Features: The IVF was attempted due to her partner’s azoospermia. The first IVF attempt was on 3/26/02. The patient had a poor follicular growth after the standard hyper-stimulation process of the ovaries, including pre-treatment with Mircette (birth control pills) and 1mg/0.2ml of Lupron (a gonadotropin releasing hormone agonist), and 3-6 amps of Gonal-F (a recombinant fsh) starting on cycle day 3. Her baseline day 3 estradiol and LH levels were only 21.2pg/me and 5.0 I.U./L respectively. On cycle day 8, estradiol was only 56% and LH was 6.6 I.U./L. The Gonal-F was increased to 6amps. This first attempt was canceled due to the poor follicle growth. Only 3-4 follicles of insufficient size between 10-14mm each were found.

Chiropractic Care and Outcomes: On 4/11/02, the patient commenced regular NSA care. The second IVF attempt began on 6/6/02. The change in IVF protocol was the addition of Repronex (also a gonadotropin a combination of LH and fsh). The total increased dose of Gonal-F and Repronex was 6amps, compared to the first attempt of only 3amps which was then increased to 6amps of Gonal-F only.

Conclusion: On the second IVF attempt, estradiol was 1001pg/ml on day 8, and 2019pg/ml on day 11, with LH at 9.3. The Oocyte retrieval after the second attempt was 10 eggs, each approximately 18mm. A successful aspiration of eggs was completed on 6/17/02, and a successful pregnancy followed. The patient is still under NSA care, and is now in her second trimester with normal fetal heart sounds. The possible role of NSA care in the vigorous follicular growth and other health benefits is discussed.

Insult, Interference and Infertility: An Overview of Chiropractic Research
Behrendt M. Journal of Vertebral Subluxation Research, May 2, 2003; 1

Objective: Infertility is distinct from sterility, implying potential, and therefore raises questions as to what insult or interference influences this sluggish outcome. Interference in physiological function, as viewed by the application of chiropractic principles, suggests a neurological etiology and is approached through the mechanism of detection of vertebral subluxation and subsequent appropriate and specific adjustments to promote potential and function. Parental health and wellness prior to conception influences reproductive success and sustainability, begging efficient, effective consideration and interpretation of overall state and any distortion. A discussion of diverse articles is presented, describing the response to chiropractic care among subluxated infertile women.

Clinical Features: Fourteen retrospective articles are referenced, their diversity includes: all 15 subjects are female, ages 22-65; prior pregnancy history revealed 11 none, 2 successful unassisted, 1 assisted, 1 history of miscarriage. 9 had previous treatment for infertility, 4 were undergoing infertility treatment when starting chiropractic care. Presenting concerns included: severe low back pain, neck pain, colitis, diabetes, and female dysfunction such as absent or irregular menstrual cycle, blocked fallopian tubes, endometriosis, infertility, perimenopause and the fertility window within a religiousbased lifestyle, and a poor responder undergoing multiple cycles of IVF.

Chiropractic Care and Outcome: Outcomes of chiropractic care include but are not limited to benefits regarding neuromuscular concerns, as both historical and modern research describe associations with possible increased physiological functions, in this instance reproductive function. Chiropractic care and outcome are discussed, based on protocols of a variety of arts, including Applied Kinesiology (A.K.), Diversified, Directional Non-Force Technique (D.N.F.T.), Gonstead, Network Spinal Analysis (N.S.A.), Torque Release Technique (T.R.T.), Sacro Occipital Technique (S.O.T.) and Stucky-Thompson Terminal Point Technique. Care is described over a time frame of 1 to 20 months.

Conclusion: The application of chiropractic care and subsequent successful outcomes on reproductive integrity, regardless of factors including age, history and medical intervention, are described through a diversity of chiropractic arts. Future studies that may evaluate more formally and on a larger scale, the effectiveness, safety and cost benefits of chiropractic care on both well-being and physiological function are suggested, as well as pursuit of appropriate funding.

Chaotic Modeling in Network Spinal Analysis: Nonlinear Canonical Correlation with Alternating Conditional Expectation (ACE): A Preliminary Report
Bohacek S, Jonckheere E. Journal of Vertebral Subluxation Research, December 1998; 2(4): 188-195

Abstract – This paper presents a preliminary non-linear mathematical analysis of surface electromyographic (sEMG) signals from a subject receiving Network Spinal Analysis (NSA).The unfiltered sEMG data was collected over a bandwidth of 10-500 Hz and stored on a PC compatible computer. Electrodes were placed at the level of C1/C2,T6, L5, and S2 and voltage signals were recorded during the periods in which the patient was experiencing the “somatopsychic” wave, characteristic of NSA care. The intent of the preliminary study was to initiate mathematical characterization of the wave phenomenon relative to its “chaotic,” and/or nonlinear nature. In the present study the linear and nonlinear Canonical Correlation Analyses (CCA) have been used. The latter, nonlinear CCA, is coupled to specific implementation referred to as Alternating Conditional Expectation (ACE). Preliminary findings obtained by comparing canonical correlation coefficients (CCC’s) indicate that the ACE nonlinear functions of the sEMG waveform data lead to a smaller expected prediction error than if linear functions are used. In particular, the preliminary observations of larger nonlinear CCC’s compared to linear CCC’s indicate that there is some nonlinearity in the data representing the “somatopsychic” waveform. Further analysis of linear and nonlinear predictors indicates that 4th order nonlinear predictors perform 20 % better than linear predictors, and 10th order nonlinear predictors perform 30% better than linear predictors.This suggests that the waveform possesses a nonlinear “attractor” with a dimension between 4 and 10. Continued refinement of the ACE algorithm to allow for detection of more nonlinear distortions is expected to further clarify the extent to which the sEMG signal associated with the “somatopsychic” waveform of NSA is differentiated as nonlinear as opposed to random.

Reduction of Psoriasis in a Patient under Network Spinal Analysis Care: A Case Report
Behrendt M. Journal of Vertebral Subluxation Research, December 1998; 2(4): 196-200

This case report describes the progress of a 52 year old male with chronic psoriasis, first diagnosed in April of 1992. After the condition exacerbated over a five year period, he was placed on 12.5 mg/week methotrexate, and oral immunosuppressant medication in October of 1997.After commencing the medication, the condition reduced from 6% body coverage, with flares of 15-20%, to a body coverage of 5%. Following a cessation of the oral medication in February, 1998, the condition recurred at the previous uncontrolled level within one month. The patient was again placed on 12.5 mg/week methotrexate, and subsequently the condition reduced to 5% body coverage. The patient’s dose was reduced to 10 mg/week, and later to 7.5 mg/week, with the psoriasis remaining at 5% coverage. On 5/18/98, the patient commenced regular NSA care. He reported a reduction in the psoriasis condition on 6/3/98, and was taken off the oral medication on 6/25/98. The reduction continued, and the patient was advised by his medical physician on 7/01/98 to continue the cessation of oral medication. As of 9/30/98 the psoriasis had decreased to 0.5% to 1.0 % of coverage, and prior plans to initiate ultraviolet-A therapy were canceled. As of 11/98, a five month period since cessation of methotrexate, the patient has remained under regular NSA care, with no recurrence of psoriasis body coverage greater than 1%, the only medication being a topical ointment. This is contrasted to the recurrence after one month, following the patient’s first cessation of methotrexate, and prior to NSA care. The possible role of NSA care in the reduction of the patient’s psoriasis, and other health benefits is discussed.

Changes in Digital Skin Temperature, Surface Electromyography, and Electrodermal Activity in Subjects Receiving Network Spinal Analysis Care
Miller E, Redmond P. Journal of Vertebral Subluxation Research, June 1998; 2(2): 87-95

A preliminary study was conducted to evaluate changes in digital skin temperature (DST), surface electromyography (sEMG), and electrodermal activity (EDA) in a group of twenty subjects receiving Network Spinal Analysis (NSA) care. Data, simultaneously derived from all three parameters, were considered to be indirect correlates of sympathetic nervous system activity. Subjects, including a group of five controls, were assessed for a period of 17 minutes. The continuous assessment period included a baseline interval of 4.5 minutes, followed by a 12.5 minute period which was divided into five 2.5 minute intervals. Care was administered to the NSA recipient group immediately after the baseline period, whereas controls received no intervention following baseline. Results revealed no significant differences in DST either within or between the two groups. Surface EMG readings were relatively constant over the five intervals following baseline in the NSA group, while controls showed significant (p < 0.05) increases in sEMG at the second through fifth intervals relative to the first interval following baseline activity. Electrodermal activity was significantly decreased (p < 0.01) in the NSA group in the second through fifth intervals compared to baseline. Moreover, decreases varied between intervals, but exhibited a leveling from the third through fifth interval. Control subjects, alternatively, exhibited an increase in EDA in all intervals following baseline. The extent of increase resulted in EDA activity significantly greater than the NSA group at the third through fifth intervals. It was concluded that the increase in EMG activity in the control groups may have reflected an increasing level of anxiety due to the duration of the recording period. Since the NSA group expressed constancy in sEMG activity during the same period, coupled to significant decreases in EDA, a “sympathetic quieting effect” was postulated to occur in subjects receiving NSA care. This conclusion is consistent with hypothesized neurological pathways linked to responses observed during NSA care, as well as other reports of self-reported improvements in mental/emotional state and stress reduction in patients receiving Network Chiropractic Care.

Functional Magnetic Resonance Imaging: About the Cover
Journal of Vertebral Subluxation Research, 1998; 2(1): Cover

About the Cover: Functional Magnetic resonance Imaging (fMRI), which measures the relative presence of oxy-hemoglobin, has gained attention as a non-invasive medium through which high resolution images of the brain and other tissue may be acquired. This technology may provide a useful assessment of cortical changes following chiropractic intervention. Images of the patient depicted on the cover, on the left, reflect cortical activity (lighted areas in the parietal cortex, frontal cortex areas 9, 10; visual association areas 19, 37, and 39) associated with the learning process of a “novel” muscular maneuver of the foot. Images on the right reflect cortical activity following a Network Spinal Analysis (form of chiropractic) adjustment session, taken approximately 20 minutes after the first set of images, involving the same activity. The decrease in “lighted” areas before and after the adjustment session suggests that less cortical “planning” or “activity” is associated with the “novel” foot maneuver. Thus, the ability of fMRI to visualize changes in cortical activity may play a significant role in elucidating the consequences of vertebral subluxation correction on neurological function.

An Impairment Rating Analysis Of Asthmatic Children Under Chiropractic Care
Graham R, Pistolese R. Journal of Vertebral Subluxation Research, 1997; 1(4): 41-48

A self-reported asthma-related impairment study was conducted on 81 children under chiropractic care. The intent of this study was to quantify self-reported changes in impairment experienced by the pediatric asthmatic subjects, before and after a two month period under chiropractic care. Practitioners, representing a general range of six different approaches to vertebral subluxation correction, administered a specifically designed asthma impairment questionnaire at the appropriate intervals. Subjects were categorized into two groups; 1-10 years and 11-17 years. Parents/guardians completed questionnaires for the younger group, while the older subjects self-reported their perceptions of impairment. Significantly lower impairment rating scores (improvement) were reported for 90.1% of subjects 60 days after chiropractic care when compared to the pre-chiropractic scores (p < 0.05) with an effect size of 0.96. As well, there were no significant differences across the age groups based on parent/guardian versus self rated scores. Girls reported higher (less improvement) before and after care compared to boys, although significant decreases in impairment ratings were reported for each gender. This suggested a greater clinical effect for boys which was supported by effect sizes ranging from 1.2 for boys compared to 0.75 for girls. Additionally, 25 of 81 subjects (30.9%) chose to voluntarily decrease their dosage of medication by an average of 66.5% while under chiropractic care. Moreover, information collected from patients revealed that among 24 patients reporting asthma “attacks” in the 30 day period prior to the study, the number of “attacks” decreased significantly by an average of 44.9% (p <.05). Based on the data obtained in this study, it was concluded that chiropractic care, for correction of vertebral subluxation, is a safe nonpharmacologic health care approach which may also be associated with significant decreases in asthma related impairment as well as a decreased incidence of asthmatic “attacks.” The findings suggest that chiropractic care should be further investigated relative to providing the most efficacious care management regimen for pediatric asthmatics.

[Note: NSA care was one of the chiropractic approaches used in this study supported by the Michigan Chiropractic Council]

A Retrospective Assessment of Network Care Using a Survey of Self-Rated Health, Wellness and Quality of Life
Blanks RH, Schuster TL, Dobson M. Journal of Vertebral Subluxation Research, 1997; 1(4): 15-31

The present study represents a retrospective characterization of Network Care, a health care discipline within the subluxation-based chiropractic model. Data were obtained from 156 Network offices (49% practitioner participation rate) in the United States, Canada, Australia, and Puerto Rico. Sociodemographic characterization of 2818 respondents, representing a 67-71% response rate, revealed a population predominately white, female, well-educated, professional, or white collar workers. A second objective of the study included the development and initial validation of a new health survey instrument. The instrument was specifically designed to assess wellness through patients’ self-rating different health domains and overall quality of life at two “time” points: “presently” and retrospectively, recalling their status before initiating care (“before Network”). Statistical evaluation employing Chronbach’s alpha and theta coefficients derived from principle components factor analyses, indicated a high level of internal reliability in regard to the survey instrument, as well as stable reliability of the retrospective recall method of self-rated perceptions of change as a function of duration of care. Results indicated that patients reported significant, positive perceived change (p < 0.000) in all four domains of health, as well as overall quality of life. Effect sizes for these difference scores were all large (>0.9). Wellness was assessed by summing the scores for the four health domains into a combined wellness scale, and comparing this combined scale “presently” and “before Network.” The difference, or “wellness coefficient” spanning a range of -1 to +1, with zero representing no change, showed positive, progressive increases over the duration of care intervals ranging from 1-3 months to over three years. The evidence of improved health in the four domains (physical state, mental/emotional state, stress evaluation, life enjoyment), overall quality of life from a standardized index, and the “wellness coefficient,” suggests that Network Care is associated with significant benefits. These benefits are evident from as early as 1-3 months under care, and appear to show continuing clinical improvements in the duration of care intervals studied, with no indication of a maximum clinical benefit. These findings are being further evaluated through longitudinal studies of current populations under care in combination with investigation of the neurophysiological mechanisms underlying its effects.

