Painless, Non-invasive, Low-Level Laser Acupuncture
What points work best for my problem?
There are no specific, cookbook-type treatment protocols available with low-level laser acupuncture, just as there are no specific, cookbook-type treatment protocols with needle acupuncture. The practitioner needs, rather, a sophisticated knowledge of Traditional Chinese Medicine, and understanding of the actions of the acupuncture points, to be a successful practitioner with laser acupuncture.
by Margaret A. Naeser, Ph.D., Lic.Ac., Dipl.Ac.
I do not recommend practicing only with laser acupuncture, rather, I recommend adding it to the collection of acupuncture modalities – i.e., acupuncture needles, microamps electrical stimulation, moxibustion, cupping, Chinese herbal medicine, ion pumping cords, magnet therapies, etc. In America, it is now required that one have a minimum of 1,725 hours of acupuncture training, before one can take the acupuncture exam for certification in acupuncture, from the National Certification Commission for Acupuncture and Oriental Medicine.
I hope the information provided below will be helpful. Thank you for your interest in low-level laser acupuncture.
For a referral to a licensed acupuncturist who has studied laser acupuncture, please call the American Association of Acupuncture and Oriental Medicine, in Sacramento, CA, 916-443-4770. They can often sort referrals by zip code.
How does this work? How can I learn to do it?
The area of low-level laser acupuncture is complex. Unfortunately there is no single laser that will do everything, and I do not recommend any specific lasers, I conduct laser acupuncture research with carpal tunnel syndrome, and formerly, with stroke patients with paralysis (acupuncture and laser acupuncture to treat paralysis in stroke, referenced in publications, at the end).
Licensed acupuncturists who want to know more about laser acupuncture might consider purchasing one of the publications (listed below) that have been published for this purpose or attending a two-day class I teach for CEU’s at the New England School of Acupuncture, Watertown, MA, near Boston. We try and do out best to keep this page updated to the time and locations of the next classes, but we are not always successful. You can see the date in which this page was last updated at the very bottom.
The next laser acupuncture class will be a two-day, weekend seminar, taught with Elaine Walsh, Lic.Ac., of Salem, MA. It will be held at the New England School of Acupuncture, September 24, 25, 2005. For more information and registration, contact the New England School of Acupuncture, http://www.nesa.edu/ce/
Technical considerations of laser acupuncture
With painless, non-invasive laser acupuncture, we work with Class IIIb lasers (5 to 500 mW). One can start to burn the skin at greater than 500 mW (Class IV lasers). With laser acupuncture, we also primarily only work with wavelengths in the red-beam range (600 – 700 nm) and in the near infrared-beam range (800 – 1000 nm).
The red-beam laser has only a shallow penetration, around 0.8 of one mm, direct energy – used on acupuncture points on the hand, foot (not the heel), face, or sometimes the ear. The red-beam is fine for the shallow Jing-Well points on the foot. For example, Bladder 67, for breech position, 5 minutes per day, the last few weeks of pregnancy (Jin, 1998). It has a 85% success rate according to Dr. Jin.
Jin Y. 1998. Handbook of Obstetrics & Gynecology in Chinese Medicine – An Integrated Approach. Seattle, WA, Eastland Press. p. 114
The red-beam laser is usually 600 – 700 nm wavelength; and less than 500 mW. How many joules do you want to use? How many joules per cm square? These are all very important facts for you to know, before you start using the lasers. For example, a 5 mW laser lecture pointer pen with a 5 mm diameter aperture requires a minimum of 3 minutes exposure time on an acupuncture point, to have approximately 4.59 joules per cm square. Some think that the anti-inflammatory effect, and the improved circulation effect starts at a minimum of 4 joules per cm square. This is especially so for wound healing (Mester, Mester, Mester, 1984), and treatment of post herpetic neuralgia (Moore et al., 1988; McKibben & Downie, 1990) and earlier stages of alopecia areata (Trelles, Mayayo, Cisneros, 1984).
Mester E, Mester AF, Mester A. The biomedical effects of laser application. Lasers Surg Med 1985;5:31-39.
