Category Archives: Back Pain

Inserting A ‘Mini Cushion’ and/or Other Implants in the Spine to Reduce Back Pain

Feature Image sourced from:

Dear Pain Matters readers,


Degenerative Cervical Myelopathy

The most common cause of spinal cord dysfunction and pain in adults is degenerative cervical myelopathy.  Myelopathy is spinal cord damage caused by disc degeneration (disc bulges), bone spurs (osteophytes) and other inflammatory triggers.

If not effectively treated, back pain, limb sensory loss and abnormal sensations (paraesthesia)* may result.  Gait and hand dexterity may be compromised.

See Anne’s story (below) that highlights degenerative cervical myelopathy including the importance of timely diagnosis and effective treatment

Degenerative Disc Disease   

Countless people suffer from severe back pain due to degenerative disc disease.  

Damaged discs in the spine may lead to reduced shock absorption while walking, jogging or pursuing other activities.  Shortened discs due to injury, disease or prior surgery may cause vertebrae to come into direct contact with one another.  This may result in bone-on-bone pain, sciatica and other complications.

Tingling and/or numbness in the buttocks or legs may occur due to herniated (i.e. bulging, collapsed or slipped) discs.  This may render walking difficult for some patients.

Once injured or arthritic, discs are usually unable to heal due to their avascular nature.  

Sadly, back pain may become a constant companion.

Novel Treatment for Back Pain Resulting from Damaged Discs: An Implant Called a Device for Intervertebral Assisted Motion (DIAM Implant)

Traditionally, the only surgical option for back pain caused by degenerated discs involved fusing the spinal bones together (aka spinal fusion).

A new implant called a Device for Intervertebral Assisted Motion (DIAM implant) is now available that may offer relief from back pain due to diseased or injured discs.

The DIAM implant is as a polyester-covered silicone interspinous shock absorber that works like a ‘bumper’.  Being small and H-shaped, this implant is designed to shift the weight away from the anterior column.  This helps restore the functional integrity of the posterior column of the spine.

Like a small cushion inserted between injured or diseased vertebrae in the spine, this implant may prevent vertebrae from coming into contact, hence preventing further damage to the vertebrae.  By acting as a shock absorber by reducing stress on damaged vertebrae, a DIAM implant may lead to reduced or eliminated back pain.

During surgery, a small surgical incision is made along the spine and a low amount of bone, interspinous ligament, muscle and/or other soft tissue is removed.  The DIAM implant is then inserted into the space between the spinous processes.**  This implant is subsequently attached to nearby vertebrae.

Other Interspinous Spacers Including Aperius Devices

Degenerative spinal disease may also be treated via alternative interspinous spacers including Aperius PercLID system (Fabrizi et al, 2011).


Wear and tear and/or rejection by the immune system of DIAM implants and other interspinous spacers may occur in some patients.  This may lead to pain and inflammation as well as the removal of affected implants (Seo et al, 2016).

‘Anne’, a 62-Year Old Woman, has Discectomy and Implants for Severe and Painful Cervical Myelopathy

‘Anne’ (not her real name) (62) suffered from severe degenerative cervical myelopathy since she was 59 (although this diagnosis was not confirmed until 3 years later).  As a result, Anne was hospitalised 11 times in the emergency room (ER) in 3 years.

Anne endured pain and abnormal sensations (paraesthesia) from her neck down including in her hands, groins, trunk and legs.  She had a ongoing feeling of water retention throughout her body.

Anne had many strange sensations including:

  • ‘A wet gel-like substance’ had invaded the skin of her face, limbs and trunk; and
  • ‘Something [was] stuck on her skin’ and ‘her hair was stuck down’.

Anne thought that these odd feelings were caused by her olive oil moisturising cream.  (This was because her severe degenerative cervical myelopathy was not diagnosed until 3 years later.)  

During her 11 visits to ER, doctors dismissed Anne ‘for being delusional’ (despite her not taking any psychiatric medication).

While doctors urged her to undergo a psychiatric assessment and a mental health review, Anne resisted.

Anne had back and neck pain as well as numbness and tingling in her arms.  Her legs were stiff and she had difficulty walking.  Anne’s right leg often gave way resulting in numerous falls.   Her coordination and manual dexterity were severely compromised.  Anne had difficulty urinating as well as urinary and faecal incontinence.

Three years later, Anne was finally referred for MRI imaging of her spine.