Network Spinal Analysis: A System of Health Care Delivery Within the Subluxation-Based Chiropractic Model
Epstein, D. Journal of Vertebral Subluxation Research, August 1996; 1(1): 51-59

The theoretical basis and clinical application of Network Spinal Analysis (NSA) is described. NSA delivers health care within the subluxation-based chiropractic model and seeks to contribute to the distinction of the various techniques and methods within the profession by describing and discussing its major characteristics. In this regard, clinical observations relative to the application of the Network Protocol have been described in relation to the monitoring of patient and practitioner outcomes. Relevant research from a separate Network Care retrospective study, which impacts on its characterization, profiles the patient population as predominantly female. Other data indicates that Network Care is widely and consistently practiced. Additionally, patients report significant, positive changes in health-related quality of life measures linked to certain clinical components of Network Care.
 

Visualization of a stationary CPG-revealing spinal wave* (Abstract from research at the University of Southern California, Professor Edmond Jonchkeere, et al.) 

Program of MEDICINE MEETS VIRTUAL REALITY 14 – ACCELERATING CHANGE IN HEALTH CARE: NEXT MEDICAL TOOLKIT* conference where Professor Jonchkeere will present a paper on the NSA Somatopsychic Wave (Prof. Jonckheere’s presentation is scheduled on pg. 20)

Paper Presentation accepted at the International Society of Quality of Life Research Conference in Prague, Czech Republic Nov. 12-15th, 2003 

Read the latest research articles on Surface Electromyography in Network Spinal Analysis™ (In order to view the files below, it is necessary that you have Adobe Acrobat Reader. If you do not have this please Click Here to download your free copy now.)

This research, which involves human subjects, has been approved by the University Park Institutional Review Board (IRB) of the University of Southern California

Network Spinal Analysis™: A Research Perspective

Statement of Efficacy

The Case Report 

Health & Wellness Quality of Life Questionnaire (Adobe Acrobat Reader Required)
(Questionnaire available to download free of charge courtesy of the Association for Network Care)

For more information on Network Spinal Analysis™  Research please visit the Association For Network Care website at www.associationfornetworkcare.com

Network Spinal Analysis,Somatopsychic Wave (Wave of Life), Birmingham.

Monday, April 19th, 2010

Network Spinal Analysis and Research

Network Spinal Analysis is a gentle and extremely effective style of chiropractic care used to evaluate and adjust the spine. The purpose of NSA is to allow restoration of proper nerve function for full health and peak performance. 

Network Spinal Analysis is a chiropractic technique developed in America in the early 80’s by Dr Donald Epstein. Network Spinal Analysis utilises light touches, specific body contacts and body positioning to develop breathing and body oscillations (or waves) that dissipate stored tension. NSA allows your body to develop new strategies to release this tension on its own. This promotes the clarity and flexibility a body needs to adapt to the challenges of our busy lives. 

How Does NSA Work?  

The spinal cord, in addition to being an electrical system, also conducts information through oscillation, or wave-like motion. Like an overstretched rubber band, the spinal cord tissues oscillate at a higher frequency, or “phase”, when they are under tension. As every cell of the body is connected via an elaborate nerve network to the spinal cord, any change in tension of the spinal cord affects the function of every cell in the body… all 75-100 trillion of them!   

From this, we found that most tension in the vertebra of the spine was secondary to tension patterns from the spinal cord. The stress of having too much to do and not enough time to do it is epidemic in our culture. Consistently high stress levels freeze the body in a “fight or flight” mode, tightening muscles, rounding shoulders, making breathing shallow, and limiting blood and oxygen to the parts of your brain responsible for relaxation, revitalization, creativity, and growth.   We find that a busy life is typically not the problem. The problem is an inability to shift gears and “unhook” from the stress-causing factors that are overwhelming you.
That’s why, instead of trying to mechanically adjust or align the spine through manipulation of the vertebra, a Network Chiropractor seeks to understand the physical, emotional, and mental factors related to the tension pattern and then find the specific points on the spine that will help the body resolve its tension using the exact amount of pressure that cues the brain from stress into ease. No twisting, popping, or cracking is necessary. 

The Network Chiropractor is using the principle of leverage. This is when they make the light gentle adjustments. The idea is like moving huge boulder without having to use a great deal of force if you use the leverage of a tree branch.
Putting the lever in the exact right place, at the right time with the right amount of light force, you can easily move the boulder. Likewise, Network Chiropractors are trained during post-graduate courses on Network Spinal Analysis to know the exact leverage point and manoeuvres to utilise on the spine to release tension to allow the body to find equilibrium. 

What scientific evidence do you have that your method works? 

NSA is one of the most researched methods in chiropractic. Network Spinal Analysis™ has been the subject of academic study, research and publication for its unprecedented effect in wellness and quality of life, adaptability to stress, enhanced life enjoyment, facilitation of constructive lifestyle changes. Also studies are being conducted as to its influence on the advancement and evolution of the nervous system’s strategies for self-organization.
A retrospective study of nearly 3,000 people through the University of California Irvine Medical College documented significant improvements in quality of life in the majority of people receiving Network Chiropractic care. 

The wave patterns that occur during a Network entrainment are the focus of University of Southern California mathematician professor Edmund Jonckheere, who is currently studying the relationship between these wave patterns and the energy-efficiency and adaptability of the nervous system.   

The Journal of Alternative and Complementary Medicine featured the evolving paradigm that contains NSA and SRI, called Reorganizational Healing, in May ’09. 

NSA Sessions 

The adjustments are made along the spine and are as gentle as the pressure that you could comfortably apply to your closed eyelid. 

  • You keep your clothes on (except your shoes) during a session.
  • Sessions last about 30-40 minutes.
  • The therapy is not painful, although the bodily sensations can be surprising and emotional releases during sessions are common.
  • Practitioners evaluate the client’s progress based on his or her self-reported experience.

Benefits of NSA 

Research has shown that as a spine, body and nervous system becomes healthier, physical wellbeing improves to provide more spinal flexibility, diminished symptoms and a greater ability to cope, developing an internal sense of wellness regardless of circumstances.
Examples of further additional benefits reported include: 

  • Less physical pain
  • Less tension or stiffness of the spine
  • Greater flexibility
  • Reduced allergies, eczema, asthma
  • Fewer colds flu & headaches
  • Less menstrual discomfort
  • Improved response to stress
  • Improved mental/emotional state
  • Improved life enjoyment
  • Improved overall quality of life

Basic care typically lasts 6 to 8 weeks, with 2 to 3 sessions per week. At the end of this period, clients generally report better body awareness, stronger spinal movement, and relief from discomfort and more ease in releasing tension.
After basic care sessions, you can choose to continue with treatment and enjoy wellness 

Network Spinal Analysis Research

The following is a list of peer-reviewed publications involving Network Spinal Analysis Care. Further information regarding Network Spinal Analysis Research currently in process or programs where information on Network Spinal Analysis Research has been presented is available at www.associationfornetworkcare.com

Improvement in Attention in Patients Undergoing Network Spinal Analysis: A Case Series Using Objective Measures of Attention
Pauli Y. Journal of Vertebral Subluxation Research, August 23, 2007; 1-9

Objective: Anecdotal preliminary evidence suggests that chiropractic care may be of benefits for individuals suffering from ADHD. This case series presents the improvement in attention experienced by 9 adult patients undergoing Network Spinal Analysis.

Methods: Nine adult patients are presented (4 male, 5 female) with a mean age of 40.4 years (range 22 – 58 years old). All patients were evaluated with the Test of Variable of Attention (TOVA) before receiving Network Spinal Analysis (NSA) care and at 2 months into care. The nine patients received level 1 NSA care for two months, as taught by the Association for Network Care. Neurospinal integrity was evaluated with palpation, as well as surface electromyography. Cognitive process of attention was objectively evaluated using a continuous performance test, the Test of Variables of Attention (TOVA).

Results: We evaluated our patient cohort before and after Network care using sEMG and variables from the continuous performance test (TOVA). Before care, all patients had an abnormal ADHD score with a mean of -3.74 (range: – 8.54 to -1.89). After 2 months of care, all patients had a significant change in ADHD score (p=0.08) and 88% completely normalized the ADHD score. 77% and 66% of patients experienced significant change in reaction time and variability score, respectively. All patients experienced a significant reduction in sEMG pattern of activation (p=0.08). We discuss possible mechanisms by which spinal care may have enhanced the function of the prefrontal cortex, thereby resulting in improved attentional capacities

Conclusion: In this case series the nine adult patients experienced significant improvement in attention, as measured by objective outcomes, after receiving two months of Network Spinal Analysis. The progress documented in this report suggests that NSA care may positively affect the brain by creating plastic changes in the prefrontal cortex and other cortical and subcortical areas serving as neural substrate for the cognitive process of attention. These findings may be of importance for individuals suffering from attention deficit. Further research into this area is greatly needed.

Quality of Life Improvements and Spontaneous Lifestyle Changes in a Patient Undergoing Subluxation-Centered Chiropractic Care: A Case Study
Pauli Y. Journal of Vertebral Subluxation Research, October 11, 2006; 1-15

Purpose of Study: This case study is to report the improvement in quality of life experienced by a patient undergoing subluxation-centered chiropractic care.

Clinical Features: A 36 year old male presented with primary health concerns of stress, eye pain and left leg pain of 14 years duration radiating to the foot and secondary complaints of gastritis, ulcers, nervousness, depression, lack of concentration and general loss of interest in daily life. The patient also smokes, does not exercise, eats a sub-optimal diet and rated his family and friends support, as well as job satisfaction as sufficient.

Intervention and Outcome: We discuss the various analyses employed to evaluate vertebral subluxations, including paraspinal surface electromyography and thermography. Adjustive care included a combination of Network Spinal Analysis, Torque Release Technique and diversified structural adjustments to correct vertebral subluxations over a six month period. We used visual analog scales, open-ended questions and selected items from the Self-Rated Health and Wellness Instrument to monitor health changes, as well as the positive improvements in quality of life as perceived by the patient himself.

Conclusion: This case study demonstrates that the correction of vertebral subluxations over an 11 month period was associated with significant improvements in the quality of life of the patient.

Chiropractic Care of a Battered Woman: A Case Study
Bedell L. Journal of Vertebral Subluxation Research, July 20, 2006; 1-6

Objective: This case study documents the chiropractic care of battered woman struggling with Intimate Partner Violence (IPV). Chiropractic offers battered women a unique service, it is the only profession trained and licensed to detect and correct vertebral subluxations. The relationship between the stresses of abuse and vertebral subluxation, as well as the subsequent changes during chiropractic care, are described.

Clinical Features: A Caucasian, 23-year old female presented with headaches, neck pain, and upper back pain. The initial complaint noted sharp, knife-like pains into the medial scapular borders, worse on the right side. Tingling extended into the right hand, most severe in the 2nd, 3rd, and 4th fingers.

Chiropractic care and outcome: Protocols of both Torque Release and Activator techniques were utilized to evaluate vertebral subluxations. Subjective quality of life issues were evaluated through a Network Spinal Analysis (NSA) Health Status Questionnaire. After commencing chiropractic care, this woman suffered a cervical spine hyper-extension/hyper-flexion type injury from an automobile accident. For the first 30 days after, adjustments were applied twice weekly. Acute exacerbations of symptoms unrelated to the original complaints were displayed and progress became irregular. During the next 60 days, there were various unexplained falls and severe flare-ups of painful symptoms, and she finally admitted to being battered by her husband. Referrals to counselors and programs dealing with domestic violence were provided. Once the physical battering stopped, consistent progress was noted in both clinical symptoms and quality of life issues.

Conclusion: As a battered woman must receive emotional and social support to improve her situation, it is important for chiropractors to recognize the “red flags” of IPV. Chiropractors re-evaluate regularly for changes in vertebral subluxation patterns and can recognize inconsistent responses. They may also be the first caregivers to offer a vitalistic approach; considering a woman’s physical, chemical, and emotional quality of life; a perspective that offers significant connection and trust. This article serves as a foundation on the topic of IPV and chiropractic, for use in both communities.

