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The Science of Laser Therapy and Clinical Applications
The Science of Laser Therapy and Clinical Applications
The Science of Laser Therapy and Clinical Applications
The Science of Laser Therapy and Clinical Applications
The Science of Laser Therapy and Clinical Applications
The Science of Laser Therapy and Clinical Applications
The Science of Laser Therapy and Clinical Applications
The Science of Laser Therapy and Clinical Applications
The Science of Laser Therapy and Clinical Applications
The Science of Laser Therapy and Clinical Applications
The Science of Laser Therapy and Clinical Applications
The Science of Laser Therapy and Clinical Applications
The Science of Laser Therapy and Clinical Applications
The Science of Laser Therapy and Clinical Applications
The Science of Laser Therapy and Clinical Applications
The Science of Laser Therapy and Clinical Applications
The Science of Laser Therapy and Clinical Applications
The Science of Laser Therapy and Clinical Applications
The Science of Laser Therapy and Clinical Applications
The Science of Laser Therapy and Clinical Applications
The Science of Laser Therapy and Clinical Applications
The Science of Laser Therapy and Clinical Applications
The Science of Laser Therapy and Clinical Applications
The Science of Laser Therapy and Clinical Applications
The Science of Laser Therapy and Clinical Applications
The Science of Laser Therapy and Clinical Applications
The Science of Laser Therapy and Clinical Applications
The Science of Laser Therapy and Clinical Applications
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The Science of Laser Therapy and Clinical Applications

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Theralase Technologies Inc., founded in 1995, designs, develops, manufactures and markets patented, superpulsed laser technology utilized in biostimulation and biodestruction applications. Theralase …

Theralase Technologies Inc., founded in 1995, designs, develops, manufactures and markets patented, superpulsed laser technology utilized in biostimulation and biodestruction applications. Theralase technology is safe and effective in treating pain, inflammation and for tissue regeneration of neural muscular skeletal conditions and wound healing. As well, these applications extend to the care of animals by veterinarians. Theralase complies with FDA, Health Canada, CE, ISO-13485 and CSA-601 regulatory approvals to ensure efficacy, safety and quality in manufacture. Theralase is currently developing patented Photo Dynamic Compounds (PDCs) that are able to target and destroy cancers, bacteria and viruses when light activated by Theralase’s proprietary and patented laser technology.

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  • 1. The Science of Laser Therapy andClinical Applications Chapter Title SectionMay 2012 Greg Bewsh
  • 2. GENERAL HYPOTHESIS FOR LOW LEVEL LIGHT THERAPYLaser Light is able to excite molecules, thus, is directly able to stimulate or amplify cellular pathways or mechanisms that support healing can re-activate systems or processes that have been de- activated as a result of injury or pathology.
  • 3. WHY LASER? Increased treatment efficacy over other modalities Increase clinic revenue by adding valuable new clinic service Ability to penetrate tissue = effective to treat deep seated injuries Fulfill patients’ requests for laser therapy Excellent adjunct to chiropractic treatment Effective and fast- no gels or pads to apply Staying competitive, value added service
  • 4. HUMAN CELLS “Engine of the Cell”
  • 5. KEY CELLULAR PATHWAY 1BEST TO ACTIVATE 3 KEY CELLULAR PATHWAYS TO STIMULATE RAPID HEALING 1.ATP Pathway: Activated by 630-670 nm, Visible Red Light Light sensitive molecules within the mitochondrial membrane are activated by red light. These molecules are integral components of the electron transport chain and their activation leads to increased production of ATP. Cytochrome c oxidase has been identified as a key integral membrane protein activated by laser light.
  • 6. KEY CELLULAR PATHWAY 2 2. Nitric Oxide Pathway: Activated by 905 nm, Near Infrared Light Nitric oxide signals endothelial cells to relax, leading to increased dilation of blood vessels and lymphatic vessels. Dilation of blood vessels inc. blood flow Dilation of lymph vessels inc. drainage/dec. swelling 905 super pulsed light increases nitric oxide levels by 700% compared to other wavelengths and technologies.* (*Published in Lasers in Surgery and Medicine 03/2009)
  • 7. KEY CELLULAR PATHWAY 3 3. Lipid Absorption Pathway: Peak activation in the 900 nm range, Near InfraredMolar Extinction Coefficient (cmM^-1) 60000 Light •Light receptors in bi-lipid membrane of cells are 40000 activated by near infrared light. •Activation of these receptors opens channels within 20000 the membrane, altering the flow of Na+ and K+ ions across the membrane. •This change in electron gradient across a nerve cell 0 can stop the propogation of impulses across the cell 620 720 820 920 1020 and remove pain signals. Wavelength (nm) Water Lipids 900 nm range laser light are able to remove pain signals emitted at source of pain.