Following MRI imaging, Anne was diagnosed with severe cervical myelopathy due to degenerative changes in her cervical spine NOT delusions!  Specifically, there was 2 bone spur protusions, one that compressed her spinal cord at C3/4 and another one that led to a narrowing near C5/6.

Surgery for decompression via anterior cervical discectomy at C3/4 was expedited as well as spinal implants.

Following recovery from spinal surgery, Anne’s pain levels decreased while her other symptoms improved.

In summary, despite having been seen by many doctors during 11 visits to ER, Anne was not diagnosed with severe cervical myelopathy until 3 years later.  As a consequence, Anne suffered from intense neck and back pain, abnormal sensations and other symptoms of severe cervical myelopathy for 3 long years.

The good news is that once a correct diagnosis was finally made, and successful spinal surgery was done, many of Anne’s symptoms either decreased or disappeared (Mowforth et al, 2019; Berres, 2019).

A Back Pain Patient Named Rebecca Who Had DIAM Implant Surgery

Having suffered severe low back pain for several years that worsened after becoming a mom of two, Rebecca Morgan of Bristol, UK, said:

‘I started to find everyday activities difficult — even sitting down for any length of time was painful.  The thought of having to lift my son in and out of the bath would sometimes drive me to tears.’

An X-Ray and MRI revealed a collapsed disc as well as changes in the adjacent joints.  Due to the disc’s shortened height, (quoting Rebecca) ‘the nearby joints were inflamed and rubbing together.’ 

In her spinal surgeon’s words:

‘A standing X-Ray showed that one of [her joints in her back] slipped backwards every time she moved or stood up.’

A DIAM implant was inserted between the inflamed joints via minimally invasive surgery.

Rebecca continued with her story (quoting):

‘… my disc was so unsupported and unstable that [the specialist] could move it every which way during the operation.’

No wonder Rebecca had severe back pain prior to her DIAM implant!!

Following successful surgery involving DIAM implant, Rebecca stated (quoting):

‘I was up and walking within a couple of hours after the operation, and within a few weeks I was back to normal. I went on a long-haul flight to Australia, to take the children to visit relatives, just seven weeks after the operation. Now, I’m looking forward to starting pilates classes.’

‘[The DIAM implant] has changed my life … As a result, I have finally said goodbye to all the prescription drugs I used to take, and gone back to the gym.’

In her surgeon’s words:

‘[The DIAM implant] acts as a firm cushion and a stabiliser, and is unique in that it is not made out of metal and isn’t stiff. Rebecca had instant relief and needed only a short stay in hospital’

(Dobson, 2010).

What a heart-warming and inspiring story!

Four Studies Involving Interspinous Spacers (e.g. DIAM Implants, Aperius Devices) for Degenerative Spinal Disease

1. A DIAM Implant Study

A study involving back pain patients (N=68; aged 23 to 75) showed that all patients enjoyed benefits including 92% who had good to excellent improvements, post-DIAM implant.  

Best of all, implant patients enjoyed pain reductions of 71% and enhanced movements by 64% (on average) (Dobson, 2010).

2. A Taiwanese DIAM Implant Study

Back pain patients (N=34) who underwent DIAM implant surgery were followed up for a minimum of 3 years.

All 34 patients enjoyed relief from symptoms.

Specifically, 31 patients (91%) remained symptom free and enjoyed excellent/good results throughout the study, post-DIAM implant. 

However, back pain not due to DIAM surgery nor degenerated discs returned in 3 patients (9%) (Lu et al, 2016).

3. An Italian Review Involving Interspinous Spacers (i.e. DIAM and Aperius Devices) for Degenerative Lumbar Spinal Disease

An Italian review was done of low back pain patients (N=1575) who underwent interspinous device (DIAM or Aperius) insertion for the treatment of degenerative spinal disease.  This included patients with degenerative disc disease (N=478), canal and/or foraminal stenosis (N=347), disc herniation (N=283), black disc and facet syndrome (N=143) and topping-off (N=64).

The average operating time for a DIAM implant was 35 minutes and for an Aperius device was 7 minutes.

Complications arose due to infections (N=10) and fractures of the posterior spinous processes (N=10).  Forty patients required spinal fusion (N=30) or total disc replacement (N=10).

The review reported that symptoms were resolved or improved in 1505 patients (95%) after interspinous device insertion.

This included 924 patients who enjoyed excellent results including nil back pain and complete restoration of mobility after implant surgery.  All 924 patients were able to return to normal work and pursue normal activities.