Wellness lifestyles II: Modeling the dynamic of wellness, health lifestyle practices, and Network Spinal Analysis.
Schuster TL, Dobson M, Jauregui M, Blanks RH. Journal of Alternative and Complimentary Medicine. April 2004;10(2):357-67.
PMID: 15165417

OBJECTIVE: Empirical application of a theoretical framework linking use of Network Spinal Analysis (NSA; a holistic, wellness-oriented form of complementary and alternative medicine [CAM]), health lifestyle practices, and self-reported health and wellness. DESIGN: Cross-sectional self-administered survey study. RESPONDENTS: Two thousand five hundred and ninety-six (2596) patients from 156 offices of doctors who were members of the Association for Network Chiropractic (currently titled Association for Network Care); estimated response rate was 69%. MEASURES: Exogenous variables entered into the structural equation model include gender, age, education, income, marital status, ailments, life change, and trauma. A wellness construct consisted of calculated difference scores between two referents, “presently” and “before Network” care, for self-reported items representing wellness domains of physical state, mental-emotional state, stress evaluation, and life enjoyment. Positive reported change in nine items assembled into dietary practices, health practices, and health risk dimensions serve as indicators of the construct of changes in health lifestyle practices. The NSA care construct consisted of duration of care in months, awareness of energy and awareness of breathing since beginning Network care. RESULTS: Of the exogenous variables only gender, age, and education remain in the final parsimonious structural equation model in these data. Reported wellness benefits accrue to individuals along a direct path from both self-reported positive lifestyle change (0.22), and from NSA care (0.43). The path (0.65) from NSA care to positive health lifestyle changes indicates that NSA care also has an indirect effect on wellness through changes in health lifestyle practices.

CONCLUSIONS: The Structural Equation model tested in these analyses lends support to our theoretical framework linking wellness, health lifestyles, and CAM. This study provides further evidence that our measurements of health and wellness are particularly appropriate for investigating wellness-oriented CAM. There is a positive relationship between the experience of NSA care and self-reported improvements in wellness as well as self-reported changes in lifestyle practices. NSA care users tend toward the practice of a positive health lifestyle, which also has a direct effect on reported improvements in wellness. These empirical links are discussed relative to the sociodemographic characteristics of this population and show that use of NSA care is an aspect of a wellness lifestyle.

Wellness lifestyles I: A theoretical framework linking wellness, health lifestyles, and complementary and alternative medicine.
Schuster TL, Dobson M, Jauregui M, Blanks RH. Journal of Alternative and Complimentary Medicine. April 2004;10(2):349-56.
PMID: 15165416

Scholarship concerning complementary and alternative medicine (CAM) practices within the United States could benefit from incorporating sociological perspectives into the development of a comprehensive research agenda. We review the literature on health and wellness emphasizing definitions and distinctions, the health lifestyles literature emphasizing issues of both life choices and life chances, and studies of CAM suggesting utilization as an aspect of a wellness lifestyle. This review forms the foundation of a new theoretical framework for CAM research based on the interrelationship of CAM with health promotion, wellness, and health lifestyles. To date, few studies have sought to bring these various elements together into a single, comprehensive model that would enable an assessment of the complexity of individual health and wellness in the context of CAM. We argue that attention to literatures on health measurement and health lifestyles are essential for exploring the effectiveness and continuing use of CAM.

The Transition of Network Spinal Analysis Care: Hallmarks of a Client-Centered Wellness Education Multi-Component System of Health Care Delivery
Epstein D. Journal of Vertebral Subluxation Research, April 5, 2004; 1-7

Network Spinal Analysis TM (NSA) care has been transitioned from a health care system with the objective of correction of two types of vertebral subluxation, to a multi-component system of health care delivery with emphasis on wellness education for participating clients. NSA care is now delivered and communicated in discrete Levels of Care with emphasis on client participation through self-evaluation. Emphasis on wellness education will be introduced into NSA practice through training via a Certificate Program currently under development. This paper considers some hallmarks that delineate a wellness education, patient (client)-centered practice. The concepts presented relative to this wellness model of health care delivery are believed to be applicable to any approach with similar practice objectives. The perspective presented considers that the major aspects of a patient-centered, wellness education health care delivery system is multi-dimensional. Hallmarks include differentiating terms, and establishing a wellness mentality. Substantiation of the discipline must be established through credible published research regarding its efficacy and safety as well as a consistent and valid means of measuring progressive outcomes derived from the care received. The relationship of NSA to other disciplines is discussed.

Successful In Vitro Fertilization in a Poor Responder While Under Network Spinal Analysis Care: A Case Report
Senzon SA. Journal of Vertebral Subluxation Research, September 14, 2003; 1-6

Objective: This case report describes the successful in vitro fertilization (IVF) of a 34 year old female who had one previous aborted IVF attempt prior to Network Spinal Analysis (NSA) care. This case report is being presented to add to other case reports that show positive physiological changes in patients receiving NSA care.

Clinical Features: The IVF was attempted due to her partner’s azoospermia. The first IVF attempt was on 3/26/02. The patient had a poor follicular growth after the standard hyper-stimulation process of the ovaries, including pre-treatment with Mircette (birth control pills) and 1mg/0.2ml of Lupron (a gonadotropin releasing hormone agonist), and 3-6 amps of Gonal-F (a recombinant fsh) starting on cycle day 3. Her baseline day 3 estradiol and LH levels were only 21.2pg/me and 5.0 I.U./L respectively. On cycle day 8, estradiol was only 56% and LH was 6.6 I.U./L. The Gonal-F was increased to 6amps. This first attempt was canceled due to the poor follicle growth. Only 3-4 follicles of insufficient size between 10-14mm each were found.

Chiropractic Care and Outcomes: On 4/11/02, the patient commenced regular NSA care. The second IVF attempt began on 6/6/02. The change in IVF protocol was the addition of Repronex (also a gonadotropin a combination of LH and fsh). The total increased dose of Gonal-F and Repronex was 6amps, compared to the first attempt of only 3amps which was then increased to 6amps of Gonal-F only.

Conclusion: On the second IVF attempt, estradiol was 1001pg/ml on day 8, and 2019pg/ml on day 11, with LH at 9.3. The Oocyte retrieval after the second attempt was 10 eggs, each approximately 18mm. A successful aspiration of eggs was completed on 6/17/02, and a successful pregnancy followed. The patient is still under NSA care, and is now in her second trimester with normal fetal heart sounds. The possible role of NSA care in the vigorous follicular growth and other health benefits is discussed.

Insult, Interference and Infertility: An Overview of Chiropractic Research
Behrendt M. Journal of Vertebral Subluxation Research, May 2, 2003; 1

Objective: Infertility is distinct from sterility, implying potential, and therefore raises questions as to what insult or interference influences this sluggish outcome. Interference in physiological function, as viewed by the application of chiropractic principles, suggests a neurological etiology and is approached through the mechanism of detection of vertebral subluxation and subsequent appropriate and specific adjustments to promote potential and function. Parental health and wellness prior to conception influences reproductive success and sustainability, begging efficient, effective consideration and interpretation of overall state and any distortion. A discussion of diverse articles is presented, describing the response to chiropractic care among subluxated infertile women.

Clinical Features: Fourteen retrospective articles are referenced, their diversity includes: all 15 subjects are female, ages 22-65; prior pregnancy history revealed 11 none, 2 successful unassisted, 1 assisted, 1 history of miscarriage. 9 had previous treatment for infertility, 4 were undergoing infertility treatment when starting chiropractic care. Presenting concerns included: severe low back pain, neck pain, colitis, diabetes, and female dysfunction such as absent or irregular menstrual cycle, blocked fallopian tubes, endometriosis, infertility, perimenopause and the fertility window within a religiousbased lifestyle, and a poor responder undergoing multiple cycles of IVF.

Chiropractic Care and Outcome: Outcomes of chiropractic care include but are not limited to benefits regarding neuromuscular concerns, as both historical and modern research describe associations with possible increased physiological functions, in this instance reproductive function. Chiropractic care and outcome are discussed, based on protocols of a variety of arts, including Applied Kinesiology (A.K.), Diversified, Directional Non-Force Technique (D.N.F.T.), Gonstead, Network Spinal Analysis (N.S.A.), Torque Release Technique (T.R.T.), Sacro Occipital Technique (S.O.T.) and Stucky-Thompson Terminal Point Technique. Care is described over a time frame of 1 to 20 months.

Conclusion: The application of chiropractic care and subsequent successful outcomes on reproductive integrity, regardless of factors including age, history and medical intervention, are described through a diversity of chiropractic arts. Future studies that may evaluate more formally and on a larger scale, the effectiveness, safety and cost benefits of chiropractic care on both well-being and physiological function are suggested, as well as pursuit of appropriate funding.

Chaotic Modeling in Network Spinal Analysis: Nonlinear Canonical Correlation with Alternating Conditional Expectation (ACE): A Preliminary Report
Bohacek S, Jonckheere E. Journal of Vertebral Subluxation Research, December 1998; 2(4): 188-195

Abstract – This paper presents a preliminary non-linear mathematical analysis of surface electromyographic (sEMG) signals from a subject receiving Network Spinal Analysis (NSA).The unfiltered sEMG data was collected over a bandwidth of 10-500 Hz and stored on a PC compatible computer. Electrodes were placed at the level of C1/C2,T6, L5, and S2 and voltage signals were recorded during the periods in which the patient was experiencing the “somatopsychic” wave, characteristic of NSA care. The intent of the preliminary study was to initiate mathematical characterization of the wave phenomenon relative to its “chaotic,” and/or nonlinear nature. In the present study the linear and nonlinear Canonical Correlation Analyses (CCA) have been used. The latter, nonlinear CCA, is coupled to specific implementation referred to as Alternating Conditional Expectation (ACE). Preliminary findings obtained by comparing canonical correlation coefficients (CCC’s) indicate that the ACE nonlinear functions of the sEMG waveform data lead to a smaller expected prediction error than if linear functions are used. In particular, the preliminary observations of larger nonlinear CCC’s compared to linear CCC’s indicate that there is some nonlinearity in the data representing the “somatopsychic” waveform. Further analysis of linear and nonlinear predictors indicates that 4th order nonlinear predictors perform 20 % better than linear predictors, and 10th order nonlinear predictors perform 30% better than linear predictors.This suggests that the waveform possesses a nonlinear “attractor” with a dimension between 4 and 10. Continued refinement of the ACE algorithm to allow for detection of more nonlinear distortions is expected to further clarify the extent to which the sEMG signal associated with the “somatopsychic” waveform of NSA is differentiated as nonlinear as opposed to random.

Reduction of Psoriasis in a Patient under Network Spinal Analysis Care: A Case Report
Behrendt M. Journal of Vertebral Subluxation Research, December 1998; 2(4): 196-200

This case report describes the progress of a 52 year old male with chronic psoriasis, first diagnosed in April of 1992. After the condition exacerbated over a five year period, he was placed on 12.5 mg/week methotrexate, and oral immunosuppressant medication in October of 1997.After commencing the medication, the condition reduced from 6% body coverage, with flares of 15-20%, to a body coverage of 5%. Following a cessation of the oral medication in February, 1998, the condition recurred at the previous uncontrolled level within one month. The patient was again placed on 12.5 mg/week methotrexate, and subsequently the condition reduced to 5% body coverage. The patient’s dose was reduced to 10 mg/week, and later to 7.5 mg/week, with the psoriasis remaining at 5% coverage. On 5/18/98, the patient commenced regular NSA care. He reported a reduction in the psoriasis condition on 6/3/98, and was taken off the oral medication on 6/25/98. The reduction continued, and the patient was advised by his medical physician on 7/01/98 to continue the cessation of oral medication. As of 9/30/98 the psoriasis had decreased to 0.5% to 1.0 % of coverage, and prior plans to initiate ultraviolet-A therapy were canceled. As of 11/98, a five month period since cessation of methotrexate, the patient has remained under regular NSA care, with no recurrence of psoriasis body coverage greater than 1%, the only medication being a topical ointment. This is contrasted to the recurrence after one month, following the patient’s first cessation of methotrexate, and prior to NSA care. The possible role of NSA care in the reduction of the patient’s psoriasis, and other health benefits is discussed.

Changes in Digital Skin Temperature, Surface Electromyography, and Electrodermal Activity in Subjects Receiving Network Spinal Analysis Care
Miller E, Redmond P. Journal of Vertebral Subluxation Research, June 1998; 2(2): 87-95

A preliminary study was conducted to evaluate changes in digital skin temperature (DST), surface electromyography (sEMG), and electrodermal activity (EDA) in a group of twenty subjects receiving Network Spinal Analysis (NSA) care. Data, simultaneously derived from all three parameters, were considered to be indirect correlates of sympathetic nervous system activity. Subjects, including a group of five controls, were assessed for a period of 17 minutes. The continuous assessment period included a baseline interval of 4.5 minutes, followed by a 12.5 minute period which was divided into five 2.5 minute intervals. Care was administered to the NSA recipient group immediately after the baseline period, whereas controls received no intervention following baseline. Results revealed no significant differences in DST either within or between the two groups. Surface EMG readings were relatively constant over the five intervals following baseline in the NSA group, while controls showed significant (p < 0.05) increases in sEMG at the second through fifth intervals relative to the first interval following baseline activity. Electrodermal activity was significantly decreased (p < 0.01) in the NSA group in the second through fifth intervals compared to baseline. Moreover, decreases varied between intervals, but exhibited a leveling from the third through fifth interval. Control subjects, alternatively, exhibited an increase in EDA in all intervals following baseline. The extent of increase resulted in EDA activity significantly greater than the NSA group at the third through fifth intervals. It was concluded that the increase in EMG activity in the control groups may have reflected an increasing level of anxiety due to the duration of the recording period. Since the NSA group expressed constancy in sEMG activity during the same period, coupled to significant decreases in EDA, a “sympathetic quieting effect” was postulated to occur in subjects receiving NSA care. This conclusion is consistent with hypothesized neurological pathways linked to responses observed during NSA care, as well as other reports of self-reported improvements in mental/emotional state and stress reduction in patients receiving Network Chiropractic Care.

