Laser Acupuncture in Your Practice: A Follow-Up Q&A
Who knew the floodgates would open after writing my last article on Laser Acupuncture entitled: Laser Acupuncture in YOUR Practice: What you Need to Know. The purpose of the original article was to spark an interest in the possibility of adding laser treatment options to your practice. Since the article was written, I have received a mass of emails from practitioners who want to know more.
Here are a few of the things I've learned from the feedback:
1. Acupuncturists are interested in incorporating laser treatment into their clinic.
"I like the idea of being able to reach people who would otherwise stay away from acupuncture."
"Your most recent article in Acupuncture Today on laser acupuncture struck me as really profound and resourceful."
2. Those who are using laser treatment find it effective.
"Kimberly, thanks to you, I pulled out my old laser 635nM, having forgotten about it for many years. I used it on an area where I had bitten my inside lower lip & [the pain] instantly decreased about 98% using the laser! So, now I have started introducing it to a few patients."
"I like it! It's very nice on 'calming' points. HT 7, Yintang etc. I find it useful to use both blue and red simultaneously...i.e. blue on LR 2 and red on SP 2. It's nicer than needles on jing-well points."
"I love the blue laser. I've been using it for two weeks and am having amazing results! The first day I used it to treat plantar fascia tightness and cervical tightness. The patients reported back the following day that they noticed a decrease in symptoms and felt more relaxed in those areas. I highly recommend it and already have told several others to buy one."
3. Practitioners want to know MORE.
"This article was intriguing and has led me to do more research."
"Thanks from us acupuncturists who have no clue to laser acupuncture. I found your article 'Laser Acupuncture in Your Practice,' very informative, but at the same time have more questions."
Today's article is a compilation of questions I have received since writing my article.
Q: There are many conflicting points of view on whether or not a 5mW laser is able to provide any benefit for acupuncture patients. I've talked to practitioners who say you MUST have a high-powered laser in order to get good results. They also say low powered lasers are a "waste of money," and you must have at least 200-600 mW to get good results. What are your thoughts?
Ahhh…. The low-power versus high-power debate for laser use rages on.
The use of high-power lasers versus low-power lasers is really a matter of preference. Those who favor high power say you have to apply a certain amount of power to have the desired effect. They typically talk about dosages measured in joules per square centimeter, consistent with the belief that a certain amount of energy must be deposited in the tissue for the treatment to be effective. Those on the team for low-powered lasers believe a gentle push within a meridian gets the existing qi moving, producing excellent results. Remember what I said in the original article regarding whispering versus shouting? Here is a recap:
"I think of the alternatives in terms of communication. Both shouting and whispering are effective forms of communication. The high-powered (Class IIIb) infrared lasers penetrate deeply and deposit lots of energy into the tissue. This is the shouting approach. The 5 mW laser is more like whispering, but because you are dealing with the power of the meridian system, all it needs is a little push, or a whisper, to do what needs to be done."
I have no doubt practitioners using higher-powered lasers are getting good results. I get great results with a lower-powered laser, and many other practitioners report they are getting amazing results with low-powered lasers as well. I still maintain it's more about communication than about energy transfer, and low power accomplishes this beautifully.
So, as I said... It all comes down to a matter of preference. Are you a whisperer or a shouter in your treatment style?
Q: I've heard of very expensive laser devices. Will I get effective results if I don't buy one of the more expensive laser systems?
I address this more fully in my previous article. There are expensive devices that are very effective. How expensive or complex a system you choose depends upon your needs. If you are specializing in deep penetration and wound healing, you will need a high-powered infrared laser in the 700-1000 nM wavelength. Similarly, if you want to program frequencies to sweep or flash the laser, you'll need a more expensive system.
For treatment of acupuncture points that are close to the surface, the 635 nM (Red) or the 450 nM (Blue) are sufficient at the 5 milliwatt (mW) power level. Deep penetration with infrared isn't necessary for movement of qi through superficial acupuncture points.
Q: Do I need both the RED and BLUE laser? If so, what are the differences?
If you are only going to get one laser, I would suggest the 635 nM red. I've been using the red laser for years with great results. The blue laser is newer on the market and is a great addition if you already have a red one. I like having BOTH so I have full flexibility during treatment.
Here is a list of general differences between the two:
635 nM (RED):
- Use this laser anytime you would normally tonify with a needle.
- Great for CHRONIC conditions.
- Excellent for scar tissue: There is a deficiency of energy at the point of scar tissue formation. Your goal is to bring energy back into the area.