Another 483 patients had good results including relief of symptoms albeit with some nonradicular pain.  All 483 patients were able to return to modified work.

A further 98 patients had fair results with some improvement in function.  However, these patients could not return to work and/or remained disabled.

Sadly, the remaining 70 patients had a poor outcome following interspinous device insertion.  Their symptoms remained unchanged and they required further surgical intervention.

Having said that, interspinous implant is reversible in failed back syndrome.  More importantly, the vast majority of patients enjoyed partial or complete relief from back pain after interspinous device insertion (Fabrizi et al, 2011).

4. A French DIAM Implant Study

A French study involving back pain patients (N=104) showed that 88.5% enjoyed improvements, 9.6% had no change and 1.9% were indeterminable.

Pain medication intake was decreased in 63.1% of the patients, increased in 12.3% and unaltered in 24.6% (Taylor et al, 2007).


I hope that the stories about Rebecca and Anne as well as the 4 studies may offer hope to some patients with severe back pain due to degenerative spinal disease.

Sabina Walker, Blogger of Pain Matters (in WordPress).


* Paraesthesia is abnormal sensation.  This may include tingling or pricking (i.e. pins and needles).  This may be due to pressure or damage to peripheral nerves.

** Spinous processes are the vertebrae that stick out in the back of your spine.  These can be felt as bumps on your back.   


(1) Dobson, Roger. Tiny cushion that sits in your spine to cure back pain. Daily Mail Australia (

Peer-Reviewed Paper

(2) Lu et al. Clinical outcome following DIAM implantation for symptomatic lumbar internal disk disruption: a 3-year retrospective analysis. J Pain Res (31 Oct 2016); 2016: 917—924.

(3) Taylor et al. Device for intervertebral assisted motion: technique and initial results. Neurosurg Focus (15 Jan 2007); 22(1): E6.

(4) Seo et al. Foreign Body Reaction after Implantation of a Device for Intervertebral Assisted Motion. J Korean Neurosurg Soc (Nov 2016); 59(6): 647–649.

(5) Fabrizi et al. Interspinous spacers in the treatment of degenerative lumbar spinal disease: our experience with DIAM and aperius devices. Eur Spine J (2011); 20(Suppl 1): S20–S26.

doi: 10.1007/s00586-011-1753-2

(6) Mowforth et al. “I am not delusional!” Sensory dysaesthesia secondary to degenerative cervical myelopathy.

Peer-Reviewed Papers Not Discussed Above

(7A) Pintauro et al. Interspinous implants: are the new implants better than the last generation? A review. Curr Rev Musculoskelet Med (2017); 10(2): 189–198.


(7B) Buric and Pulidori. Long-term reduction in pain and disability after surgery with the interspinous device for intervertebral assisted motion (DIAM) spinal stabilization system in patients with low back pain: 4-year follow-up from a longitudinal prospective case series. Eur Spine J (2011); 20(8): 1304–1311.

doi: 10.1007/s00586-011-1697-6

(7C) Gazzeri et al. Failure rates and complications of interspinous process decompression devices: a European multicenter study. Neurosurg Focus (2015); 39(4): E14.

doi: 10.3171/2015.7.FOCUS15244

Media (in German)

(8) Berres, Irene. Eine rätselhafte PatientinDie ist doch verrückt. Spiegel (5 May 2019).

Frida Kahlo, the Mexican Heroine of Pain (La Heroina del Dolor)

This Feature Image depicts the beautiful and talented painter, Frida Kahlo (on left).  It also shows one of Frida’s famous paintings called ‘The Broken Column’ that embodies her own severe pain and suffering (on right).

Feature Image sourced from:


Dear Pain Matters blog readers,

I was first ‘introduced’ to the famous Mexican artist, Frida Kahlo, by my own beautiful daughter, Sarah, who invited me to watch the movie ‘Frida’ with her.

Diminutive in stature, Frida was larger than life itself.

Known for her talent as a Surrealist painter, Frida is a beloved cultural icon in Mexico.

Sadly, Frida endured a spate of tragedies that resulted in lifelong chronic pain including excruciating back pain.

Born to a German father and a mestiza* mother on 6 July 1907, Frida was stricken with polio when she was about 6.  Polio caused her right leg and foot to be severely damaged and left her with a permanent limp.

Sadly, polio was not the only tragedy in Frida’s life.

Quoting Frida:   

‘I suffered two grave accidents in my life.  One involved a bus, the other is [husband] Diego.’