Functional Magnetic Resonance Imaging: About the Cover
Journal of Vertebral Subluxation Research, 1998; 2(1): Cover

About the Cover: Functional Magnetic resonance Imaging (fMRI), which measures the relative presence of oxy-hemoglobin, has gained attention as a non-invasive medium through which high resolution images of the brain and other tissue may be acquired. This technology may provide a useful assessment of cortical changes following chiropractic intervention. Images of the patient depicted on the cover, on the left, reflect cortical activity (lighted areas in the parietal cortex, frontal cortex areas 9, 10; visual association areas 19, 37, and 39) associated with the learning process of a “novel” muscular maneuver of the foot. Images on the right reflect cortical activity following a Network Spinal Analysis (form of chiropractic) adjustment session, taken approximately 20 minutes after the first set of images, involving the same activity. The decrease in “lighted” areas before and after the adjustment session suggests that less cortical “planning” or “activity” is associated with the “novel” foot maneuver. Thus, the ability of fMRI to visualize changes in cortical activity may play a significant role in elucidating the consequences of vertebral subluxation correction on neurological function.

An Impairment Rating Analysis Of Asthmatic Children Under Chiropractic Care
Graham R, Pistolese R. Journal of Vertebral Subluxation Research, 1997; 1(4): 41-48

A self-reported asthma-related impairment study was conducted on 81 children under chiropractic care. The intent of this study was to quantify self-reported changes in impairment experienced by the pediatric asthmatic subjects, before and after a two month period under chiropractic care. Practitioners, representing a general range of six different approaches to vertebral subluxation correction, administered a specifically designed asthma impairment questionnaire at the appropriate intervals. Subjects were categorized into two groups; 1-10 years and 11-17 years. Parents/guardians completed questionnaires for the younger group, while the older subjects self-reported their perceptions of impairment. Significantly lower impairment rating scores (improvement) were reported for 90.1% of subjects 60 days after chiropractic care when compared to the pre-chiropractic scores (p < 0.05) with an effect size of 0.96. As well, there were no significant differences across the age groups based on parent/guardian versus self rated scores. Girls reported higher (less improvement) before and after care compared to boys, although significant decreases in impairment ratings were reported for each gender. This suggested a greater clinical effect for boys which was supported by effect sizes ranging from 1.2 for boys compared to 0.75 for girls. Additionally, 25 of 81 subjects (30.9%) chose to voluntarily decrease their dosage of medication by an average of 66.5% while under chiropractic care. Moreover, information collected from patients revealed that among 24 patients reporting asthma “attacks” in the 30 day period prior to the study, the number of “attacks” decreased significantly by an average of 44.9% (p <.05). Based on the data obtained in this study, it was concluded that chiropractic care, for correction of vertebral subluxation, is a safe nonpharmacologic health care approach which may also be associated with significant decreases in asthma related impairment as well as a decreased incidence of asthmatic “attacks.” The findings suggest that chiropractic care should be further investigated relative to providing the most efficacious care management regimen for pediatric asthmatics.

[Note: NSA care was one of the chiropractic approaches used in this study supported by the Michigan Chiropractic Council]

A Retrospective Assessment of Network Care Using a Survey of Self-Rated Health, Wellness and Quality of Life
Blanks RH, Schuster TL, Dobson M. Journal of Vertebral Subluxation Research, 1997; 1(4): 15-31

The present study represents a retrospective characterization of Network Care, a health care discipline within the subluxation-based chiropractic model. Data were obtained from 156 Network offices (49% practitioner participation rate) in the United States, Canada, Australia, and Puerto Rico. Sociodemographic characterization of 2818 respondents, representing a 67-71% response rate, revealed a population predominately white, female, well-educated, professional, or white collar workers. A second objective of the study included the development and initial validation of a new health survey instrument. The instrument was specifically designed to assess wellness through patients’ self-rating different health domains and overall quality of life at two “time” points: “presently” and retrospectively, recalling their status before initiating care (“before Network”). Statistical evaluation employing Chronbach’s alpha and theta coefficients derived from principle components factor analyses, indicated a high level of internal reliability in regard to the survey instrument, as well as stable reliability of the retrospective recall method of self-rated perceptions of change as a function of duration of care. Results indicated that patients reported significant, positive perceived change (p < 0.000) in all four domains of health, as well as overall quality of life. Effect sizes for these difference scores were all large (>0.9). Wellness was assessed by summing the scores for the four health domains into a combined wellness scale, and comparing this combined scale “presently” and “before Network.” The difference, or “wellness coefficient” spanning a range of -1 to +1, with zero representing no change, showed positive, progressive increases over the duration of care intervals ranging from 1-3 months to over three years. The evidence of improved health in the four domains (physical state, mental/emotional state, stress evaluation, life enjoyment), overall quality of life from a standardized index, and the “wellness coefficient,” suggests that Network Care is associated with significant benefits. These benefits are evident from as early as 1-3 months under care, and appear to show continuing clinical improvements in the duration of care intervals studied, with no indication of a maximum clinical benefit. These findings are being further evaluated through longitudinal studies of current populations under care in combination with investigation of the neurophysiological mechanisms underlying its effects.

Network Spinal Analysis: A System of Health Care Delivery Within the Subluxation-Based Chiropractic Model
Epstein, D. Journal of Vertebral Subluxation Research, August 1996; 1(1): 51-59

The theoretical basis and clinical application of Network Spinal Analysis (NSA) is described. NSA delivers health care within the subluxation-based chiropractic model and seeks to contribute to the distinction of the various techniques and methods within the profession by describing and discussing its major characteristics. In this regard, clinical observations relative to the application of the Network Protocol have been described in relation to the monitoring of patient and practitioner outcomes. Relevant research from a separate Network Care retrospective study, which impacts on its characterization, profiles the patient population as predominantly female. Other data indicates that Network Care is widely and consistently practiced. Additionally, patients report significant, positive changes in health-related quality of life measures linked to certain clinical components of Network Care.
 

Visualization of a stationary CPG-revealing spinal wave* (Abstract from research at the University of Southern California, Professor Edmond Jonchkeere, et al.) 

Program of MEDICINE MEETS VIRTUAL REALITY 14 – ACCELERATING CHANGE IN HEALTH CARE: NEXT MEDICAL TOOLKIT* conference where Professor Jonchkeere will present a paper on the NSA Somatopsychic Wave (Prof. Jonckheere’s presentation is scheduled on pg. 20)

Paper Presentation accepted at the International Society of Quality of Life Research Conference in Prague, Czech Republic Nov. 12-15th, 2003 

Read the latest research articles on Surface Electromyography in Network Spinal Analysis™ (In order to view the files below, it is necessary that you have Adobe Acrobat Reader. If you do not have this please Click Here to download your free copy now.)

This research, which involves human subjects, has been approved by the University Park Institutional Review Board (IRB) of the University of Southern California

Network Spinal Analysis™: A Research Perspective

Statement of Efficacy

The Case Report 

Health & Wellness Quality of Life Questionnaire (Adobe Acrobat Reader Required)
(Questionnaire available to download free of charge courtesy of the Association for Network Care)

For more information on Network Spinal Analysis™  Research please visit the Association For Network Care website at www.associationfornetworkcare.com

Network Spinal Analysis,Somatopsychic Wave (Wave of Life)

Monday, April 19th, 2010

Network Spinal Analysis and Research

Network Spinal Analysis is a gentle and extremely effective style of chiropractic care used to evaluate and adjust the spine. The purpose of NSA is to allow restoration of proper nerve function for full health and peak performance. 

Network Spinal Analysis is a chiropractic technique developed in America in the early 80’s by Dr Donald Epstein. Network Spinal Analysis utilises light touches, specific body contacts and body positioning to develop breathing and body oscillations (or waves) that dissipate stored tension. NSA allows your body to develop new strategies to release this tension on its own. This promotes the clarity and flexibility a body needs to adapt to the challenges of our busy lives. 

How Does NSA Work?  

The spinal cord, in addition to being an electrical system, also conducts information through oscillation, or wave-like motion. Like an overstretched rubber band, the spinal cord tissues oscillate at a higher frequency, or “phase”, when they are under tension. As every cell of the body is connected via an elaborate nerve network to the spinal cord, any change in tension of the spinal cord affects the function of every cell in the body… all 75-100 trillion of them!   

From this, we found that most tension in the vertebra of the spine was secondary to tension patterns from the spinal cord. The stress of having too much to do and not enough time to do it is epidemic in our culture. Consistently high stress levels freeze the body in a “fight or flight” mode, tightening muscles, rounding shoulders, making breathing shallow, and limiting blood and oxygen to the parts of your brain responsible for relaxation, revitalization, creativity, and growth.   We find that a busy life is typically not the problem. The problem is an inability to shift gears and “unhook” from the stress-causing factors that are overwhelming you.
That’s why, instead of trying to mechanically adjust or align the spine through manipulation of the vertebra, a Network Chiropractor seeks to understand the physical, emotional, and mental factors related to the tension pattern and then find the specific points on the spine that will help the body resolve its tension using the exact amount of pressure that cues the brain from stress into ease. No twisting, popping, or cracking is necessary. 

The Network Chiropractor is using the principle of leverage. This is when they make the light gentle adjustments. The idea is like moving huge boulder without having to use a great deal of force if you use the leverage of a tree branch.
Putting the lever in the exact right place, at the right time with the right amount of light force, you can easily move the boulder. Likewise, Network Chiropractors are trained during post-graduate courses on Network Spinal Analysis to know the exact leverage point and manoeuvres to utilise on the spine to release tension to allow the body to find equilibrium. 

What scientific evidence do you have that your method works? 

NSA is one of the most researched methods in chiropractic. Network Spinal Analysis™ has been the subject of academic study, research and publication for its unprecedented effect in wellness and quality of life, adaptability to stress, enhanced life enjoyment, facilitation of constructive lifestyle changes. Also studies are being conducted as to its influence on the advancement and evolution of the nervous system’s strategies for self-organization.
A retrospective study of nearly 3,000 people through the University of California Irvine Medical College documented significant improvements in quality of life in the majority of people receiving Network Chiropractic care. 

The wave patterns that occur during a Network entrainment are the focus of University of Southern California mathematician professor Edmund Jonckheere, who is currently studying the relationship between these wave patterns and the energy-efficiency and adaptability of the nervous system.   

The Journal of Alternative and Complementary Medicine featured the evolving paradigm that contains NSA and SRI, called Reorganizational Healing, in May ’09. 

NSA Sessions 

The adjustments are made along the spine and are as gentle as the pressure that you could comfortably apply to your closed eyelid. 

  • You keep your clothes on (except your shoes) during a session.
  • Sessions last about 30-40 minutes.
  • The therapy is not painful, although the bodily sensations can be surprising and emotional releases during sessions are common.
  • Practitioners evaluate the client’s progress based on his or her self-reported experience.

Benefits of NSA 

Research has shown that as a spine, body and nervous system becomes healthier, physical wellbeing improves to provide more spinal flexibility, diminished symptoms and a greater ability to cope, developing an internal sense of wellness regardless of circumstances.
Examples of further additional benefits reported include: 

  • Less physical pain
  • Less tension or stiffness of the spine
  • Greater flexibility
  • Reduced allergies, eczema, asthma
  • Fewer colds flu & headaches
  • Less menstrual discomfort
  • Improved response to stress
  • Improved mental/emotional state
  • Improved life enjoyment
  • Improved overall quality of life

Basic care typically lasts 6 to 8 weeks, with 2 to 3 sessions per week. At the end of this period, clients generally report better body awareness, stronger spinal movement, and relief from discomfort and more ease in releasing tension.
After basic care sessions, you can choose to continue with treatment and enjoy wellness 

Network Spinal Analysis Research

The following is a list of peer-reviewed publications involving Network Spinal Analysis Care. Further information regarding Network Spinal Analysis Research currently in process or programs where information on Network Spinal Analysis Research has been presented is available at www.associationfornetworkcare.com

Improvement in Attention in Patients Undergoing Network Spinal Analysis: A Case Series Using Objective Measures of Attention
Pauli Y. Journal of Vertebral Subluxation Research, August 23, 2007; 1-9

Objective: Anecdotal preliminary evidence suggests that chiropractic care may be of benefits for individuals suffering from ADHD. This case series presents the improvement in attention experienced by 9 adult patients undergoing Network Spinal Analysis.

Methods: Nine adult patients are presented (4 male, 5 female) with a mean age of 40.4 years (range 22 – 58 years old). All patients were evaluated with the Test of Variable of Attention (TOVA) before receiving Network Spinal Analysis (NSA) care and at 2 months into care. The nine patients received level 1 NSA care for two months, as taught by the Association for Network Care. Neurospinal integrity was evaluated with palpation, as well as surface electromyography. Cognitive process of attention was objectively evaluated using a continuous performance test, the Test of Variables of Attention (TOVA).

Results: We evaluated our patient cohort before and after Network care using sEMG and variables from the continuous performance test (TOVA). Before care, all patients had an abnormal ADHD score with a mean of -3.74 (range: – 8.54 to -1.89). After 2 months of care, all patients had a significant change in ADHD score (p=0.08) and 88% completely normalized the ADHD score. 77% and 66% of patients experienced significant change in reaction time and variability score, respectively. All patients experienced a significant reduction in sEMG pattern of activation (p=0.08). We discuss possible mechanisms by which spinal care may have enhanced the function of the prefrontal cortex, thereby resulting in improved attentional capacities

Conclusion: In this case series the nine adult patients experienced significant improvement in attention, as measured by objective outcomes, after receiving two months of Network Spinal Analysis. The progress documented in this report suggests that NSA care may positively affect the brain by creating plastic changes in the prefrontal cortex and other cortical and subcortical areas serving as neural substrate for the cognitive process of attention. These findings may be of importance for individuals suffering from attention deficit. Further research into this area is greatly needed.