Moore KC, Hira N, Kumar PS et al. A double blind crossover trial of low level laser therapy in the treatment of post herpetic neuralgia. Lasers in Medical Science, Abstracts Issue, July 1988; 301.
McKibben LS, Downie R. Treatment of postherpetic pain using a 904 nm low-energy infrared laser. Laser Therapy 1990; 2:20.
Trelles MA, Mayayo E, Cisneros JL. Treatment of the Alopecia Areata with He/Ne laser. Tratamiento de la Alopecia Areata con laser He/Ne. INVESTIGACION Y CLINICA LASER, 1984;1:15-17.
If you plan to be treating deeper acupuncture points on the limbs or back, you need an infrared laser (800 – 1000 nm wavelength). The infrared lasers tend to have a deeper effect, up to an inch or so. Again, a very complex topic.
Pulsed Laser Settings, and Some Possible Therapeutic Indications
These pulse rates (pulses per second) and indications, for each rate are based on P.F.M. Nogier, M.D., Lyon, France. Here, I am referring to them as used with the infrared (904 nm) pulsed, Respond Laser 2400, Respond Systems, Branford, CT. No medical claims are made.
|F SETTING||PULSE RATE||INDICATIONS|
|F1||73 pps||Acute injury, non-union fracture, Tonification of Acupuncture Points, Wound Healing|
|F2||146 pps||Sub-acute injury and yellow scar tissue|
|F3||292 pps||For outermost layer of tissue (Ectodermal), Chronic conditions, Acupuncture Points, Arthritis, Scar Tissue|
|F4||584 pps||For inner most layer of tissue (Endodermal), Circulatory Stimulation|
|F5||1168 pps||For tissue of Mesodermal origin, For Acupuncture Points on limbs, Scar tissue|
|F6||3,500 pps||For chronic conditions, For Sedation of Acupuncture Points, Pain control. Very Dispersive, recommend following up with F4 for a few minutes, and then F1 for a few minutes at the end of a pain treatment.|
Examples of Laser Protocols using Pulsed Infrared laser, as listed above
Often with cases who have a Traditional Chinese Medicine diagnosis of Deficiency, I do not use F6 at all. For example, with Heel Spurs in a case with Deficiency (often Ki Def.), I try F4 for 5 or 10 minutes; then F3 for 5 minutes; then F2 for 5 minutes; then F1 for 5 minutes. The patient can simply rest the heel onto the laser block (four laser diodes in an array, in the 4-inch by 3-inch laser block that is part of the Respond laser equipment), while sitting up, using pillows for support. The exact treatment times are probably not known, but it seems to be important to use primarily the F4 down to F1 with Deficient cases (I have observed that using too much of F6, alone, Disperses too much, and the patient has no effect from the treatment at all. The number of treatments may be 12 (every other day) or less, depending on the case. I learned this treatment from Jennifer Blahnik, L.Ac., Wausau, WI (715-854-9234) and Beloit, WI (608-365-6771) -M. Naeser, Ph.D., L.Ac.
The Respond Systems Co. also manufactures an infrared (IR), 904 nm, continuous wave, single probe which has a higher power output, than the pulsed probe. The continuous wave probe is 500 mW. This probe delivers 1 joule per cm square every 2 seconds.
Ten seconds with the continuous wave, 500 mW IR probe may also help to improve the circulation at the tender spots in the fascia, on the heel spurs. If the 500 mW IR probe is used first, on the tender spots, it is also recommended to follow up with some Tonification on these areas, with lower Nogier frequencies with the pulsed IR laser, for a few minutes, as mentioned above.
Low Back Pain:
Also, when treating low back pain, for example, while the acupuncture needles are in Bl 23, place/tape the laser block (4 laser diodes in an array, in the 4-inch by 3-inch laser block that is part of the Respond System laser equipment) next to the needles, either in between L and R, Bl 23 (across the spine), or lateral to Bl 23, especially if pain is there. The IR laser local stimulation next to the acupuncture needle seems to improve the circulation there. I learned this from Ken Branco, L.Ac., Westport, MA.