  • 8. LASER DRIVE TECHNOLOGIES Super Pulsed: High peak power (50 W) laser diodes delivered in bursts of very short duration (200 nanoseconds) at high frequencies (10 kHz). Provides high number of photons without any heat. Pulsed, Chopped or Pseudo Wave: Continuous wave laser diodes or LEDs which are either electronically (pulse train) or mechanically (shutter) to pulse at low frequencies (100 Hz to 1 kHz). Usually delivered at 50 / 50 duty cycles effectively cutting average power in half. Continuous Wave: Continuous wave laser diodes or LEDs which have a set output power.
  • 9. LASERS VERSUS LIGHT EMITTING DIODES
  • 10. THERAPEUTIC WINDOW
  • 11. THERAPEUTIC LASER PARAMETERSWAVELENGTH: Wavelengths between 600-950 nanometers can create therapeutic (biostimulation) effects. Wavelength and power determine how deep the light will effectively penetrate into the tissues660 nm red light penetrates up to 0.25” per penetration depth into tissue905 nm infrared light penetrates up to 0.42” per penetration depth into tissueCombine 2 wavelengths of light for increased tissue healing & activation of multiplecellular pathways required for healing.POWER: Power of the laser determines the rate at which photons travel into tissue. Higher power delivers a larger quantity of photons to tissue over time, thus achieving the required energy in a shorter period of time.High peak powers are able to deliver high doses of photons to the tissue surface withoutexceeding the Maximum Permissible Exposure (MPE) of tissue.
  • 12. Conditions TreatedACUTE INJURIES• sports injuries• motor vehicle accidents• tendon tears, muscle tears• ligament sprains• fractures• meniscus tears• labrum tears• contusions/hematomas
  • 13. Conditions TreatedCHRONIC INJURIES DEGENERATIVE CONDITIONS• RSIs: Carpal Tunnel • Osteoarthritis • Chondromalacia• Nerve Root Irritation • Degenerative Disc Disease• Facet/capsular irritation • Disc herniation• Compartment syndrome WOUND MANAGEMENT• Myofascial syndromes• Chronic Inflammatory • Ulcers: diabetic, Conditions: tendonitis pressure• Bursitis, myositis, synovitis • Venous insufficiency • Post-operative wounds/scars
  • 14. WHO IS USING COLD LASER THERAPY AND WHERE?Therapeutic lasers are used by various healthcare providers inoutpatient clinics across North America and Europe, including: Medical Doctors and Specialists Pain Clinics Chiropractors Physical Therapists Dentists Podiatrists Naturopaths Nurses Veterinarians
  • 15. HOW OFTEN DO I NEED TO TREAT?The latency period of light into tissue is 24 to 72 hours; therefore, the most often youwould treat is every day and the least often is once every four days.The number of treatments depends on the chronicity of the condition, typically: Acute Injury: 4-6 treatments (Average 5 treatments) Subacute injury : 8-12 treatments (Average 10 treatments) Chronic Injury: 15-25 treatments (Average 20 treatments)Frequency : 3 days in a row, then 3 times per week for the first 3 weeks, followed by 2 times per week thereafter dependent on the number of treatments
  • 16. BENEFITS OF THERAPEUTIC LASER THERAPY • Decrease / eliminate pain • Reduce inflammation • Stimulate new tissue growth (muscle/tendon tears) • Promote new blood vessels (angiogenesis) • Promote nerve axon growth (neuropathies) • Faster wound healing and closure • Non-Invasive / No Side Effects • Extremely Safe / Drug Free • Few contraindications – eyes, cancer, pregnant abdomen, thyroid gland. • Safe over implants, pacemakers, growth plates.
  • 17. TREATMENT-LATERAL EPICONDYLITIS Laser Settings 60 mW, 2.5 minutes per point Treatment Points Treatment with multiple probe over extensor tendon and extensor muscles (2-3 treatment points). Patient Position Seated with arm extended # Treatments Depends on chronicity Acute Injury: 4-6 treatments Subacute injury : 8-12 treatments Chronic Injury: 15-25 treatments Frequency 3 days in a row, then 3 times per week Treatment Goals Eliminate pain Remove inflammation Reduce healing time by up to 50%
  • 18. OSTEOARTHRITIS OF THE KNEES Laser Settings 50 mW, 3 minutes per point Treatment Points Treatment with multiple probe over 4 locations around the knee. Treat over painful areas and arthritic locations: medial/lateral joint lines, peripatellar, posterior knee. Patient Position Seated with knee at 30 degrees flexion (open joint position) #Treatments 15-25 treatments (chronic injury) Frequency 3 days in a row, then 3 times per week Treatment Goals Reduce Pain Stimulate tissue repair Increase activity level/function
  • 19. OSTEOARTHRITIS OF THE KNEES Knee @ 30 deg. flexion to open joint space
  • 20. SCIATICA Laser Settings Settings change with treatment location (due to depth of injury): Lumbar Spine 90 mW, 3 minutes Buttock 80 mW, 3 minutes Posterior Thigh 70 mW, 2 minutes Posterior leg 70 mW, 1 minutes Treatment Points Treatment with multiple probe over involved Spinal level then distal points in buttocks and lower extremities (chase the pain). Patient Position Side or prone with flexed lumbar spine (open joint position) Treatment Goals Eliminate pain / Inflammation Repair Injured nerves Stimulate repair of paraspinal muscles and discal tissue.
