Featured Image – Intra-articular laser treatment
Dear Pain Matters blog readers,
Recent developments have enabled the delivery of low level laser therapy (LLLT) beneath the skin including via:
- Interstitial laser therapy;
- Intra-articular laser therapy; and
- Intravenous laser therapy.
Dr. Med. Dipl. Chem. Michael Weber
This Blog Post will focus on:
- Interstitial laser therapy; and
- Intra-articular laser therapy
for pain management.
Different laser lights are used in interstitial and intra-articular laser therapy including:
- Red laser light – Red laser may increase cell activity and blood circulation as well as enhance regeneration of damaged body tissues in chronic pain conditions;
- Green laser light – Green laser may have anti-inflammatory effects in acute painful conditions including acute swellings; and
- Blue laser light – Blue laser may have strong anti-inflammatory effects, hence reduce acute pain as well as promote wound healing.
Interstitial Laser Therapy:
(Percutaneous) interstitial laser therapy may offer some pain relief for chronic back pain (spinal pain) including:
- Chronic spinal illnesses;
- Slipped discs;
- Scar pain after slipped disc surgery;
- Spinal stenoses;
- Neural lesions; and
- Deep tendinitis and strains.
Interstitial laser therapy uses a sterile catheter to enable laser light (e.g. green and blue laser light) to access deep within the tissue (up to 12 cm penetration depth). Thus, for example, blue laser light can exert its anti-inflammatory effects deep within the body tissue.
Without a sterile catheter, green and blue laser light cannot access deep body tissue regions. Instead, most of the higher energy waves (i.e. green and blue) are absorbed in the skin during external laser therapy only.
Interstitial laser therapy
A Study Involving Interstitial Laser Therapy for Back Pain:
Eleven (11) patients with chronic spinal disorders (disc herniation and spinal stenosis) received interstitial laser spine laser treatments (average = 7.64 treatments per patient).
Red = Pain (before interstitial laser spine treatments)
Green = Pain (after interstitial laser spine treatments)
(‘Kreuzschmerzen’, in German = Back pain; VAS = visual analogue scale; Pain from 0 to 10)
Chronic back pain before interstitial laser spine treatment averaged 5.45 (VAS) (Refer to red).
Chronic back pain after 7 interstitial laser spine treatments decreased to an average of 2.55 (VAS) (Refer to green) (Weber).
Intra-Articular Laser Therapy:
Intra-articular laser therapy may offer some pain relief for painful arthroses including:
- Knee osteoarthritis;
- Hip osteoarthritis;
- Painful shoulder syndromes; and
- Ankle joint osteoarthritis.
Specifically, intra-articular laser therapy allows direct access into painful and injured/diseased intra-articular joints including knee and shoulder joints.
Intra-articular laser therapy
A Study Involving Intra-Articular Laser Therapy for Shoulder Pain:
Ten (10) patients with chronic shoulder pain received intra-articular laser treatments (average = 9.2 treatments per patient).
Red = Pain (before intra-articular laser treatments)
Green = Pain (after intra-articular laser treatments)
(‘Schulterschmerzen’, in German = Shoulder pain; VAS = visual analogue scale; Pain from 0 to 10)
Chronic shoulder pain before intra-articular laser treatments averaged 6.2 (VAS) (Refer to red).
Chronic shoulder pain after 7 intra-articular laser treatments decreased to an average of 2.8 (VAS) (Refer to green) (Weber).
Other Information About Low Level Laser Therapy (LLLT):
Classical low level laser therapy (LLLT) can be topically and non-invasively applied to the skin surface and may include:
- External laser therapy;
- Laser needle acupuncture; and
- Laser needle treatment of the skull (transcranial) and the ear.
Low level laser therapy (LLLT) can also form part of photodynamic therapy including external/topical, systemic and interstitial. Photodynamic therapy includes:
- Photodynamic tumor therapy (for cancer); and
- Anti-microbial photodynamic therapy (e.g. for Lyme disease) (Weber & Junggebauer).
Treatment and research involving stem cells and laser therapy is ongoing.
Whilst relatively new (and undergoing further research), interstitial laser therapy may be useful for reducing chronic back pain (spinal pain), while intra-articular laser therapy may provide certain relief from painful arthroses including knee osteoarthritis, hip osteoarthritis, painful shoulder syndromes and ankle joint osteoarthritis.
Dear Pain Matters blog readers, if you would like to get in touch with Dr Michael Weber and his team, please email Martin Junggebauer on:
Martin is an integral member of Dr Michael Weber’s team, and he will be sure to assist you with your enquiries.
“Sedare dolorem divinum opus est”
“It is divine to alleviate pain”
Galen, 130-200 C.E.
“Medical knowledge is not enough; we must apply it with a passion”
Dr Henri Basam, Spine Care Center, Cairo, Egypt
(1A) Michael Weber, MD, President of International Society for Medical Laser Applications (ISLA)
(1B) Medical Low-Level-Lasertherapy – Foundations and Clinical Applications (2nd Edition, June 2015)
Michael Weber, MD, Robert Weber, Martin Junggebauer
(1C) Michael Weber, MD
Interstitial and intraarticular laser therapy – attractive new therapeutic option for the treatment of spinal diseases and advanced joint osteoarthritis
(1D) Dr Henri Basam, Sherry N Fanous
Knee Pain Management Using Ultrasound-Guided Weberneedle Endo-Laser in Comparison to Fluoroscopy-Guided Thermal Radio-Frequency (2015) (9AP5-10)
Spine Care Center, Cairo, Egypt
(1E) Michael Weber, MD, Thomas Fussgänger-May, MD, Tillman Wolf, MD
“Needles of Light”: A New Therapeutic Approach
Medical Acupuncture (2007); 19(3)
(1F) Weber & Junggebauer. Anti-Microbial Photodynamic Therapy (aPDT) – A New Treatment Option for Infectious Diseases. ISLA Research Group.
(1G) Litscher G, Rachbauer D, Ropele S, Wang L, Schikora D, Fazekas F, Ebner F.
Acupuncture using laser needles modulates brain function: first evidence from functional transcranial Doppler sonography and functional magnetic resonance imaging.
Lasers Med Sci. 2004;19(1):6-11.
(1H) International Society for Medical Laser Applications (ISLA)
(2) Norman Doidge MD
The Brain’s Way of Healing – Remarkable Discoveries and Recoveries from the Frontiers of Neuroplasticity (Chapter 4 – Rewiring a Brain with Light)
Publisher: Penguin Publishing Group (26 January 2016)
(3) Blog by Fred Kahn, MD FRCS(C), LLLT Specialist
YouTubes (in English and German):
(2A) New fiber optic cannula. Interstitial therapy at the root of the Ischia hernia
(2C) Where ‘Coxarthrosis’ = Osteoarthritis of the hip joint