Ten seconds with the continuous wave, 500 mW IR probe may also help to improve the circulation at the tender spots on the back, prior to initiating work with the pulsed laser probe. When the 500 mW IR probe is used first, it should be followed up with Tonification – either with the lower Nogier pulsed frequencies with the IR laser, or with acupuncture needles or moxa. This is also a method used successfully by a licensed acupuncturist in Hull, MA, Jeanne Christianson, L.Ac.
Legal issues regarding the practice of low-level laser therapy
Low-level laser therapy is considered investigational by the FDA, and no medical claims of cures are permitted in the US, at this time. It is my understanding, however, that if low-level lasers are defined within the state scope of medical practice (as it is in Massachusetts for licensed acupuncturists), then the FDA will not interfere, as long as the licensed acupuncturist does not make any medical claims of cures.
We do have an independent institutional review board (IIRB) for laser acupuncture (research) in Massachusetts, with which the licensed acupuncturist may register his/her laser and his/her laser acupuncture treatment protocols, for a specific disorder, etc. This board is limited to licensed acupuncturists in Massaschusetts, only. The licensed acupuncturist also obtains informed consent from each patient.
I have published a laser acupuncture, introductory textbook (listed below), and there is a 48-page addendum to the textbook which explains FDA regulations from written materials in the 1980′s. The information regarding the issue of low-level laser therapy being within the scope of medical practice per state regulations, per state, is only from verbal conversations with the FDA in the last year or so – I have nothing in writing. The information regarding investigational use, and the issue of being within the scope of medical practice per state regulations, per state, is only from verbal conversations with the FDA in the last year or so – I have nothing in writing. In theory, if the licensed acupuncturist uses the low-level lasers, without registering with an IIRB, and there is a complaint by a patient directly to the FDA (there have been none since we started in Mass., 6 years ago), then the FDA has the right to take away the lasers from the acupuncture office, as I understand it. This is fairly complex and I cannot speak for the FDA.
Where can I get a laser?
Some laser vendors are the following, and I repeat that I do not endorse any lasers, nor do I make any medical claims of cures for any lasers.
- John HubacherPresident, Pantheon Research626A Venice Blvd.Venice, CA 90291310-822-4965John Hubacher builds red-beam, or infrared beam lasers, mostly 830 nm wavelength.
- Don HudsonPresident, Respond Systems, Inc.20 Baldwin Dr.Branford, CT 064051-800-722-1228 or 203-481-2810Don Hudson builds two types of lasers, continuous wave, and pulsed, infrared (IR) lasers (904 nm). The continuous wave laser is 500 mW, and emits one joule per cm square every two seconds.The pulsed laser (9.4 W, with 180 nanoseconds on-time) is configured to emit the Nogier pulsed frequencies (73 pps, 146 pps, 292 pps, 584 pps, etc., and a very high frequency pulse of 3,500 pps, see above table). At 3,500 pps, the laser is only emitting 5.92 mW equivalent, and it is, of course, emitting a much lower mW equivalent, at the lower pulsed frequencies. An example of the different pulse frequencies and their indications appears earlier in this article.
- Felix Kramer,President Lasotronic near Zurich, Switzerlande-mail: email@example.com website: www.lasotronic.ch
- Phil Passy, Ms. Anita Saltmarche.Contacts at MedX Health Corp3350 Ridgeway Drive, Unit 3, Mississauga, Ontario Canada L5L 5Z9Website: http://www.medxhealth.com 888-363-3112 or 905-826-0766Phil Passy also builds excellent lasers, they are 785 nm, and easy to use (can be strapped into place at the wrist, instead of holding them).
- Melyni Worth, Ph.D., in Virginia, who uses lasers from Australia and the UKMelyni Worth, Ph.D. PAS,THOR, LTU and Equilaser Therapy Lasers, FOXDEN EQUINE,(Lasers for sale or rent)WEB: www.foxdenequine.com or www.thorlaser.com TEL or FAX (540)-337-2264Expert sources for more information:Licensed acupuncturists in the U.S. who have a great deal of experience with low-level laser therapies, especially for Carpal Tunnel Syndrome are Kenneth Branco, Lic.Ac., Westport, MA, and Michael Ranft, Lic.Ac., Hot Springs, Arkansas, firstname.lastname@example.org.
