6. Class IIIb Cold Laser-Auriculotherapy
What do you get when you combine the ancient wisdom embodied in acupuncture with conventional laser technology applied within the context of auricular therapeutics? Auricular LASAC, or laser acupuncture, is performed using a class IIIb device with a pencil-like probe that creates a very small irradiation zone, such as required for the treatment of the face or ear. For this therapy, class IV lasers would be overkill. One requires a surgeon-like precision best applied with a laser device in the 50 to 200-mW power range (Table 1).
Auriculotherapy is reflexogenic medicine. The premise is that certain ear points are associated with the various organs and body parts, as observed using a homunculus representation in the ear. In effect, the external ear point becomes a rheostat-like mechanism that can control flow of vital energy to a sick body part, increasing or decreasing the flow of vital energy that, ultimately, controls the health and balance of that specific body area or organ (Figure 1).
The entire concept of mechano-transduction challenges our mechanistic schemas and reductionist beliefs and provides alternative explanations about why energy-based treatments restore function and improve health.
Strength of Treatment
Auriculotherapy using a class IIIb laser usually is a subtle treatment, with most patients not experiencing a sensation per se. There are some associated effects, such as light-headedness, that often occur. However, these are transient and self-limiting. Auriculotherapy programs can target specific pathologies, such as sciatica, or more general pain syndromes, such as back pain. In addition, auriculotherapy is a popular treatment technique used at many addiction centers, since pain often is associated with dependencies. There is no doubt that there is a subset of the population that responds optimally to this genre of treatment, and belief and expectation is an important part of therapy, as it is with any pharmacotherapy.
Ease of Treatment
This mode of treatment is a powerful adjunct to other forms of therapy, whether for addiction or pain symptoms. The best part of this technique (outcomes aside) is that it can be performed relatively quickly and as often as necessary. There is no overdosing on auriculotherapy.
For the vast majority of patients treated with this therapy, adherence is very high with virtually no adverse effects expected or documented in many years of application. In many cases, patients develop an affinity to this treatment believing and expecting positive changes in their condition.When a patient builds loyalty to a therapy, believes it is working, and expects to get better as a result, discontinuing it can be a challenge.
This therapy is being practiced all around the globe and especially in countries that have very limited financial resources. The laser is the most expensive part of the treatment equation and an adequately powered infrared laser with the pencil probe apparatus can be purchased for under $2,000. U.S. facilities that use auriculotherapy for detoxification purposes usually will charge $100 to $250 per session. Our internal success rate (published in American Journal of Acupuncture 1994) for complete and total smoking cessation after 3 months post treatment was then, and remains now, circa 50% of patients undergoing LASAC.
The relatively low score I gave this technology (6) reflects 2 things: first, that the quantity of research is miniscule in comparison to some of these other therapies described, but the research that does exist is intriguing. I am referring to the outcome studies performed and published showing impressive results, especially with addictions (nicotine and alcohol). Even more impressive are the functional magnetic resonance imaging (MRI) studies that support a very specific effect when stimulating a certain ear point. Studies support the neurophysiological connection between specific ear points and corresponding regions of the brain. Functional MRI has helped to validate not only connections between ear points and the human brain, but also the differences between real and sham acupuncture.