In addition to polio, tragedy struck on 17 September 1925 when Frida was only 18.  While returning home from Mexico City with her then-boyfriend, the wooden bus that they were travelling in crashed into a tram.

During this bus accident that involved multiple fatalities, a steel handrail smashed Frida’s pelvis and was impaled through her left hip, belly and womb, exiting through her genitals.

Needless to say, Frida’s injuries were severe and horrific and included fractures in her back, collarbone and two ribs.  Her lower spine and pelvis were both broken in 3 different places while her left shoulder was out of joint.  Frida’s polio-deformed right leg had eleven (11!) fractures and her right foot was dislocated and crushed (Rogers, 2009).  (Wow!  Imagine going through all that!!)

Amazed that Frida barely survived this terrible bus accident, doctors (correctly) predicted that she would never have children.

Instead, chronic pain would become her ultimate companion.

To distract herself from the boredom of 2 years of bed rest including months in a plaster corset to hold her body in place, Frida started to paint extensively and with great passion.

It was at this stage in her life when Frida decided to become a painter instead of a doctor.


On 21 August 1929, Frida married Diego Rivera, a chronic cheater during his previous relationships.  At 42, Diego was 20 years older than Frida, overweight and very big.  Diego was also a well-travelled and famous painter whose friends included Pablo Picasso, Amedeo Modigliani and Leon Trotsky.


Wedding photo of Frida and Diego

Source of Image:

Pinterest and

Whilst in love, their relationship was a turbulent one that included a year-long divorce.  Diego continued with his many extramarital affairs.

Deciding to ‘fight fire with fire’, Frida indulged in her own extramarital affairs (including an affair with her husband’s friend, Leon Trotsky) while also exploring intimacy and sexuality with other women.

While trying to have a baby with Diego, Frida had to abort a pregnancy because of health issues pertaining to her bus crash in 1925.  She also suffered a miscarriage in 1932 (Espinoza, 2007).

(Whilst it would be interesting to explore Frida’s vivacious and colourful love life, this is outside the scope of this blog.  See references below including Lisa Waller Rogers for further details.)


Frida endured more than 30 operations after her severe bus accident until her death in 1954.  This included 7 spinal operations, one that involved a 2nd spinal fusion because the wrong vertebrae were fused during an earlier operation.  Frida also had her right leg amputated (see below).

Frida’s increasing pain levels meant that she could only paint for short periods of time.

Frida’s health issues only worsened with time.  Her rigid medical corset no longer supported her failing spine and she had to undergo radical spinal and leg surgery.

In 1953, her right leg had to be amputated below her knee due to gangrene that may have resulted from a previous surgery.

Sadly, Frida, the Mexican Heroine of Pain (La Heroina del Dolor), died on 13 July 1954, having turned 47 only one week earlier.


‘The Broken Column’ (1944)

When looking at her painting, ‘The Broken Column’ (shown earlier and below), people often assumed that Frida was a Surrealist painter.  In actual fact, Frida expressed her own reality that included severe pain in the ‘The Broken Column’.

In her words,

‘They thought I was a Surrealist, but I wasn’t. I never painted dreams. I painted my own reality.’

‘My painting carries with it the message of pain.’

Thus, Frida used her painting, The Broken Column’, to express her own excruciating pain and suffering.


‘The Broken Column’ (Frida Kahlo, 1944)

Source of Image:

As seen here, repeated spinal surgery had confined her body in a rigid corset apparatus.  Despite holding her broken body together, her corset appears very tight, uncomfortable and restrictive.

Frida’s spinal column appears to be cracked, broken and injured in many places.

The nails embedded throughout her body clearly show the severity of her pain and suffering.

Frida shows herself as being alone in a barren wasteland.  This further adds to a sense of hopelessness, helplessness, emptiness and despair.

Despite all her pain, suffering, sadness and vulnerability, Frida exudes beauty, elegance, femininity and dignity in ‘The Broken Column’ (Peters, 2002).

‘Tree of Hope’ (1946)


‘Tree of Hope’ (Frida Kahlo, 1946)

Source of Image:

Despite bed rest and wearing a steel corset for 8 months following yet another spinal surgery, Frida’s health issues including sharp pains in her back became worse.

In response to her severe back pain and deteriorating health, Frida painted the ‘Tree of Life’.      

