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174 Veterinary Laser Therapy in Small Animal Practice

neuropathic pain, [433] and clinical studies in people third, either no effect or inconclusive outcomes. The
with musculoskeletal disorders, such as knee osteoar- authors pointed out that these negative reports usually
thritis, [434] subacromial impingement syndrome, [435] or did not express parameters properly and/or used inad-
rheumatoid polyarthritis, [436] to name a few. It’s also equate doses, and that half of them were actually of
been reported in the preoperative period; for instance, very low methodological quality, and they concluded
a recent report described improved analgesia in chil- that “the evidence is sufficiently robust to determine
dren after kidney biopsy [437] ; and cats receiving laser the effectiveness of laser acupuncture at long term for
acupuncture at ST-36 and SP-6 points (described in treating musculoskeletal conditions.” According to the
the section on “Acupoint selection”) bilaterally prior same review, its analgesic effects are not always imme-
to induction had lower analgesic requirements after diately appreciated; the difference is more marked in
spaying. [438] If you are curious, the study reports using 3 long-term follow-ups. An idea to consider is to combine
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J/cm , 9 seconds/point, 904 nm, 124 Hz. your laser acupuncture (distal points) with regular laser
Laser acupuncture can also be anti-inflammatory, as treatment of the affected area in musculoskeletal cases.
described in experimental models and clinical studies. Of course, the power used is very different, and as we
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For example, 4 J/cm of 830 nm light decreased car- have said, while you can turn down the power of your
rageenan-induced paw edema in mice. [27] In human class IV laser to use it for acupuncture, you cannot
patients with arthritis, it increases antioxidant levels make a class III laser (perfect for acupuncture) more
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and decreases inflammatory biomarkers (4–6 J/cm ), powerful to allow you to treat a big area with a high
reduces periarticular swelling, and improves range of enough dose using a scanning technique.
motion. [436, 439, 440] Laser acupuncture is more effective when the
Other reported effects in clinical studies are as Traditional Chinese Medicine (TCM) pattern of
follows. disease is yang deficiency, [450] which makes sense since
laser is energy/heat/yang. In TCM theory, yang repre-
• Improvement of symptoms (strength, ROM) in sents heat, activity, movement (yes, in a very simplistic
chronic post-stroke phase. [441] way). Yang deficiency patients show signs such as wors-
• Decrease in morphine needs and hospital stay in ening in cold conditions. This means that your geriatric
newborns with neonatal abstinence syndrome. [442] patients with low back pain and weakness or OA that
• Increase in salivary production in patients with worsens in cold weather will love your laser session
Sjögren’s syndrome [443] during treatment and even more – that works even if you do regular LT.
several weeks after its cessation.
• Modulation of gastric motility. [444] Parameters and technique
• It has an effectiveness similar to pharmacological Wavelength: both red and infrared light have been
treatment for nocturnal enuresis in children. [445] used; infrared will have a deeper penetration, and longer
• Decrease of postoperative vomiting in children – infrared wavelengths will penetrate even more (with the
applied 15 min before induction and in the recovery outputs used in acupuncture, this means deeper as in a
room. [446] few mm). Some authors use the term laser moxibustion
• Improvement of asthma symptoms in children. [447] to refer to the use of infrared wavelengths similar to the
infrared spectrum of moxibustion. [451]
A systematic review of randomized controlled trials Frequency: some of the published results have used
that evaluated laser acupuncture vs. no treatment/ continuous wave and others pulsed wave. I use the latter
sham procedure in people with different conditions to help avoid a thermal effect. Some people hypothe-
concluded there was moderate positive evidence to size that each meridian/organ/location of disorder has
support this use in the treatment of myofascial pain/ its own frequency (for instance, 18,688 Hz for mental
musculoskeletal pain, postoperative nausea and vom- disorders, or 442 Hz to stimulate the Liver meridian)
iting, tension headache, and others. [448] A more recent and therefore you should change it to be in tune with
systematic review with meta-analysis [449] included 49 your target. The most popular series of frequencies are
randomized controlled studies on laser acupuncture those from Nogier, Reininger, and Bahr. [452] Some prac-
and musculoskeletal disorders: two thirds of those titioners have reported positive results, but this has not
reported a positive analgesic effect, and the remaining been scientifically proven. [453]

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