Another licensed acupuncturist in the U.S. who has a great deal of experience with low-level laser therapies is Peter A. Courtnage, D.Ac., Psy.D., Jade Acupuncture & Behavioral Health, LLC. 626 K Street, Anchorage, AK 99501. Phone: (907) 243-3031, Fax: (907) 243-3922. Email: LaserLLC@aol.com
A chiropractor who has extensive experience with low-level laser therapies is Scott Deuel, D.C., Castle Rock, CO.
There is also the North American Association for Laser Therapies, (NAALT). Dr. Paul Bradley is the President of NAALT. For more info, please contact the secretary for NAALT Melyni Worth, Ph.D.
Laser Acupuncture Teaching Publications:
- Naeser MA, Wei XB: Laser Acupuncture – An Introductory Textbook for Treatment of Pain, Paralysis, Spasticity and Other Disorders. Clinical and Research Uses of Laser Acupuncture from Around the World. Boston: Boston Chinese Medicine. 1994.This laser acupuncture textbook ($44.95) can be ordered from a company in South Hadley, MA, called Spanda Medical Co.Spanda Medical Co.c/o Michael Travis154 S. Main St.South Hadley, MA 01075Telephone: 413-448-2022, 1-800-772-6320
- Naeser MA, Hahn C, Lieberman BE: Booklet: Naeser Laser Home Treatment Program for the HandВ©. An Alternative Therapy to Treat Painful Symptoms of Carpal Tunnel Syndrome and Repetitive Strain Injury. Sacramento, CA. You can now download a PDF copy of this publication by simply clicking on “Naeser Laser Home Treatment Program for the Hand ©“. Ms. Naeser has many other projects, research, and publications that deal with laser acupuncture, and it is all available at her website.
Other laser acupuncture publications include:
- Naeser MA, Alexander MP, Stiassny-Eder D, Galler V, Hobbs J, Bachman D, Lannin L: Laser Acupuncture in the Treatment of Paralysis in Stroke Patients: A CT Scan Lesion Site Study. American Journal of Acupuncture, 23(1):13-28, 1995.
- Naeser MA: Acupuncture and Laser Acupuncture in the Treatment of Paralysis in Stroke Patients, Carpal Tunnel Syndrome and Alopecia Areata. Frontier Perspectives. 5(1):8-15, 1996.
- Naeser MA: Neurological Rehabilitation: Acupuncture and Laser Acupuncture to Treat Paralysis in Stroke and Other Paralytic Conditions and Pain in Carpal Tunnel Syndrome. Paper in Proceedings, National Institutes of Health Consensus Development Conference on Acupuncture sponsored by the Office of Alternative Medicine and the Office of Medical Applications of Research. Bethesda, MD, November 3-5, 1997. pp. 93-109.
- Branco K and Naeser MA: Carpal tunnel syndrome: Clinical outcome after low-level laser acupuncture, microamps transcutaneous electrical nerve stimulation, and other alternative therapies – an open protocol study. The Journal of Alternative and Complementary Medicine, 5(1): 5-26, 1999.
- Naeser MA & Deuel SK: Review of Second Congress, World Association for Laser Therapy Meeting (WALT), September 2-5, 1998, Kansas City, MO, U.S.A. The Journal of Alternative and Complementary Medicine 55(2):177-180, 1999.
Margaret A. Naeser received her B.A. from Smith College, and her Ph.D. degree in Linguistics from the University of Wisconsin (1970). She is a Research Professor of Neurology, Boston University School of Medicine, where she conducts rehabilitation research with stroke and CTS patients. She is a graduate of the New England School of Acupuncture and is a Licensed Acupuncturist in Massachusetts. In 1985, she was invited by the Shanghai Medical University to exchange research information. While in China, she studied the use of acupuncture and laser acupuncture in the treatment of paralysis in stroke patients. She has published four papers on this research, and two books: Outline Guide to Chinese Herbal Patent Medicines in Pill Form – with Sample Pictures of the Boxes, and Laser Acupuncture – An Introductory Textbook for the Treatment of Pain, Paralysis, Spasticity and Other Disorders.
More acupuncture research from Margaret Naeser
Low-level laser research to help treat spinal cord injury cases discussed at http://laserponcture.net