This document discusses a study on the use of laser acupuncture to treat temporomandibular disorders (TMD). While the study claimed to use laser acupuncture, it actually used a combination of laser acupuncture on acupuncture points and low-level laser therapy (LLLT) on trigger points. The laser parameters matched those typically used in LLLT studies rather than acupuncture. Future studies should clearly separate laser acupuncture from LLLT in order to properly evaluate the contribution of each approach.

1. Laser acupuncture – to be or not to be
By Jan Tunér
A comment on: Hu WL, Chang CH, Hung YC, Tseng YJ, Hung IL, Hsu SF. Laser acupuncture
therapy in patients with treatment-resistant temporomandibular disorders. PLoS One. 2014 Oct
17;9(10):e110528.
Is acupuncture really working? There is still a controversy around this medical treatment. Some
believe that it is just placebo, others believe in it but doubt the traditional explanations of the
mechanisms. Then, what about laser acupuncture? Could dry needling (pain) produce the same
effects as gentle low level laser light? Seems unlikely? We have previously touched upon this
controversy (http://www.laserannals.com/2015/06/02/laser-acupuncture-works-but-how/) and
our conclusion is that there is some evidence after all.
Advances have been seen with “laser needles” with different wavelengths and multi-
wavelength options. New studies have been published, but the quality is varying. A prerequisite
that has to be fulfilled in a laser acupuncture study is that only acu points are irradiated. In
traditional acupuncture there are “ashi points” that are treated. These are very similar to what
is called trigger points or tender points in Western medicine. All are located by manual
palpation. In the study by Hu et al., three acu points and 2-4 ashi points were irradiated, all but
one (Hegu, LI4) were in the area of the masticatory muscles. So in fact, laser acupuncture and
traditional LLLT for TMD was used. Let us look at the laser parameters:
The laser was a 810 nm 150 mW laser, “chopped” at 50%, so actually 75 mW. Reason for
chopping is not presented.
Two acu points were in the TMD area: ST7 = condyle, ST6 = mandibular corner = muscle
masseter.
5 s per acu point = 0.375 J. Two points in the TMD area = 0.750 J.
40 s per ashi/tender point = 3 J. For two points 6 J, for four points 12 J. Maximum total 12.750
J.
Several studies on TMD and LLLT have used energy ranges between 3 and 6 J per point, or
even less, and targeting tender points. Therefore, this study is a traditional LLLT study and the
contribution of the acu points cannot be evaluated. Future studies should not mix local LLLT
with laser acupuncture.