  • 21. MARKETING FOR LASER SERVICESInternal :• In office marketing, handouts, talking about new treatments in the office, patient brochures, posters, video streaming in reception area• Patient newsletter announcing new laser technology in clinic• Offer a free treatmentExternal:• Community lectures, paper or radio advertising, sporting events (i.e. set up treatment booth at marathons, races)• Word of mouth referrals from satisfied patients• Have a social media presence
  • 22. BILLING FOR LASER1. Average Billing Fees for Laser ($30 to $140 per 10 minute treatment)2. Sample CPT codes: 97026 Infrared 97026-22 Attended Infrared 97039 Attended Infrared/Attended laser (include 1 page description) 97110 Therapeutic Exercise : In patients who are unable to perform therapeutic exercise due to pain, use the laser 7 - 10 min. then have the patient perform therapeutic exercises minimum 8 minutes (minimum to bill CPT 97110). i.e. Bill $0 for the laser and $30 to $40 per unit of therapeutic exercise (dependent on insurance provider) where 1 unit = 8 to 22 minutes, 2 units = 23 to 37 minutes3. Many clinics charge cash only for laser treatments.4. Extended Health Insurance
  • 23. RETURN ON INVESTMENTPractitioners bill $30 to $140 per 10 min. treatment($3 to $14 per minute, Average of $4.50 per minute)Practitioner assistants administer 100 to 300 patients treatments per month(Average of 200 laser treatments per month)Average Monthly Revenue: $9,000 incrementalCost of Equipment: $10,000 TO $18,000ROI (annual): 514 %Payback Period: 2 to 6 months (depending on the laser configuration)
  • 24. RETURN ON INVESTMENT
  • 25. WHAT TO LOOK FOR IN A LASER MANUFACTUREREvidence based: Look for a laser manufacturer which uses technology and protocolsbased on solid clinical research by a team of clinical and scientific researchers and thefeedback of thousands of health care clinics worldwide.Clinical Research: Look for a laser manufacturer who uses on-going, cutting-edge clinicalresearch from major teaching hospitals, universities and research institutions.Advisory Board: Look for a laser manufacturer with a medical and scientific advisoryboard chaired by renowned medical practitioners and scientific researchers .Results Driven: Look for a laser manufacturer with 100,000’s patients successfully treated,with 1000’s of therapeutic lasers in the field to ensure protocols deliver efficacy, safetyand qualityWorld Class Manufacturer: Look for a laser manufacturer with FDA, Health Canada, CE,ISO-13485 and CSA-601 regulatory approvals to ensure efficacy, safety and quality inmanufacture.
  • 26. THERALASE THERAPEUTIC MEDICAL LASER • Dual wavelength 660nm & 905nm super pulsed laser system • High peak power - up to 4” depth • Short Treatment Times (10 minutes) • Class 3B Laser – extremely safe • FDA , Health Canada and CE cleared - chronic knee pain & neural muscular skeletal conditions • Clinically supported and used by thousands of practitioners Portable / battery operated / Hands free • 72 Pre-Programmed Treatment Protocols • 3 different probes available
  • 27. THERALASE TLC-1000 TESTIMONIALS“The Theralase laser is the most effective technology we have ever used. Our players nowrely on Theralase to keep them healthy and playing at their peak.”George Poulis and Dave Abraham, Toronto Blue Jays, Athletic Trainers“The Theralase laser is now a standard of care treatment methodology within our rehabclinics and is a great tool in helping our athletes return to competition.”James Andrews, MD, Andrews Institute, Orthopedics and Sports Medicine, Florida“I love the Theralase medical laser system and use it in our clinic at least 20 times per day.”Kevin Wilk, DPT, Champion Sports Medicine, Sports Medicine, Alabama“As a chronic pain specialist, the most advanced laser I have used is the Theralasetherapeutic laser system, with which I have treated over 1000 patients.”Dr. Laurence Altshuler MD, Balanced Healing Medical Center, Oklahoma“I use the Theralase laser to keep my throwing arm healthy. It reduces fatigue and allowsme to play at my peak, game after game.”Roy Halladay, Cy Young Award, Toronto Blue Jays, 2003, Philadelphia Phillies, 2010
  • 28. CONCLUSION Increase efficacy of your chiropractic care. Spinal adjustments have longer lasting effects with laser enhanced tissue repair. Expand your range of treatment services. Offer a non-invasive, safe and comfortable treatment option to patients. Increase your revenue stream . Choose a technology with the optimal wavelengths, power, and ease of operation . Choose a treatment that patients are asking for. Practice Growth - Laser patients often become chiropractic patients or refer others. Sports injuries are having great success with laser. High profile athletes using laser has increased exposure of the modality. Questions? THANK YOU FOR ATTENDING www.theralase.com

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