Although Frida is seen weeping in this painting, she is hopeful for a recovery from her recent spinal operation.  The Spanish words ‘Cielito Lindo’ (‘Tree of Hope, keep strong’) appear on a flag in her right hand.  This flag has a red tip that looks like a surgical instrument stained with blood.  Frida holds a pink orthopaedic corset in her left hand.     

Frida is also seen under anaesthetic in hospital and bleeding from fresh surgical wounds following her spinal operation.

In the background, the landscape looks forlorn and barren without a trace of hope.  There are 2 large fissures in the dry earth that mirror the 2 gaping wounds in Frida’s back.

Quoting Frida, this painting was ‘nothing but the result of the damned operation!’


Frida leaves behind a legacy of her paintings despite suffering, and perhaps because she suffered, from chronic pain during most of her life.

I hope that you find Frida’s story inspirational, in particular, her passion for art, life and love despite enduring severe and debilitating chronic pain.

Sabina Walker

Blogger, Pain Matters (in WordPress)

* A mestiza is a person with indigenous and European ancestry.


Peer-Reviewed Articles

(1) Courtney, Carol A et al; Frida Kahlo: Portrait of Chronic Pain. Physical Therapy (1 January 2017); 97(1): 90–96.

doi: 10.2522/ptj.20160036

(2) Antelo, Fernando. Images of Healing and Learning- Pain and the Paintbrush: The Life and Art of Frida Kahlo. American Medical Association Journal of Ethics – Virtual Mentor(May 2013); 15(5): 460-465.

doi 10.1001/virtualmentor.2013.15.5.imhl1-1305

Media, Blogs and Newspaper Articles

(1) Courtney, Carol A. Frida Kahlo’s life of chronic pain.

(2) Espinoza, Javier. Frida Kahlo’s last secret finally revealed. The Guardian – Australia Edition (12 August 2007).

(3) Walter, Natasha. Feel my pain. The Guardian – Australia Edition (21 May 2005).

(4) Sykes, Alan. Frida Kahlo and Diego Rivera at the Bowes Museum. The Guardian – Australia Edition (11 May 2012).

(5A) Frida Kahlo and Diego Rivera – Love and Pain.  Art Gallery of NSW (25 Jun – 23 Oct 2016).

(5B) Verghis, Sharon. Frida Kahlo: artistic genius and queen of pain. The Weekend Australian (18 June 2016).

(6) Mantalvanos, Soula. Frida Kahlo: Portrait of Chronic Pain. Pudental Nerve – Soula’s Chronic Pelvic Pain Story (25 August 2016).

(7) neurophilosophy. Frida Kahlo’s life of pain. Science Blogs(24 January 2008).

(8) Siqueira-Batista, Rodrigo et al.Art and pain in Frida Kahlo. Rev. dor – São Paulo (April/June 2014); 15(2).

(9) Peters, Katie. Frida Kahlo’s Self-Portraits – The Broken Column (1944). Virginia Commonwealth University(2002).

(10) Kelley, Wes. The Painful Life of Frida Kahlo: How Injury Led to Inspiration.

Medium(14 Oct 2016).

(11) Medrut, Flavia. 17 Frida Kahlo Quotes to Inspire You to Turn Pain Into Beauty. Goalcast (28 November 2017).

(12) Exploring Frida Kahlo’s Relationship With Her Body

(13) Brown, Amy. Frida Kahlo – An Amazing Woman (1907-1954)


(14) Collins, Amy Fine. Diary Of A Mad Artist. Vanity Fair (3 Sept 2013).

(15) Frida Kahlo

(16) Frida Kahlo Corporation

(17) Frida Kahlo – Paintings, Biography, Quotes

(18) Katz, Neil. Frida Kahlo Biography: Medical Mystery, Controversial Death. CBS News (6 July 2010).

(19) Rogers, Lisa Waller. Lisa’s History Room – Where the Past is Always Present (26/27 May 2009).

Frida’s First Bad Accident.

Frida Kahlo’s Other Accident.

Frida Kahlo: A Few Small Nips.

Many other fascinating blog posts by Lisa Waller Rogers are offered here:


(1A) Frida. A Hollywood production by Miramax directed by Julie Taymor (2002; 123 minutes).

(1B) Frida, Naturaleza Viva. A Mexican film directed by Paul Leduc (1983).


(1) La heroine del dolor (heroine of pain).

Article in German

(1) Rothenfluh, Anna. Frida Kahlo: Die Frau, die den Tod auslachte. Watson (14 Jan 2018). 