Quality of Life Improvements and Spontaneous Lifestyle Changes in a Patient Undergoing Subluxation-Centered Chiropractic Care: A Case Study
Pauli Y. Journal of Vertebral Subluxation Research, October 11, 2006; 1-15

Purpose of Study: This case study is to report the improvement in quality of life experienced by a patient undergoing subluxation-centered chiropractic care.

Clinical Features: A 36 year old male presented with primary health concerns of stress, eye pain and left leg pain of 14 years duration radiating to the foot and secondary complaints of gastritis, ulcers, nervousness, depression, lack of concentration and general loss of interest in daily life. The patient also smokes, does not exercise, eats a sub-optimal diet and rated his family and friends support, as well as job satisfaction as sufficient.

Intervention and Outcome: We discuss the various analyses employed to evaluate vertebral subluxations, including paraspinal surface electromyography and thermography. Adjustive care included a combination of Network Spinal Analysis, Torque Release Technique and diversified structural adjustments to correct vertebral subluxations over a six month period. We used visual analog scales, open-ended questions and selected items from the Self-Rated Health and Wellness Instrument to monitor health changes, as well as the positive improvements in quality of life as perceived by the patient himself.

Conclusion: This case study demonstrates that the correction of vertebral subluxations over an 11 month period was associated with significant improvements in the quality of life of the patient.

Chiropractic Care of a Battered Woman: A Case Study
Bedell L. Journal of Vertebral Subluxation Research, July 20, 2006; 1-6

Objective: This case study documents the chiropractic care of battered woman struggling with Intimate Partner Violence (IPV). Chiropractic offers battered women a unique service, it is the only profession trained and licensed to detect and correct vertebral subluxations. The relationship between the stresses of abuse and vertebral subluxation, as well as the subsequent changes during chiropractic care, are described.

Clinical Features: A Caucasian, 23-year old female presented with headaches, neck pain, and upper back pain. The initial complaint noted sharp, knife-like pains into the medial scapular borders, worse on the right side. Tingling extended into the right hand, most severe in the 2nd, 3rd, and 4th fingers.

Chiropractic care and outcome: Protocols of both Torque Release and Activator techniques were utilized to evaluate vertebral subluxations. Subjective quality of life issues were evaluated through a Network Spinal Analysis (NSA) Health Status Questionnaire. After commencing chiropractic care, this woman suffered a cervical spine hyper-extension/hyper-flexion type injury from an automobile accident. For the first 30 days after, adjustments were applied twice weekly. Acute exacerbations of symptoms unrelated to the original complaints were displayed and progress became irregular. During the next 60 days, there were various unexplained falls and severe flare-ups of painful symptoms, and she finally admitted to being battered by her husband. Referrals to counselors and programs dealing with domestic violence were provided. Once the physical battering stopped, consistent progress was noted in both clinical symptoms and quality of life issues.

Conclusion: As a battered woman must receive emotional and social support to improve her situation, it is important for chiropractors to recognize the “red flags” of IPV. Chiropractors re-evaluate regularly for changes in vertebral subluxation patterns and can recognize inconsistent responses. They may also be the first caregivers to offer a vitalistic approach; considering a woman’s physical, chemical, and emotional quality of life; a perspective that offers significant connection and trust. This article serves as a foundation on the topic of IPV and chiropractic, for use in both communities.

Wellness lifestyles II: Modeling the dynamic of wellness, health lifestyle practices, and Network Spinal Analysis.
Schuster TL, Dobson M, Jauregui M, Blanks RH. Journal of Alternative and Complimentary Medicine. April 2004;10(2):357-67.
PMID: 15165417

OBJECTIVE: Empirical application of a theoretical framework linking use of Network Spinal Analysis (NSA; a holistic, wellness-oriented form of complementary and alternative medicine [CAM]), health lifestyle practices, and self-reported health and wellness. DESIGN: Cross-sectional self-administered survey study. RESPONDENTS: Two thousand five hundred and ninety-six (2596) patients from 156 offices of doctors who were members of the Association for Network Chiropractic (currently titled Association for Network Care); estimated response rate was 69%. MEASURES: Exogenous variables entered into the structural equation model include gender, age, education, income, marital status, ailments, life change, and trauma. A wellness construct consisted of calculated difference scores between two referents, “presently” and “before Network” care, for self-reported items representing wellness domains of physical state, mental-emotional state, stress evaluation, and life enjoyment. Positive reported change in nine items assembled into dietary practices, health practices, and health risk dimensions serve as indicators of the construct of changes in health lifestyle practices. The NSA care construct consisted of duration of care in months, awareness of energy and awareness of breathing since beginning Network care. RESULTS: Of the exogenous variables only gender, age, and education remain in the final parsimonious structural equation model in these data. Reported wellness benefits accrue to individuals along a direct path from both self-reported positive lifestyle change (0.22), and from NSA care (0.43). The path (0.65) from NSA care to positive health lifestyle changes indicates that NSA care also has an indirect effect on wellness through changes in health lifestyle practices.

CONCLUSIONS: The Structural Equation model tested in these analyses lends support to our theoretical framework linking wellness, health lifestyles, and CAM. This study provides further evidence that our measurements of health and wellness are particularly appropriate for investigating wellness-oriented CAM. There is a positive relationship between the experience of NSA care and self-reported improvements in wellness as well as self-reported changes in lifestyle practices. NSA care users tend toward the practice of a positive health lifestyle, which also has a direct effect on reported improvements in wellness. These empirical links are discussed relative to the sociodemographic characteristics of this population and show that use of NSA care is an aspect of a wellness lifestyle.

Wellness lifestyles I: A theoretical framework linking wellness, health lifestyles, and complementary and alternative medicine.
Schuster TL, Dobson M, Jauregui M, Blanks RH. Journal of Alternative and Complimentary Medicine. April 2004;10(2):349-56.
PMID: 15165416

Scholarship concerning complementary and alternative medicine (CAM) practices within the United States could benefit from incorporating sociological perspectives into the development of a comprehensive research agenda. We review the literature on health and wellness emphasizing definitions and distinctions, the health lifestyles literature emphasizing issues of both life choices and life chances, and studies of CAM suggesting utilization as an aspect of a wellness lifestyle. This review forms the foundation of a new theoretical framework for CAM research based on the interrelationship of CAM with health promotion, wellness, and health lifestyles. To date, few studies have sought to bring these various elements together into a single, comprehensive model that would enable an assessment of the complexity of individual health and wellness in the context of CAM. We argue that attention to literatures on health measurement and health lifestyles are essential for exploring the effectiveness and continuing use of CAM.

The Transition of Network Spinal Analysis Care: Hallmarks of a Client-Centered Wellness Education Multi-Component System of Health Care Delivery
Epstein D. Journal of Vertebral Subluxation Research, April 5, 2004; 1-7

Network Spinal Analysis TM (NSA) care has been transitioned from a health care system with the objective of correction of two types of vertebral subluxation, to a multi-component system of health care delivery with emphasis on wellness education for participating clients. NSA care is now delivered and communicated in discrete Levels of Care with emphasis on client participation through self-evaluation. Emphasis on wellness education will be introduced into NSA practice through training via a Certificate Program currently under development. This paper considers some hallmarks that delineate a wellness education, patient (client)-centered practice. The concepts presented relative to this wellness model of health care delivery are believed to be applicable to any approach with similar practice objectives. The perspective presented considers that the major aspects of a patient-centered, wellness education health care delivery system is multi-dimensional. Hallmarks include differentiating terms, and establishing a wellness mentality. Substantiation of the discipline must be established through credible published research regarding its efficacy and safety as well as a consistent and valid means of measuring progressive outcomes derived from the care received. The relationship of NSA to other disciplines is discussed.

Successful In Vitro Fertilization in a Poor Responder While Under Network Spinal Analysis Care: A Case Report
Senzon SA. Journal of Vertebral Subluxation Research, September 14, 2003; 1-6

Objective: This case report describes the successful in vitro fertilization (IVF) of a 34 year old female who had one previous aborted IVF attempt prior to Network Spinal Analysis (NSA) care. This case report is being presented to add to other case reports that show positive physiological changes in patients receiving NSA care.

Clinical Features: The IVF was attempted due to her partner’s azoospermia. The first IVF attempt was on 3/26/02. The patient had a poor follicular growth after the standard hyper-stimulation process of the ovaries, including pre-treatment with Mircette (birth control pills) and 1mg/0.2ml of Lupron (a gonadotropin releasing hormone agonist), and 3-6 amps of Gonal-F (a recombinant fsh) starting on cycle day 3. Her baseline day 3 estradiol and LH levels were only 21.2pg/me and 5.0 I.U./L respectively. On cycle day 8, estradiol was only 56% and LH was 6.6 I.U./L. The Gonal-F was increased to 6amps. This first attempt was canceled due to the poor follicle growth. Only 3-4 follicles of insufficient size between 10-14mm each were found.

Chiropractic Care and Outcomes: On 4/11/02, the patient commenced regular NSA care. The second IVF attempt began on 6/6/02. The change in IVF protocol was the addition of Repronex (also a gonadotropin a combination of LH and fsh). The total increased dose of Gonal-F and Repronex was 6amps, compared to the first attempt of only 3amps which was then increased to 6amps of Gonal-F only.

Conclusion: On the second IVF attempt, estradiol was 1001pg/ml on day 8, and 2019pg/ml on day 11, with LH at 9.3. The Oocyte retrieval after the second attempt was 10 eggs, each approximately 18mm. A successful aspiration of eggs was completed on 6/17/02, and a successful pregnancy followed. The patient is still under NSA care, and is now in her second trimester with normal fetal heart sounds. The possible role of NSA care in the vigorous follicular growth and other health benefits is discussed.

Insult, Interference and Infertility: An Overview of Chiropractic Research
Behrendt M. Journal of Vertebral Subluxation Research, May 2, 2003; 1

Objective: Infertility is distinct from sterility, implying potential, and therefore raises questions as to what insult or interference influences this sluggish outcome. Interference in physiological function, as viewed by the application of chiropractic principles, suggests a neurological etiology and is approached through the mechanism of detection of vertebral subluxation and subsequent appropriate and specific adjustments to promote potential and function. Parental health and wellness prior to conception influences reproductive success and sustainability, begging efficient, effective consideration and interpretation of overall state and any distortion. A discussion of diverse articles is presented, describing the response to chiropractic care among subluxated infertile women.

Clinical Features: Fourteen retrospective articles are referenced, their diversity includes: all 15 subjects are female, ages 22-65; prior pregnancy history revealed 11 none, 2 successful unassisted, 1 assisted, 1 history of miscarriage. 9 had previous treatment for infertility, 4 were undergoing infertility treatment when starting chiropractic care. Presenting concerns included: severe low back pain, neck pain, colitis, diabetes, and female dysfunction such as absent or irregular menstrual cycle, blocked fallopian tubes, endometriosis, infertility, perimenopause and the fertility window within a religiousbased lifestyle, and a poor responder undergoing multiple cycles of IVF.

Chiropractic Care and Outcome: Outcomes of chiropractic care include but are not limited to benefits regarding neuromuscular concerns, as both historical and modern research describe associations with possible increased physiological functions, in this instance reproductive function. Chiropractic care and outcome are discussed, based on protocols of a variety of arts, including Applied Kinesiology (A.K.), Diversified, Directional Non-Force Technique (D.N.F.T.), Gonstead, Network Spinal Analysis (N.S.A.), Torque Release Technique (T.R.T.), Sacro Occipital Technique (S.O.T.) and Stucky-Thompson Terminal Point Technique. Care is described over a time frame of 1 to 20 months.

Conclusion: The application of chiropractic care and subsequent successful outcomes on reproductive integrity, regardless of factors including age, history and medical intervention, are described through a diversity of chiropractic arts. Future studies that may evaluate more formally and on a larger scale, the effectiveness, safety and cost benefits of chiropractic care on both well-being and physiological function are suggested, as well as pursuit of appropriate funding.

Chaotic Modeling in Network Spinal Analysis: Nonlinear Canonical Correlation with Alternating Conditional Expectation (ACE): A Preliminary Report
Bohacek S, Jonckheere E. Journal of Vertebral Subluxation Research, December 1998; 2(4): 188-195

Abstract – This paper presents a preliminary non-linear mathematical analysis of surface electromyographic (sEMG) signals from a subject receiving Network Spinal Analysis (NSA).The unfiltered sEMG data was collected over a bandwidth of 10-500 Hz and stored on a PC compatible computer. Electrodes were placed at the level of C1/C2,T6, L5, and S2 and voltage signals were recorded during the periods in which the patient was experiencing the “somatopsychic” wave, characteristic of NSA care. The intent of the preliminary study was to initiate mathematical characterization of the wave phenomenon relative to its “chaotic,” and/or nonlinear nature. In the present study the linear and nonlinear Canonical Correlation Analyses (CCA) have been used. The latter, nonlinear CCA, is coupled to specific implementation referred to as Alternating Conditional Expectation (ACE). Preliminary findings obtained by comparing canonical correlation coefficients (CCC’s) indicate that the ACE nonlinear functions of the sEMG waveform data lead to a smaller expected prediction error than if linear functions are used. In particular, the preliminary observations of larger nonlinear CCC’s compared to linear CCC’s indicate that there is some nonlinearity in the data representing the “somatopsychic” waveform. Further analysis of linear and nonlinear predictors indicates that 4th order nonlinear predictors perform 20 % better than linear predictors, and 10th order nonlinear predictors perform 30% better than linear predictors.This suggests that the waveform possesses a nonlinear “attractor” with a dimension between 4 and 10. Continued refinement of the ACE algorithm to allow for detection of more nonlinear distortions is expected to further clarify the extent to which the sEMG signal associated with the “somatopsychic” waveform of NSA is differentiated as nonlinear as opposed to random.

