Guest Blog by Dr. Perry Nickelston DC, NKT, FMS, SFMA
If you are a medical professional or a word buff, you probably know that when the suffix “itis” is added to the end of a word, it indicates the presence of inflammation. There are so many common conditions that include this suffix in their nomenclature that people often don’t think about the inflammatory component. Yet looking at the naming conventions of medical conditions can help us better understand their qualities, and more importantly, potential treatments.
When developing a treatment plan for “itis” conditions, you can expect that inflammation reduction will play a key part in the treatment process. Typically, patients focus on relieving the pain, while the clinician may be focused on both relieving the pain and reducing the inflammation to not only make the patient more comfortable in the short term, but also encourage resolution of the condition and permanently reduce discomfort.
Common therapeutic approaches for pain and inflammation reduction include ultrasound, electrical muscle stimulation and ice. Each of these methods does their part in reducing pain and inflammation, but there is another method that also works wonders – laser therapy.
What makes laser therapy an excellent choice for patients and clinicians looking to reduce both pain and inflammation? For one, it is non-invasive, fast, and effective. Additionally, laser light works with the body on a cellular level, specifically targeting damaged cells and tissues, to activate the body’s own analgesic and inflammatory mechanisms. The effects are also photochemical in nature, not photothermal, so thermal damage to tissue is not a concern as it may be with other common treatments. Finally, laser therapy can also increase vasodilation, helping to bring vital nutrients to damaged areas. Here are 3 common and stubborn “itis” conditions that laser therapy works wonders on:
1. Arthritis Treatment plans for chronic “itis” conditions, like arthritis, usually focus on maintenance of pain and inflammation, rather than complete resolution. Often, several medications are used to alleviate the symptoms – typically one or more for each symptom, and occasionally additional ones to manage the side effects.
Laser therapy presents a great option for people looking for a drug-free, non-invasive treatment option. Class IV therapy lasers are particularly effective for treating the pain and inflammation related to arthritis because they are more powerful and can deliver larger doses in shorter treatment times. When treating chronic conditions like arthritis, larger dosages are recommended for maximum relief. Dosage applications range from 6-10 joules/cm2 depending on the area being treated, for a total of 600-1,000 joules of laser energy per 100 cm2. Treatments every two days for 6-10 sessions is recommended.
2. Epicondylitis Epicondylitis is another common condition that is notoriously difficult to treat and resolve. Cortisone shots are a common treatment for this condition, and can be effective for temporary relief of pain and inflammation at the injection site. However, these treatments are not without side effects, and do not generally facilitate long-term relief or resolution.
Physical therapy is also commonly used to treat this condition and frequently results in positive outcomes. Depending on the situation, therapists may decide to use manual manipulation only or they may opt to incorporate modalities. When incorporating modalities, one great tool to help physical therapists increase the frequency of these positive outcomes is laser therapy.
Laser therapy has been shown to effectively treat this condition, without side-effects, by promoting long-term relief from the symptoms associated with chronic epicondylitis. It can additionally be used to treat areas other than the direct site of pain, which is especially helpful in chronic cases that frequently see the development of satellite pain sites. A dosage of 6-8 J/cm2 is recommended, for a total of 600-800 J of laser energy per 100 cm2. Average treatment for an elbow is 3,000 J. Moving the elbow joint through flexion, extension, supination, and pronation during treatment is effective at delivering laser energy to tissue and keeps the client actively involved. Most cases require 8-10 treatment sessions. 3. Plantar Fasciitis Most people have either suffered from plantar fasciitis themselves or have known someone who has. It can be an extremely painful condition that patients struggle to find relief from. Treatment options range from orthotics such as inserts, splints, and boots, to medications such as aspirin or even opioids. Patients can also engage in certain exercises to help stretch and strengthen the area.
Physical therapy is another treatment option that is especially effective when coupled with laser therapy. The laser helps to reduce the pain and inflammation quickly to enhance the positive effects from the physical therapy. The laser can also be used to relieve inflammation in areas such as the calf and hip, which may either be contributing to or affected by the initial condition.
Application of the massage ball on the calf and soles is very helpful in delivering laser energy and manual therapy to troublesome trigger points that refer pain to the foot. The recommended dosage for this condition is 8-10 J/cm2, for a total of 800-1,000 joules per 100 cm2. Plantar surface of the foot usually gets between 1,500-2,000 J and the calf and Achilles receive 3,000 J. Typically, 6-10 treatment sessions are advised for this condition.
Watch a plantar fasciitis treatment video here.
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