External Laser Therapy and Laserneedle Acupuncture for Chronic Pain

Featured Image:   Comb Jelly (Mnemiopsis sp.)

Dear Pain Matters blog readers,

External laser therapy is used to exert various biological/cellular effects in the body including:

  • Stimulation of various acupuncture points (via noninvasive, painless Laserneedle acupuncture); and
  • Treatment of local damaged areas within the tissue.  Local laser therapy may be done for pain management, rehabilitation and regeneration of damaged tissue.

External laser therapy uses various laser wavelengths (i.e. colours) to penetrate different depths and tissues beneath the skin including:

  • Infrared laser (800 – 900 nanometers, ‘nm’; 810 nm, may be used) – 5 to 7 cm depth below the skin;
  • Red laser (630 – 680 nm; 658 nm may be used) – 2 to 3 cm depth below the skin.  Red laser can increase cellular activity and blood circulation as well as stimulate immune cells, fibroblasts and mitochondria, leading to regeneration and improved healing including wound healing;
  • Green laser  (532 nm) – 0.5 to 1 cm depth beneath the skin.  Green light is largely absorbed by haemoglobin in the red blood cells; and
  • Blue laser (405 nm) – 1 to 2 mm depth only.  Blue laser light has anti-inflammatory effects.

External laser therapy can be applied via:

  • Single point lasers.  Only one point and 1 wavelength can be used in single point lasers; or
  • Laserneedles.  Up to 12 multi-channel lasers/points including different wavelengths/colours/power outputs may be used at the same time (e.g. Weberneedle system, Lasershower).

External laser therapy may treat various painful medical conditions including:

  • Spine syndromes/back pain;
  • Osteoarthritis;
  • Rheumatoid diseases;
  • Tendon inflammation;
  • Migraine/headache; and
  • Trigeminal neuralgia

(Michael Weber MD).




A study involving laser acupuncture treatment for fibromyalgia patients reported an average Pain Scale of 4.4, post-laser acupuncture (compared to an average Pain Scale of 8.5, pre-laser acupuncture).

Further improvements occurred when laser acupuncture plus intravenous laser was offered to fibromyalgia patients (i.e. average Pain Scale of 2.9, post-laser acupuncture plus intravenous laser, compared to 8.9, pre-treatment).


  • Laser acupuncture; and
  • Laser acupuncture plus intravenous laser

were more effective for pain management than medication alone (6.8, post-medication, versus 8.7, pre-medication) and metal needle acupuncture (6.0, post-treatment, versus 8.5, pre-treatment) in fibromyalgia patients (Wieden).

(For more on intravenous laser, please refer to:

Possible Mechanisms:

I urge all interested readers to read Chapter 4 called ‘Rewiring a Brain with Light’, in Norman Doidge’s 2nd book, ‘The Brain’s Way of Healing’.  This book provides an excellent introduction into phototherapy (i.e. low level laser therapy; LLLT) (Doidge, 2016).  

Scientists have recently shown that humans (including the human eye and brain) may detect and perceive a single photon (Tinsley et al, 2016).  This is very interesting as it shows the sensitivity of the human body to the biological (hence potential healing) effects of natural light including its visible wavelengths from 400 to 700 nm (blue to red) and invisible wavelengths from 800 to 900 nm (near infrared).


Whilst relatively new (and undergoing further research), external laser therapy and Laserneedle acupuncture may be useful for reducing pain in many chronic pain conditions including fibromyalgia.

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.

Sabina Walker

“Sedare dolorem divinum opus est”
“It is divine to alleviate pain”

Galen, 130-200 C.E.


(1A) Michael Weber MD

Laser in Pain Therapy and Rehabilitation

(1B) Michael Weber MD, Robert Weber, Martin Junggebauer

Medical Low Level Laser Therapy – Foundations and Clinical Applications (2nd Edition, June 2015)

(1C) Michael Weber MD, President of International Society for Medical Laser Applications (ISLA)

International Society for Medical Laser Applications (ISLA)

(1D) Michael Weber MD, Thomas Fussgänger-May MD, Tillman Wolf MD

“Needles of Light”: A New Therapeutic Approach

Medical Acupuncture (2007); 19(3)

DOI: 10.1089/acu.2007.0539

(1E) Michael Weber MD, Zulia Frost MD

Multi-Laser Needle Acupuncture and Laser Blood Irradiation Therapy – Clinical Application of Biological Laser Therapy (Pages 1-50)

Other Papers, Articles and a Blog by Fred Kahn, MD FRCS(C):

(2) Wieden, Torsten E. (MD Anaesthesiologist, Special pain therapy)


Fibromyalgia in Pain Therapy – Mechanisms and Treatment Options in Laser Therapy

(3) Pryor, Brian A

Class IV Laser Therapy – Interventional and Case Reports Confirm Positive Therapeutic Outcomes in Multiple Clinical Indications (2009)

(4) Class IV Laser Therapy – Case Study Reports (Pages 1-39)

(5) 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.