Reduction of Psoriasis in a Patient under Network Spinal Analysis Care: A Case Report
Behrendt M. Journal of Vertebral Subluxation Research, December 1998; 2(4): 196-200

This case report describes the progress of a 52 year old male with chronic psoriasis, first diagnosed in April of 1992. After the condition exacerbated over a five year period, he was placed on 12.5 mg/week methotrexate, and oral immunosuppressant medication in October of 1997.After commencing the medication, the condition reduced from 6% body coverage, with flares of 15-20%, to a body coverage of 5%. Following a cessation of the oral medication in February, 1998, the condition recurred at the previous uncontrolled level within one month. The patient was again placed on 12.5 mg/week methotrexate, and subsequently the condition reduced to 5% body coverage. The patient’s dose was reduced to 10 mg/week, and later to 7.5 mg/week, with the psoriasis remaining at 5% coverage. On 5/18/98, the patient commenced regular NSA care. He reported a reduction in the psoriasis condition on 6/3/98, and was taken off the oral medication on 6/25/98. The reduction continued, and the patient was advised by his medical physician on 7/01/98 to continue the cessation of oral medication. As of 9/30/98 the psoriasis had decreased to 0.5% to 1.0 % of coverage, and prior plans to initiate ultraviolet-A therapy were canceled. As of 11/98, a five month period since cessation of methotrexate, the patient has remained under regular NSA care, with no recurrence of psoriasis body coverage greater than 1%, the only medication being a topical ointment. This is contrasted to the recurrence after one month, following the patient’s first cessation of methotrexate, and prior to NSA care. The possible role of NSA care in the reduction of the patient’s psoriasis, and other health benefits is discussed.

Changes in Digital Skin Temperature, Surface Electromyography, and Electrodermal Activity in Subjects Receiving Network Spinal Analysis Care
Miller E, Redmond P. Journal of Vertebral Subluxation Research, June 1998; 2(2): 87-95

A preliminary study was conducted to evaluate changes in digital skin temperature (DST), surface electromyography (sEMG), and electrodermal activity (EDA) in a group of twenty subjects receiving Network Spinal Analysis (NSA) care. Data, simultaneously derived from all three parameters, were considered to be indirect correlates of sympathetic nervous system activity. Subjects, including a group of five controls, were assessed for a period of 17 minutes. The continuous assessment period included a baseline interval of 4.5 minutes, followed by a 12.5 minute period which was divided into five 2.5 minute intervals. Care was administered to the NSA recipient group immediately after the baseline period, whereas controls received no intervention following baseline. Results revealed no significant differences in DST either within or between the two groups. Surface EMG readings were relatively constant over the five intervals following baseline in the NSA group, while controls showed significant (p < 0.05) increases in sEMG at the second through fifth intervals relative to the first interval following baseline activity. Electrodermal activity was significantly decreased (p < 0.01) in the NSA group in the second through fifth intervals compared to baseline. Moreover, decreases varied between intervals, but exhibited a leveling from the third through fifth interval. Control subjects, alternatively, exhibited an increase in EDA in all intervals following baseline. The extent of increase resulted in EDA activity significantly greater than the NSA group at the third through fifth intervals. It was concluded that the increase in EMG activity in the control groups may have reflected an increasing level of anxiety due to the duration of the recording period. Since the NSA group expressed constancy in sEMG activity during the same period, coupled to significant decreases in EDA, a “sympathetic quieting effect” was postulated to occur in subjects receiving NSA care. This conclusion is consistent with hypothesized neurological pathways linked to responses observed during NSA care, as well as other reports of self-reported improvements in mental/emotional state and stress reduction in patients receiving Network Chiropractic Care.

Functional Magnetic Resonance Imaging: About the Cover
Journal of Vertebral Subluxation Research, 1998; 2(1): Cover

About the Cover: Functional Magnetic resonance Imaging (fMRI), which measures the relative presence of oxy-hemoglobin, has gained attention as a non-invasive medium through which high resolution images of the brain and other tissue may be acquired. This technology may provide a useful assessment of cortical changes following chiropractic intervention. Images of the patient depicted on the cover, on the left, reflect cortical activity (lighted areas in the parietal cortex, frontal cortex areas 9, 10; visual association areas 19, 37, and 39) associated with the learning process of a “novel” muscular maneuver of the foot. Images on the right reflect cortical activity following a Network Spinal Analysis (form of chiropractic) adjustment session, taken approximately 20 minutes after the first set of images, involving the same activity. The decrease in “lighted” areas before and after the adjustment session suggests that less cortical “planning” or “activity” is associated with the “novel” foot maneuver. Thus, the ability of fMRI to visualize changes in cortical activity may play a significant role in elucidating the consequences of vertebral subluxation correction on neurological function.

An Impairment Rating Analysis Of Asthmatic Children Under Chiropractic Care
Graham R, Pistolese R. Journal of Vertebral Subluxation Research, 1997; 1(4): 41-48

A self-reported asthma-related impairment study was conducted on 81 children under chiropractic care. The intent of this study was to quantify self-reported changes in impairment experienced by the pediatric asthmatic subjects, before and after a two month period under chiropractic care. Practitioners, representing a general range of six different approaches to vertebral subluxation correction, administered a specifically designed asthma impairment questionnaire at the appropriate intervals. Subjects were categorized into two groups; 1-10 years and 11-17 years. Parents/guardians completed questionnaires for the younger group, while the older subjects self-reported their perceptions of impairment. Significantly lower impairment rating scores (improvement) were reported for 90.1% of subjects 60 days after chiropractic care when compared to the pre-chiropractic scores (p < 0.05) with an effect size of 0.96. As well, there were no significant differences across the age groups based on parent/guardian versus self rated scores. Girls reported higher (less improvement) before and after care compared to boys, although significant decreases in impairment ratings were reported for each gender. This suggested a greater clinical effect for boys which was supported by effect sizes ranging from 1.2 for boys compared to 0.75 for girls. Additionally, 25 of 81 subjects (30.9%) chose to voluntarily decrease their dosage of medication by an average of 66.5% while under chiropractic care. Moreover, information collected from patients revealed that among 24 patients reporting asthma “attacks” in the 30 day period prior to the study, the number of “attacks” decreased significantly by an average of 44.9% (p <.05). Based on the data obtained in this study, it was concluded that chiropractic care, for correction of vertebral subluxation, is a safe nonpharmacologic health care approach which may also be associated with significant decreases in asthma related impairment as well as a decreased incidence of asthmatic “attacks.” The findings suggest that chiropractic care should be further investigated relative to providing the most efficacious care management regimen for pediatric asthmatics.

[Note: NSA care was one of the chiropractic approaches used in this study supported by the Michigan Chiropractic Council]

A Retrospective Assessment of Network Care Using a Survey of Self-Rated Health, Wellness and Quality of Life
Blanks RH, Schuster TL, Dobson M. Journal of Vertebral Subluxation Research, 1997; 1(4): 15-31

The present study represents a retrospective characterization of Network Care, a health care discipline within the subluxation-based chiropractic model. Data were obtained from 156 Network offices (49% practitioner participation rate) in the United States, Canada, Australia, and Puerto Rico. Sociodemographic characterization of 2818 respondents, representing a 67-71% response rate, revealed a population predominately white, female, well-educated, professional, or white collar workers. A second objective of the study included the development and initial validation of a new health survey instrument. The instrument was specifically designed to assess wellness through patients’ self-rating different health domains and overall quality of life at two “time” points: “presently” and retrospectively, recalling their status before initiating care (“before Network”). Statistical evaluation employing Chronbach’s alpha and theta coefficients derived from principle components factor analyses, indicated a high level of internal reliability in regard to the survey instrument, as well as stable reliability of the retrospective recall method of self-rated perceptions of change as a function of duration of care. Results indicated that patients reported significant, positive perceived change (p < 0.000) in all four domains of health, as well as overall quality of life. Effect sizes for these difference scores were all large (>0.9). Wellness was assessed by summing the scores for the four health domains into a combined wellness scale, and comparing this combined scale “presently” and “before Network.” The difference, or “wellness coefficient” spanning a range of -1 to +1, with zero representing no change, showed positive, progressive increases over the duration of care intervals ranging from 1-3 months to over three years. The evidence of improved health in the four domains (physical state, mental/emotional state, stress evaluation, life enjoyment), overall quality of life from a standardized index, and the “wellness coefficient,” suggests that Network Care is associated with significant benefits. These benefits are evident from as early as 1-3 months under care, and appear to show continuing clinical improvements in the duration of care intervals studied, with no indication of a maximum clinical benefit. These findings are being further evaluated through longitudinal studies of current populations under care in combination with investigation of the neurophysiological mechanisms underlying its effects.

Network Spinal Analysis: A System of Health Care Delivery Within the Subluxation-Based Chiropractic Model
Epstein, D. Journal of Vertebral Subluxation Research, August 1996; 1(1): 51-59

The theoretical basis and clinical application of Network Spinal Analysis (NSA) is described. NSA delivers health care within the subluxation-based chiropractic model and seeks to contribute to the distinction of the various techniques and methods within the profession by describing and discussing its major characteristics. In this regard, clinical observations relative to the application of the Network Protocol have been described in relation to the monitoring of patient and practitioner outcomes. Relevant research from a separate Network Care retrospective study, which impacts on its characterization, profiles the patient population as predominantly female. Other data indicates that Network Care is widely and consistently practiced. Additionally, patients report significant, positive changes in health-related quality of life measures linked to certain clinical components of Network Care.
 

Visualization of a stationary CPG-revealing spinal wave* (Abstract from research at the University of Southern California, Professor Edmond Jonchkeere, et al.) 

Program of MEDICINE MEETS VIRTUAL REALITY 14 – ACCELERATING CHANGE IN HEALTH CARE: NEXT MEDICAL TOOLKIT* conference where Professor Jonchkeere will present a paper on the NSA Somatopsychic Wave (Prof. Jonckheere’s presentation is scheduled on pg. 20)

Paper Presentation accepted at the International Society of Quality of Life Research Conference in Prague, Czech Republic Nov. 12-15th, 2003 

Read the latest research articles on Surface Electromyography in Network Spinal Analysis™ (In order to view the files below, it is necessary that you have Adobe Acrobat Reader. If you do not have this please Click Here to download your free copy now.)

This research, which involves human subjects, has been approved by the University Park Institutional Review Board (IRB) of the University of Southern California

Network Spinal Analysis™: A Research Perspective

Statement of Efficacy

The Case Report 

Health & Wellness Quality of Life Questionnaire (Adobe Acrobat Reader Required)
(Questionnaire available to download free of charge courtesy of the Association for Network Care)

For more information on Network Spinal Analysis™  Research please visit the Association For Network Care website at www.associationfornetworkcare.com

Chiropractic Treatment Warwickshire, Back Pain,Warwick.

Saturday, March 20th, 2010

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Back injuries 

Cold Laser Therapy for pain relief and recovery for back injuries such as Bulging, Prolapsed, Herniated or Slipped discs. Disc Degeneration. Spinal Stenosis. Spondylolysis Spondylolisthesis. Sacroiliac joint. Facet Joints. Muscles. Ligaments. Ankylosing Spondylitis.

Causes of back pain

Muscles/Ligaments

Among the many causes of back pain, the most common by far is a sprain or strain of muscles or ligaments. Muscle spasm can occur after twisting or bending awkwardly, or from a simple sneeze or cough. The majority of muscle spasms tend to get better over time. Severe cases of muscle spasms are treated with medication, physical therapy, also cold laser therapy, see our cold laser therapy section under “Treatments”. 

Discs

Disc Degeneration

Disc problems are common causes of back pain. After an injury, or as we age, discs lose fluid content and deteriorate in a process called disc

The earliest form of injury to a disc is in the form of tears or fissures in the annulus fibrosis (outer portion) of the disc. The annulus fibrosis is very much is like a large round ligament that prevents the nucleus pulposus (inner gel-like portion) of the disc from protruding outward. Tears in the annulus heal by scar formation weakening the tissue. The repetitive annular tears degeneration.which heal by scar formation lead to a disc that begins to degenerate.

As degeneration progresses the disc becomes stiff, narrow, and losses its ability to act as a shock absorber. Loss of shock absorbing capacity of the disc leads to increased stress being put on the bones of the spine causing formation of bone sours or osteophytes. If bone spurs get large enough, they may cause pressure on nerves in the spinal canal which would present as numbness and weakness in the arms or legs depending on the spinal level being affected. The combination of disc degeneration and bone spur formation in the spine is called spondylosis. Any narrowing within the spinal canal, from bone spur formation or from any other cause such as disc prolapsed of thickening of the ligaments of the spine is called spinal stenosis. Spondylosis or spinal stenosis can occur at any region in the spine: cervical, thoracic, or lumbar.

Bulging Disc, Protruding Disc, Prolapsed Disc, Herniated Disc, Extruded disc, Slipped Disc.