- Ear therapy: I find the electrically active points on the ear and then treat with the red laser if I'm treating a CHRONIC condition.
450 nM (BLUE):
- Use this laser anytime you would normally sedate with a needle.
- Great for ACUTE conditions.
- Excellent for treating pain caused by inflammation.
- Ear therapy: I find the electrically active point on the ear, and then treat with the blue laser if I'm treating an ACUTE condition.
Q: There are so many lasers on the market. How do I choose a laser to fit my needs? Where did you purchase your lasers?
We discussed knowing the difference in wavelength and output in the last article. You should first assess your clinical needs. Are you looking for a high-powered laser device for the shouting effect (Class III b), or a low-powered laser device for a whispering effect?
I use low-power lasers in my clinic and get great results. Red lasers can easily be found on the Internet. Just make sure you get the correct wavelength for your needs. Blue lasers on the other hand are harder to find because they are newer on the market. One resource that carries both the red and blue lasers I use in my clinic is www.AcuBeam.com.
For more information about regulations regarding acupuncture and high-level acupuncture devices, I suggest you read an article by Margaret A. Naeser, Ph.D., Lic.Ac., Dipl.Ac: "Some General Information on Painless, Non-Invasive, Low-Level Acupuncture."
Dr. Naeser sent a nice letter thanking me for my article. She has done some incredible research in non-invasive, low-level acupuncture, and written a book entitled: Laser Acupuncture to Treat Paralysis in Stroke, Pain in Carpal Tunnel Syndrome and other Disorders.
Q: When do you use laser instead of needles? Do you ever use needles and laser together?
I know a lot of practitioners who only use laser. Because I have a TCM degree, I like to use needles. But, NOT everyone who walks through my door likes to be treated with needles. I choose to use laser instead of needles for the following conditions.
- Patients who are afraid of needles
- Auriculotherapy on sensitive ears
- Extremely painful points such as Jing-well and Kidney 1
- Children and infants
- Scar tissue blockages
I sometimes use laser and needles together—especially if I find a point that is extremely painful for the patient but I know the treatment is needed. Sometimes when a patient is extremely needle sensitive on a particular day, I'll laser the point first and then insert the needle. In my experience, laser seems to take the excess pressure off a "full" acupuncture point, which results in less pain when needling.
Q: Can you share the article referencing how laser light moves through the "fiberoptic network" in the body?
The article referred to is entitled "Meridians Conduct Light" by Pankratov. This article talks about how laser light can be measured within an acupuncture channel. The research in this article states that "light, when exposed to human skin, has been shown to pass into the body between 2 and 30 mm, depending on the color spectrum of the light."
Q: Do patients still get a nice neurotransmitter effect from laser treatment, as they do from relaxing with acupuncture needles for 30 minutes?
Low-level lasers, used to treat brain disorders, were found to activate the brain. Here is a helpful research study: The Brain Effects of Laser Acupuncture in Healthy Individuals: An fMRI Investigation.
Q: You mention avoiding laser on a tumor on the surface of the skin. Since laser increases proliferation of cells and angiogenesis, is it safe to have laser move through a channel and possibly activate a tumor in a distal region of the body? (Example: Will treating ST 36 cause proliferation of cancer cells in breast tissue?)
To stimulate cell growth, the light needs to be intense and concentrated on the actual cells. After the laser light goes through the skin, the intensity decreases. For example, if you have a tumor in the colon, you can't get enough light up the large intestine channel to make its way to the tumor. The contraindication I mentioned in the article was in relation to cancer cells on the surface of the skin.
Q: Can I bill insurance companies for laser acupuncture?
Billing codes for acupuncture specifically state you must use one or more needles during your treatment procedure. The insurance company won't stop you from "including" extra modalities such as laser, acupressure, massage or moxa into your treatment session, but you must insert at least one needle if you intend to bill under the acupuncture billing codes.
Q: How do you charge for laser treatment? If you treat with acupuncture and laser, do you charge extra?
I charge the same as any other acupuncture visit. I do not bill it as a separate modality. I'm still treating points. Patients pay for my time. I may choose to treat points with acupuncture needles, microcurrent, electrical stimulation, moxa, cupping, etc. Whatever the method, I charge the same.
So there they are. Some of the more interesting questions that have come my way since I wrote my last article on laser acupuncture. What started out as a "spark" to create an awareness of laser acupuncture, turned into a bonfire where acupuncturists worldwide are joining the conversation and sharing success stories. Laser acupuncture may not be for everyone—but it may be for you.