DOI: 10.1007/s10103-004-0291-0

(6) 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)

ISBN: 9780143128373

(7) Blog by Fred Kahn, MD FRCS(C), LLLT Specialist

(8) Tinsley JN et al

Direct detection of a single photon by humans.

Nat. Commun. 7:12172

doi: 10.1038/ncomms12172 (2016).



Interstitial and Intra-Articular Laser Therapy for Chronic Pain Including Back Pain and Painful Osteoarthritis

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.

Sabina Walker

“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)

DOI: 10.1089/acu.2007.0539

(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.

DOI: 10.1007/s10103-004-0291-0

(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)

ISBN: 9780143128373

(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


Traditional Chinese Medicine (TCM) For Chronic Pain? Let’s Talk About Corydalis, A Traditional Chinese Herbal Remedy For Chronic Pain

Source of Featured Image:

Courtesy of Shutterstock


Dear Pain Matters blog readers,

Is traditional chinese medicine (TCM) a treasure box that needs to be opened more fully??

In other words, should more research be done to scientifically explore the hidden treasures of TCM?  If we did this, would we find additional effective pain treatment options not yet offered by conventional medicine?

Consider this ancient, nonaddictive, Chinese herbal remedy for chronic nerve pain that may, at times, offer longer lasting pain relief than opiates:

The roots of a flowering poppy plant called Corydalis yanhusuo (C. yanhusuo; Corydalis) has been used for centuries as a Chinese remedy for chronic pain.  Corydalis is grown in China, Japan and Siberia.  The underground tubers from the Corydalis plant must be harvested, dried, ground, and boiled in hot vinegar before they can be used as a remedy for pain including headaches, back pain, menstrual cramps, chest pain and abdominal pain.


Source of photo showing Corydalis yanhusuo:

In collaboration with Chinese scientists, University of California researchers have recently identified and isolated a key pain-relieving compound called dehydrocorybulbine (DHCB) in the roots of Corydalis.  Specifically, basic research showed that DHCB (extracted from the Corydalis tubers) reduced acute pain, inflammatory pain as well as injury-induced nerve pain.  The compound, DHCB, blocks dopamine D2 receptors.

More importantly, the DHCB does not interact with the morphine receptor.  As such, the effectiveness of DHCB will not weaken over time, nor will tolerance, addiction and drug dependence become issues (as often occurs with conventional opiate medicine including codeine and morphine).

Researchers felt that DHCB could offer some relief for low-level chronic pain without the risk of addiction or tolerance following repeated use (Zhang et al, 2014; Ingram, 2014).

Patient experiences with Corydalis yanhusuo extracts:

While not scientifically verifiable, the following (partially copied) user comments are interesting to read:


User Reviews & Rating – CORYDALIS

Quoting comments from a disappointed pain patient:

Patient –

“I took my first capsule this morning and have felt tired, dragged out, strangely a little depressed and above all light-headed–dizzy enough to stumble and fall. If anything, my painful back, hips and knees hurt more today. Obviously I won’t take it again.

Quoting positive comments from people with chronic pain who use Corydalis:

Patient –

“…both knees replaced at the same time, and also suffer from frequent headaches.  I began using this product after my surgery and it has provided me with great relief!  ….easier on my GI system….Love Corydalis!  Been a lifesaver for me!

Patient –

“I have been taking 1-2 capsules a day.  It helps my joint pain considerably which I’ve had for 20 years….”

Patient –

“I have had severe knee pain for several years due to old sports injuries and have began using the Cordyalis 10:1 pills recently. The first day my pain was so subtle that I hardly noticed it at all. Stairs were a nightmare for me, but they are much, much easier to handle. I know that nothing can completely remove the pain I suffer from, but this is positively changing my quality of life!!

