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 = 
or 15 minutes (n = 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.