The above terms generally describe a disc that is displaced beyond the limits of the intervertebral disc space i.e. the borders of annulus fibrous (the outer fibrous part of the disc)

Disc prolapse or herniation is the protrusion of the central portion of the disc through a tear in the outer annular wall of the disc. If disc prolapsed results in the compression (direct or indirect) of the nerve root it would cause symptoms of pain, numbness, or weakness. In some individuals however, disc protrusions will not cause any symptoms. A disc extrusion is a severe version of a disc protrusion in which a large portion of the nucleus pulposus is displaced through the wall of the disc. A disc extrusion is almost always would result in the symptoms of nerve root compression.

 Facet Joints

Facet joints irritation is another cause of back pain. Facet joints are small pairs of joints on the back of the spinal column where the vertebrae meet. Facet joints provide stability to the spine by interlocking two adjacent vertebrae. Facet joints also allow the spine to bend forward (flexion), bend backward (extension), and twist. 

Inflammation of facet joints can occur from injuries, excessive stress put on the spine or a form of arthritis. Facet joint problems are functional problems and would not be visualised on the x-rays of the MRI scan.

Spinal Stenosis

The term stenosis describes any narrowing of the spinal canal. Among many causes of spinal stenosis the most common one is degenerative changes or oseoarthritis of the spine, which occurs almost inevitably as a part of the aging process.

Canal stenosis can be caused by many factors such as enlargement of the facet joints due to degenerative changes; hypertrophy (enlargement) of the ligamentum flavum – the main ligament of the spinal canal; the protrusion or herniation of intervertebral discs into the canal and forward slippage of vertebrae in a condition called spondylolisthesis – all contribute into narrowing of spinal canal on their own or in conjunction with each other.

Main symptoms of spinal stenosis in lumbar spine is pain in the back and legs aggravated by standing and walking and relieved by sitting or stooping forward. Legs pain induced by walking is known as neurogenic claudication (from the Latin claudico, to limp). Neurogenic claudication must be distinguished from is vascular claudication, or leg pain on walking caused by insufficient blood flow to the legs. The features which help to distinguish neurogenic from vascular claudication are the following:

In neurogenic claudication pain occurs after varying amounts of exercise, with standing, or with coughing. Vascular claudication is reliably produced with a fixed amount of exercise, such as walking a certain number of blocks, and is rare at rest. The main distinguishing feature of neurogenic claudication and vascular claudication is the pain relief with sitting and stooping in cases of neurogenic claudication while vascular claudication pain is usually quickly relieved by resting in a standing position. Sensory loss of neurological claudication is in a nerve root distribution, while with vascular insufficiency it is in a stocking-glove distribution. Signs of vascular insufficiency should be absent in neurogenic claudication: diminished pulses, foot pallor on elevation, and decreased temperature of the feet.

Spondylolysis and Spondylolisthesis

Spondylolysis and Spondylolistheses are the most common causes of lower back pain in adolescents. Spondylolysis is a  fracture in one  or both pedicles  of the vertebrae that make up the spinal column. It usually affects either the fourth or the fifth lumbar vertebra in the lower back. The fracture site is called a pars defect.

If the bone is unable to maintain its proper position, the top vertebrae can shift forward on top of the bottom vertebrae. This condition is called spondylolisthesis.

For adults, a spondylolisthesis is normally caused from degenerative changes in the spine. When too much movement or slippage occurs, the bones may begin to press on nerves and surgery may become necessary to correct the condition.

Causes such as genetic, overuse or degenerative changes can contribute to development of spondylolisthesis. 

Sacroiliac Joints

Another very common cause of lower back pain is a dysfunction of sacro-iliac joints. The sacroiliac joint connects the sacrum (the triangular bone at the bottom of the spine) with the pelvis (iliac crest).

The inflammation of sacroiliac joint can result from an acute injury or from chronic postural abnormalities such as undue stress on the joint following lower back fusion surgery, degenerative changes of the hip and knee joint as well as from fallen arches of the foot. Pain distribution from sacroiliac joint abnormalities is in the low back, buttock/hip, abdomen, groin, or legs.

Ankylosing Spondylitis

Ankylosing spondylitis is an inflammatory condition affecting the spine. With ankylosing spondylitis, the joints and ligaments that normally permit the spine to move become inflamed and stiff. with time the bones of the spine may fuse together, causing the spine to become rigid and inflexible.

Other rare causes of back pain include:

Benign or malignant tumors of the spine or spinal cord Problems of the digestive tract, genitourinary or gynaecological problems can cause referred low back pain Infections.

Cold laser Therapy/Treatment

The lasers used at Central Chiropractic and Physiotherapy Clinic are certified as Cold Laser.  For the past 30 years the technology of Cold Laser Therapy (also known as Low Level Laser Therapy) has been formally accepted in North America and in many other parts of the world such as Europe, Russia and Japan.  In all this time there have been no recorded long-term adverse effects from low level laser therapy.  It is considered to be non-invasive, painless and safe.

Cold Laser Therapy uses laser light energy to stimulate cells to function optimally.  In the body, light sensitive chromophores and other elements within the cell absorb energy, initiating a series of important photochemical changes such as increased production of ATP. The mitochondria and Kreb’s Cycle stimulation initiates the production of ATP, providing the cell with the extra energy needed to accelerate the healing process and positively influence pain.  These activities can occur in all types of cells and includes ligament, nerves, cartilage and muscle.

Low Level Cold Laser Therapy (LLLT) is a Handheld, non-invasive, light-emitting medical device which is used over different areas of the body. It provides an unmatched advantage in the treatment of conditions such as;

Back pain, lower back pain

Slipped disc, Prolapsed disc, Herniated disc, Bulging disc.

Trapped  nerve.

Hip Pain Sacroiliac joint inflammation 

Athletic InjuriesLower Back Pain
Knee and Foot Pain
Shoulder Injury
Carpal Tunnel Syndrome
Arthritic Pain relief, Muscle Spasm
Relief of Muscle and Joint Pain
Skin infections.

Wound Management including Skin Ulcers, Pressure Sores and Burn

Soft Tissue Injuries including

Sprains and Strains, Tendonitis and Haematomas.

Joint Disorders including Arthritis pain relief and Tenosynovitis.

Chronic pain such as Trigeminal Neuralgia and Chronic Neck and Back pain.

Whiplash Associated Disorder (WAD) “Whiplash” injury Neck Pain and injuries.

For further in depth information on Back Pain, Sciatica, Lower Back Pain, please go to top left corner under “Pain” or “Conditions”. 

 

Chiropractor Warwick Sciatica Chiropractors

Friday, March 19th, 2010

Sciatica.

Back Pain. Registered with BUPA. AXA PPP. HSA. AVIVA. CIGNA. Simpleyhealth. Standard life. Pru health. Mercia health. All health insurance accepted.

Sciatica. What Causes Sciatica? How do I know if I have sciatica? How is Sciatica treated? Cold Laser Treatment  

The sciatic nerve is the longest nerve in your body. It runs from your lower back, through your hip area and buttocks and down each leg. The sciatic nerve divides into smaller nerves as it travels down the legs providing feeling to your thighs, legs, and feet as well as controlling the muscles in your lower legs. The term “Sciatica” refers to pain that radiates along the length of this nerve.

What causes Sciatica?

Sciatica is a sign of underlying problem resulting in pressure being applied on sciatic nerve along its course. The most common cause of this nerve compression is a bulging or herniated disc (in lumbar spine). Piriformis syndrome is another cause of sciatica. The piriformis is a muscle that sits directly over the sciatic nerve. If this muscle becomes tight or if you have a spasm in this muscle, it puts pressure on the sciatic nerve. 

How do I know if I have sciatica?

Pain that radiates from your lower back to your buttock or buttocks and down the back of your leg or legs is the hallmark of sciatica. Sciatica can be accompanied by numbness, tingling, and muscle weakness in the affected leg or legs. This pain can vary from a mild ache to a sharp or burning sensation or excruciating discomfort. Sometimes it may feel like a sharp stabbing pain or electric shock. Sciatic pain often starts gradually and intensifies over time. Normally it gets worse when you sit.  

How is Sciatica Treated?

The majority of the time, sciatic pain can be relieved through a combination of stretches, deep tissue massage of the piriformis muscle and chiropractic manipulation on lumbar spine. Occasionally, in cases where chronic spasm of the low back or piriformis muscles is causing the sciatic pain, it may be necessary to do a procedure called a trigger point injection, where a medical pain specialist injects a small amount of aesthetic directly into a spasmed muscle to break the spasm cycle. However, this is typically not necessary.

Cold laser Therapy/Treatment

The lasers used at Central Chiropractic Clinic are certified as Cold Laser.  For the past 30 years the technology of Cold Laser Therapy (also known as Low Level Laser Therapy) has been formally accepted in North America and in many other parts of the world such as Europe, Russia and Japan.  In all this time there have been no recorded long-term adverse effects from low level laser therapy.  It is considered to be non-invasive, painless and safe.

Cold Laser Therapy uses laser light energy to stimulate cells to function optimally.  In the body, light sensitive chromophores and other elements within the cell absorb energy, initiating a series of important photochemical changes such as increased production of ATP. The mitochondria and Kreb’s Cycle stimulation initiates the production of ATP, providing the cell with the extra energy needed to accelerate the healing process and positively influence pain.  These activities can occur in all types of cells and includes ligament, nerves, cartilage and muscle.

Low Level Cold Laser Therapy (LLLT) is a Handheld, non-invasive, light-emitting medical device which is used over different areas of the body. It provides an unmatched advantage in the treatment of conditions such as;

Sciatica

Chronic back and Lower back pain

Piriformis syndrome

Slipped disc

Prolapsed disc

Herniated disc

Buldging disc

Trapped nerves

Sacroiliac Joint inflammation 

For further in-depth information, please go to the left top corner under “pain” or “conditions” and for Cold laser therapy, please go to “Treatments,” cold laser therapy is very effective for both pain relief and healing.

 

 

For further in depth information on Back Pain Sciatica, Disc injuries, please go to top left hand corner under “Pain” or “Conditions “and “Treatments” for Cold Laser Therapy is very effective in pain relief and healing

Chiropractor Warwickshire,Back Pain.

Friday, March 19th, 2010

Registered with BUPA. AXA PPP. HSA. AVIVA. CIGNA. Simpleyhealth. Standard life. Pru health. Mercia health.Medicash Medisure. All health insurances accepted.

Back  injuries. 

Cold Laser Therapy for pain relief for back injuries such as  Bulging, Prolapsed, Herniated or Slipped discs. Disc Degeneration. Spinal Stenosis. Spondylolysis Spondylolisthesis. Sacroiliac joint. Facet Joints. Muscles. Ligaments. Ankylosing Spondylitis.

Causes of Back Pain Muscles/Ligaments

Among the many causes of back pain, the most common by far is a sprain or strain of muscles or ligaments. Muscle spasm can occur after twisting or bending awkwardly, or from a simple sneeze or cough. The majority of muscle spasms tend to get better over time. Severe cases of muscle spasms are treated with medication, physical therapy, also Cold Laser Therapy, The Cold Laser Therapy section can be found listed under “Treatments”. 

Disc Degeneration

Disc problems are common causes of back pain. After an injury, or as we age, discs lose fluid content and deteriorate in a process called disc

The earliest form of injury to a disc is in the form of tears or fissures in the annulus fibrosis (outer portion) of the disc. The annulus fibrosis is very much is like a large round ligament that prevents the nucleus pulposus (inner gel-like portion) of the disc from protruding outward. Tears in the annulus heal by scar formation weakening the tissue. The repetitive annular tears degeneration.which heals by scar formation lead to a disc that begins to degenerate.

As degeneration progresses the disc becomes stiff, narrow, and losses its ability to act as a shock absorber. Loss of shock absorbing capacity of the disc leads to increased stress being put on the bones of the spine causing formation of bone sours or osteophytes. If bone spurs get large enough, they may cause pressure on nerves in the spinal canal which would present as numbness and weakness in the arms or legs depending on the spinal level being affected. The combination of disc degeneration and bone spur formation in the spine is called spondylosis. Any narrowing within the spinal canal, from bone spur formation or from any other cause such as disc prolapsed of thickening of the ligaments of the spine is called spinal stenosis. Spondylosis or spinal stenosis can occur at any region in the spine: cervical, thoracic, or lumbar.

Bulging Disc, Protruding Disc, Prolapsed Disc, Herniated Disc, Extruded disc, Slipped Disc.

The above terms generally describe a disc that is displaced beyond the limits of the intervertebral disc space i.e. the borders of annulus fibrous (the outer fibrous part of the disc)

Disc prolapse or herniation is the protrusion of the central portion of the disc through a tear in the outer annular wall of the disc. If disc prolapsed results in the compression (direct or indirect) of the nerve root it would cause symptoms of pain, numbness, or weakness. In some individuals however, disc protrusions will not cause any symptoms. A disc extrusion is a severe version of a disc protrusion in which a large portion of the nucleus pulposus is displaced through the wall of the disc. A disc extrusion is almost always would result in the symptoms of nerve root compression.

 Facet Joints

Facet joints irritation is another cause of back pain. Facet joints are small pairs of joints on the back of the spinal column where the vertebrae meet. Facet joints provide stability to the spine by interlocking two adjacent vertebrae. Facet joints also allow the spine to bend forward (flexion), bend backward (extension), and twist. 

Inflammation of facet joints can occur from injuries, excessive stress put on the spine or a form of arthritis. Facet joint problems are functional problems and would not be visualised on the x-rays of the MRI scan.