Patient –

“I have degenerative disc disease and get spinal headaches from intermittent neck pain. I was instructed by a Taiwanese doctor to take 20g boiled in water from 500cc down to 250cc (about 25 minutes on electric stove med-hi), straining out and discarding the root at the end. I found 20g was too much (I experienced worse spasms), tried 5g, and ended up using 10g per serving, up to twice a day. I found that taking it daily was less effective than taking as needed (was hoping to keep the pain away by taking daily.) When I first used it, it made me “high” like cough syrup. After a few servings, I no longer feel that. It’s probably the most effective thing I’ve taken for the pain (I will not take opioids, which tend to make me sick anyway.) …. The tea from root tastes horrible….”

Patient –

“I have had constant shoulder and neck pain for 2 yrs which also cause headaches and migraines. Muscle relaxers and fiorcet are my daily regimine but still constant pain that made me so tired and energy draining. Since using corydalis i have energy and no shoulder pain.

Patient –

“Has eased my intractable nerve pain.”

Patient –

“Female, 66 – for sciatica. I take the powder: premixed, in hot water – drink it fast so as to obscure the taste. Worked in 30 min. the first time taken. I take it 1/2 hr before eating dinner. I’ve learned to put Stevia in it – helps with the taste.”

Patient –

This stuff works, however, I have only taken it in the powdered form. It tastes terrible … Its hard to figure out dosages. I take two teaspoons per day on most days to augment my pain medication, hydrocodone. It dramatically extends the time the hydrocodone works and seems to add some additional relief. I am concerned about possible harmful effects and standardization of strengths of the herb……

[Blogger’s comments:

Based on above, is it possible that the effectiveness of certain conventional pain medication (in this case, hydrocodone) may be increased, and/or prolonged, through the use of Corydalis?  Further research is warranted.]   

Patient –

I have experience chronic low back pain for about 2 years. The pain is 24/7 and worsens with inactivity or excessive physical fitness. I purchased capsules. The serving size is 8 capsules and I only took 3 and felt amazing relief. I lifted weights today for my legs and shoulders then did 15 minutes of interval sprints and my back feels PHENOMENAL! For $15.99 it is worth the try!….

Patient –

“I have a bulging disk and pain 24/7, at times it feels like to torture. Corydalis has helped the pain a little so my pain level is 4 instead of 7 or 8.

Patient –

“I have had fibromyalgia for 25 years and now suffer spinal stenosis after car wreck 10 years ago. I have found acupuncture and this herb to help the pain and neurological problems.….”

A huge word of caution:

While DHCB is currently not available, TCM practitioners can offer Chinese herbal remedies/extracts that specifically include Corydalis yanhusuo extracts or roots/tubers (as they have already done for many centuries).  Corydalis extracts are also available in Chinese specialist stores and on-line.

However, in Dr Civelli’s words, “DHCB is present in low quantities, but it’s there” (Chia, 2014).

Thus, traditional Chinese remedies that include Corydalis yanhusuo extracts or tubers are certainly worth trying (after discussing with your GP first).  

Please discuss with your GP before deciding to undergo any TCM treatments and/or other alternative/complementary medical treatments (as well as post-TCM treatment, if necessary).


Increased funding and research into TCM including ancient Chinese herbal remedies for pain are warranted.

In particular, we need to expand research into Corydalis, and its key pain-relieving ingredient, DHCB (as well as research into other effective pain-alleviating remedies offered by TCM).

After all, the best approach is a global and unified approach to the global challenge of chronic pain.

Sabina Walker


(1) Zhang et al; A Novel Analgesic Isolated From a Traditional Chinese Medicine; Current Biology (20 January 2014); 24(2): 117-123.

doi: 10.1016/j.cub.2013.11.039

(2) Ingram; Pain: Identification of novel analgesics from traditional Chinese medicines; Current Biology (3 February 3 2014); 24(3): R114–R116.

doi: 10.1016/j.cub.2013.12.030

(3A) Plant Used in Chinese Medicine Fights Chronic Pain; Cell Press (2 January 2014).

(3B) Zhang, Wang, et al; Chinese Herbal Compound Relieves Inflammatory and Neuropathic Pain; UCI News (2 January 2014).

(3C) Ericson, John; Chinese Poppy Plant, Corydalis, Works For Chronic Pain; Drugs (2 January 2014).

(3D) Chia, Jessica; The Plant That Could Erase Chronic Pain; Prevention (2 January 2014).

(3E) Pain, Stephanie

Painful Progress

Nature (14 July 2016); 535, S18–S19


(4) User Reviews & Rating – CORYDALIS