Spinal Stenosis

The term stenosis describes any narrowing of the spinal canal. Among many causes of spinal stenosis the most common one is degenerative changes or oseoarthritis of the spine, which occurs almost inevitably as a part of the aging process.

Canal stenosis can be caused by many factors such as enlargement of the facet joints due to degenerative changes; hypertrophy (enlargement) of the ligamentum flavum – the main ligament of the spinal canal; the protrusion or herniation of intervertebral discs into the canal and forward slippage of vertebrae in a condition called spondylolisthesis – all contribute into narrowing of spinal canal on their own or in conjunction with each other.

Main symptoms of spinal stenosis in lumbar spine is pain in the back and legs aggravated by standing and walking and relieved by sitting or stooping forward. Legs pain induced by walking is known as neurogenic claudication (from the Latin claudico, to limp). Neurogenic claudication must be distinguished from is vascular claudication, or leg pain on walking caused by insufficient blood flow to the legs. The features which help to distinguish neurogenic from vascular claudication are the following:

 

In neurogenic claudication pain occurs after varying amounts of exercise, with standing, or with coughing. Vascular claudication is reliably produced with a fixed amount of exercise, such as walking a certain number of blocks, and is rare at rest. The main distinguishing feature of neurogenic claudication and vascular claudication is the pain relief with sitting and stooping in cases of neurogenic claudication while vascular claudication pain is usually quickly relieved by resting in a standing position. Sensory loss of neurological claudication is in a nerve root distribution, while with vascular insufficiency it is in a stocking-glove distribution. Signs of vascular insufficiency should be absent in neurogenic claudication: diminished pulses, foot pallor on elevation, and decreased temperature of the feet.

Spondylolysis and Spondylolisthesis

Spondylolysis and Spondylolistheses are the most common causes of lower back pain in adolescents. Spondylolysis is a  fracture in one  or both pedicles  of the vertebrae that make up the spinal column. It usually affects either the fourth or the fifth lumbar vertebra in the lower back. The fracture site is called a pars defect.

If the bone is unable to maintain its proper position, the top vertebrae can shift forward on top of the bottom vertebrae. This condition is called spondylolisthesis.

For adults, a spondylolisthesis is normally caused from degenerative changes in the spine. When too much movement or slippage occurs, the bones may begin to press on nerves and surgery may become necessary to correct the condition.

Causes such as genetic, overuse or degenerative changes can contribute to development of spondylolisthesis. 

Sacroiliac Joints

Another very common cause of lower back pain is a dysfunction of sacro-iliac joints. The sacroiliac joint connects the sacrum (the triangular bone at the bottom of the spine) with the pelvis (iliac crest).

The inflammation of sacroiliac joint can result from an acute injury or from chronic postural abnormalities such as undue stress on the joint following lower back fusion surgery, degenerative changes of the hip and knee joint as well as from fallen arches of the foot. Pain distribution from sacroiliac joint abnormalities is in the low back, buttock/hip, abdomen, groin, or legs.

Ankylosing Spondylitis

Ankylosing spondylitis is an inflammatory condition affecting the spine. With ankylosing spondylitis, the joints and ligaments that normally permit the spine to move become inflamed and stiff, with time the bones of the spine may fuse together, causing the spine to become rigid and inflexible.

Other rare causes of back pain include:

Benign or malignant tumors of the spine or spinal cord Problems of the digestive tract, genitourinary or gynaecological problems can cause referred low back pain Infections.

Cold laser Therapy/Treatment

The lasers used at Central Chiropractic and Physiotherapy Clinic are certified as Cold Laser.  For the past 30 years the technology of Cold Laser Therapy (also known as Low Level Laser Therapy) has been formally accepted in North America and in many other parts of the world such as Europe, Russia and Japan.  In all this time there have been no recorded long-term adverse effects from low level laser therapy.  It is considered to be non-invasive, painless and safe.

Cold Laser Therapy uses laser light energy to stimulate cells to function optimally.  In the body, light sensitive chromophores and other elements within the cell absorb energy, initiating a series of important photochemical changes such as increased production of ATP. The mitochondria and Kreb’s Cycle stimulation initiates the production of ATP, providing the cell with the extra energy needed to accelerate the healing process and positively influence pain.  These activities can occur in all types of cells and includes ligament, nerves, cartilage and muscle.

Low Level Cold Laser Therapy (LLLT) is a Handheld, non-invasive, light-emitting medical device which is used over different areas of the body. It provides an unmatched advantage in the treatment of conditions such as;

Back pain, lower back pain

Slipped disc, Prolapsed disc, Herniated disc, Bulging disc.

Trapped  nerve.

Hip Pain Sacroiliac joint inflammation 

Athletic InjuriesLower Back Pain
Knee and Foot Pain
Shoulder Injury
Carpal Tunnel Syndrome
Arthritic Pain relief and Muscle Spasm
Relief of Muscle and Joint Pain
Skin infections.

Wound Management including Skin Ulcers, Pressure Sores and Burn

Soft Tissue Injuries including

Sprains and Strains, Tendonitis and Haematomas.

Joint Disorders including Arthritic pain relief and Tenosynovitis.

Chronic pain such as Trigeminal Neuralgia and Chronic Neck and Back pain.

Whiplash Associated Disorder (WAD) “Whiplash” injury Neck Pain and injuries.

For further in depth information on Back Pain, Sciatica, Lower Back Pain, please go to top left corner under “Pain” or “Conditions”. 

 

Chiropractor Neck Shoulder Pain Cervical Disc Injuries

Friday, March 12th, 2010

Call 024 7622 2002Registered with BUPA. AXA PPP. HSA. AVIVA. CIGNA. Simpleyhealth. Standard life. Pru health. Mercia health.Medicash Medisure.      All health insurance accepted.

Neck  Shoulder Pain. Cervical Disc Injuries, Cervicalgia, Cervicogenic headaches.

Neck Shoulder Pain,WHIPLASH – ASSOCIATED DISORDER (WAD).

From the Journal of Orthopaedic Medicine 1999;   21 (1):   22–25 university Department of Orthopaedic Surgery, Bristol, UK 

Conclusion:

 “Whiplash”(WAD) and Neck injuries are common. Chiropractic is the only proven effective treatment in chronic cases. Our study enables patients to be classified at initial assessment in order to target those patients who will benefit from such treatment. 

Cervicalgia.

The neck muscles are constantly placed under tension, although this tension helps to keep the head in position i.e. upright. However, the muscles in the neck are more prone to becoming stiff and painful as a result of this tension. As a result of violent movement or sudden impact (known sometimes as “whiplash” (WAD)).
Cervicalgia is a localized pain that does not radiate through into other areas of the neck.

Symptoms include:

  • A sharp pain in the neck
  • Neck ache
  • Pain resulting from head movement
  • Pain radiating to the shoulders, arms and fingers

It also may radiate pain into other areas; this is usually caused by a trapped nerve or nerves. Nerves can become trapped by tight muscles, disc damage, or the formation of bony deposits. Radiating pain in the neck which affects the shoulders and arms may also affect the fingers.

Neck dysfunction can result in dizziness, nausea or headaches but it can be successfully treated by Cold Laser Therapy, one of the treatments offered by Central Chiropractic Clinic

Cervicogenic headaches  

Cervicogenic headaches   are defined as headaches originating from the neck. The location is typically at the back of the head, sides and top of the head as well as around the forehead and eyes affecting one or more of the above regions at once. These headaches can be located on one or both sides of the head. Cervicogenic headaches are usually associated with dysfunction of the upper neck which can present itself as neck pain or local tenderness, reduced neck range of motion and exacerbation of the headaches by neck movement. The past history of neck trauma is typical for this type of headaches.

The Cervicogenic headaches are caused by irritation of nerve endings of injured joints, ligaments, muscles and discs of the neck. The nerve endings in the injured areas send pain signals up the upper nerves of the neck to the brain causing “cross wiring” with the fibers of the trigeminal nerve (one of the nerves in the head) which is responsible for perception of the head pain thus causing the headaches.

Cervical Disc Injuries

Most cervical disc injuries are caused by hyperextension, which results in compression of the cervical area 

Flexion injuries in the cervical area do not result in nerve compression.

Symptoms of Cervical Disc Injuries

The Pain may cause loss of sensation or tingling/pins and needles to the arms and weakness are the main symptoms and signs of cervical disc injury. The pain is most noticeable symptom and it is usually the only one. Cervical disc injury can complicated by compression of either a cervical nerve root or by a compression of the spinal cord, but this reported injury is very infrequent.  When compression of the nervous tissue occurs, patients may report different sensations other than pain. Weakness to the legs/leg this is called spinal cord compression. if the arms/arm are  affected this is called nerve root compression

Pain can be felt in the Neck Shoulder or Arm. 

Pain is always in the area of the neck and upper back between the shoulder blades. This is due to inflammation of the disk and the cervical vertebra joints. Sever inflammation can flare up after a minor added injury or for other unknown reasons. Neck and shoulder pain are due to the disc bulges that herniates, and stretches the posterior longitudinal ligament.  

b. Rarely, the pain will be felt down the arm.  This pain can be lightning, caused or aggravated by movements of the neck, or can be dull and persistent. Pre-existing neck pain is also present in many individuals. After the arm pain starts, some people report feeling less pain in their neck. When arm pain is present, it is usually because of a combination of disc herniation and bony spurs compressing a nerve root. A free disc fragment can also intrude on a cervical root and cause quite a bit of pain in shoulder or down the arm.

 2. Sensory symptoms other then pain.

When felt in only one arm, they are due to compression of a cervical root and felt in the territory of the cervical root. The C4 root mainly supplies the shoulder with nerves, while the C5 root supplies primarily the arm. The C6 root supplies nerves to the radial side of the forearm, the C7 root addresses the arm and forearm, and the C8 and the T1 root handle mostly the hand. Broadly speaking, two types of sensory symptoms are felt: loss of sensation and new sensations. A loss of sensation is simply numbness. New sensations include tingling (pins and needles), heat, or cold sensations.

If the spinal cord is compressed, most patients report losing sensation in their hand and in the lower part of their body. (Numbness) They have difficulty feeling the floor when they walk and cannot feel that their bladder is full or inconstancy this is an emergency and patients should be brought to the hospital right away.

3. Motor symptoms and signs.

Weakness of one arm (the other one being normal) only signals a compression of a nerve root. A compression of C4 results in a weak shoulder; C5 indicates a weak bicep muscle; C6 represents a weak wrist, thumb, and index finger; C7 is a weak Tricep, extension of the fingers, and Pectoralis muscles; C8 designates weak flexion of the fingers; and T1 corresponds to a weak hand.

Emergency treatment.

If the spinal cord is compressed, patients report having difficulty walking and weak legs and hands, numbness these can be the only symptoms and should be treated as an emergency.

Although neck pain can be caused by injury, such as ‘whiplash’ injuries, it is often caused by the cumulative effect of improper sitting posture, reading in bed, poor work habits, stomach sleeping, lack of proper exercise and other lifestyle-related factors. All of these factors cause misalignments in the spine and eventually pain. In fact, the most important factor producing neck pain appears to be spinal misalignments. Even for people who complain that “stress” is causing their pain, the great majority of those have significant spinal misalignments that are contributing to their condition.

Uncorrected chronic spinal misalignments can eventually cause neck pain. As a spinal misalignment worsens, pressure can be put on delicate nerves, sending the surrounding neck muscles go into painful and movement-limiting spasm, headache, even numbness, tingling or weakness in the arms or hands

Neck pain as well as “whiplash”(WAD) injuries and both conditions can result in headaches and all three are commonly treated by Chiropractors.
The treatment is focused on the small joints in the back of the neck called facet joints that are responsible for neck pain. When these joints dysfunction but injury to the muscles he nerve fibers that innervate / act as sensors for these facet joints also serve to act as sensors to parts of the head. When this facet joints dysfunction these sensors become active, the brain cannot clearly differentiate between the facet joints and the mapping of the head and create the sensation of pain in a broader area- Headache.

FROM:   Journal of Orthopedic Medicine 1999;   21 (1):   22–25uinversity Department of Orthopedic Surgery, Bristol, UK

Khan S, Cook J, Gargan M, Bannister G 

Objective:   To determine which patients with chronic “whiplash” (WAD) will benefit from chiropractic treatment.

Design:   Retrospective review by structured telephone interviews of 93 consecutive patients seen in chiropractic clinic.

Setting:   Independent chiropractic clinic in a large city.

Subjects:   93 patients, 68 female.

Main outcome measure:   Gargan and Bannister grading pre and post treatment.

Results:   Three groups of patients were recognized. Group 1 consisted of patients with isolated neck pain associated with a restricted range of neck movement. Group 2 consisted of patients with neurological symptoms or signs associated with a restricted range of movement. Group 3 comprised patients who described severe neck pain but all of whom had a full range of neck movement. Patients in this group often described an unusual group of symptoms, with a bizarre, non-dermatomal pain distribution. There was a significant difference in outcome between the three groups (p<0.001) with only groups 1 and 2 improving following chiropractic manipulation.

Conclusion:

“Whiplash”(WAD) and Neck injuries are common. Chiropractic is the only proven effective treatment in chronic cases. Our study enables patients to be classified at initial assessment in order to target those patients who will benefit from such treatment.

Journal of Orthopedic Medicine 1999;   21 (1):   22–25 university Department of Orthopedic Surgery

Maria Kibkalo DC.MSc (Chiro) CCEP & Associates BCA & GCC registered.

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