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11 Articles in Volume 6, Issue #5
Clinical Pearls for Treating Headache Patients
Determining Which Low Level Laser to Use
Guidelines for Opioid Management of Pain
Interventional Therapies in the Continuum of Care
Lessons Learned from a Headache TMD Study
Potential Hazards of Vertebroplasty
Splenius Capitis Muscle Syndrome
The Moral Community of the Clinical Pain Medicine Encounter
Urine Drug Testing and Monitoring in Pain Management
Vitamin D Deficiencies in Pain Patients
Why Electromedicine?

Determining Which Low Level Laser to Use

What do you suppose Albert Einstein would say if he knew one of his more important scientific discoveries was not being used today to help control the pain and suffering of the estimated 50 million Americans affected every day from some type of pain? Einstein’s discovery was called LASER —meaning Light Amplification by Stimulated Emission by Radiation. Maybe it was the word “radiation,” and the fear that word carries that has kept his remarkable medical discovery in the closet. Research has shown that pain of all kinds, including fingers, hands, elbows, shoulder, neck, back, hips, knees, ankles, and even organ pain can all be helped by low level lasers.

Today, research has shown that a healthy body communicates from cell to cell by generating its own infrared light called biophotons.1 These biophotons carry information that affects the health of cells and the cells’ ability to make good DNA which, in turn, makes good, healthy new cells.2 Human kind simply cannot live without light, a fact highlighted by the evident lack of biophoton activity in a sick cell.3 Low level laser therapy interrupts the pain process by delivering electrons back to the injured cells and subsequently allows repair of the cell’s biological processes.4 A big plus of low level laser therapy is that it causes one’s own cells to produce a substance called endorphins that controls pain regardless of the location.5 In fact, the Norwegian Health Technology Report states that low level laser therapy is twice as effective as NSAIDS for controlling osteoarthritis type pain.6

Low level lasers are not new. They have been used for over forty years in industry and nearly as long in pain management —at least in some foreign countries. Until recently, results have been inconsistent—even at the same wavelength and with what appeared to be the same low level laser diodes. This inconsistency has led many professionals to wonder if low level lasers really work. What hasn’t worked, and is now changing, is the misconception that a single laser, or a single wavelength, can treat everything associated with pain and healing.4

Low level laser therapy has also been held back by the belief that if you don’t get results—use more power. Today, clinical results demonstrate that more is not necessarily better!

“One laser cannot efficiently be used for all disorders. For example, laser beams need to be large enough to cover larger areas for burns, large bruises, bed sores, etc. Bones, nerves, joints, tendons, cartilage, and ligaments require more joules of energy and the energy needs to be more concentrated at the pain site.”

Pain, especially joint pain, is usually associated with tight muscles. It is better to relax and release tight muscles with a multi-diode, low power, constant output, and resonating laser. Bones, ligaments, cartilage, joints, and nerves, on the other hand, respond better to higher power low level lasers. You can not maximize results by using just one wave length laser.7 Therefore, best results are achieved by first resonating bellies of muscles, organs and glands, followed by stimulating joints, nerves, ligaments cartilage and tendons.4

What is the difference between resonating and stimulating lasers, and how does someone determine which type to use?

To understand when to use resonating lasers and when to use stimulating lasers, we must first understand some basic laser physics terminology.

  • Photons are small packets of light energy in the form of a wave element with a defined wavelength and a frequency related to that wavelength. Photons absorbed in the body give up energy and momentum to produce several other types of quantum excitations at the cell level, each having its own quantified energy and momentum. All living organisms emit electromagnetic radiation in the infrared level, creating photon-bioelectric field interactions, which leads to other intracellular responses. Photon energy matches energy differences between filled and empty electron energy levels and thus transports electrons to needy areas. Since there is a continuum of both empty and filled energy bands, one might expect an extensive region of high energy absorption and photon storage. This explains why subtle energy, resonating, multidiode low level laser energy is accumulative and cascading.8
  • Biophotons or Charge Density Pulses are small packets of coherent light in the infrared wavelength emitted by cells for intercellular communication. All humans and probably all vertebrates have their own energy pump (chi/prana) and via focused attention, can self regulate their space and produce a variety of healing. All cells in our body, in fact all living cells, emit biophotons which communicate with other biophotons and control the biological processes of nature. A person with strong vitality and lack of inner stress emits more biophotons. With balanced universal energy fields, these biophotons combine to form a soliton wave—that is, the photons now have increased velocity producing an aura which is able to be imaged via Kirlian photography or newer imaging techniques, such as Bio-Liminal Photography. Cellular photon emission and biophoton intercellular communication is altered by many things, such as medications, life style, quality of food, food sensitivities, environment, emotional conflicts, and stability/stress. Injury and associated pain, psychological, emotional, and environmental, all produce significant alteration in the Charge Density Waveform of the individual. Charge Density Pulses are associated with trans-membrane electrical fields where solitons take place on the cell membrane as an energy transductive step and enhances the transfer of energy from one cell to another. These and other factors affect the vitality of a person. Subtle energy resonating soliton wave lasers put photons back into the body and replenishes cell membrane electrons lost by life style, accidents, sickness, injury, surgery and aging.9-11
  • Soliton Waves are a non-linear light wave that maintains its shape and increases amplitude after colliding with a similar wave. The increased amplitude of combined wavelengths allows the soliton waves to penetrate deep into the body tissue without increasing power density. This principle has revolutionized low level laser therapy and enables lasers that generate the soliton wave to deliver electrons to damaged tissue deep within the body without injuring or altering surface tissues with increased power. Restoring the electrons to the damaged cells enables osmosis of essential nutrients into the injured cell and restores biological processes to normal.4
  • Coherence means the photons are well-ordered or are in synchronicity. Coherence is the major difference between LEDs and true lasers. Coherence enables the light to carry more information. True lasers with coherence and different wavelengths have different energy levels and subsequently provide different results to the body.
  • Wavelength is measurement of the length of the waves that constitute a laser and are measured in nanometers (1/1000 of a millimeter and corresponds to color. For example, a blue light is a shorter wave length, red light is a longer wave length, and infrared is even longer. To avoid misconception, it is important to note that frequency and wavelength do not mean the same thing and are not interchangeable.
  • Power Density is the measurement of the power of the instrument. It is the light concentration or energy density of the instrument. The formula for calculating power density is watts/cm2. Low level laser instruments are primarily identified by wavelength and power density. Example: A 650nm-30Mw laser is a laser that emits a red light beam of 650 nanometers at a power of 30 milliwatts. This power of laser would be considered a stimulating low level laser. More power is not better for many things. If you apply more power, the body sets up impedance, or polarizes, against excessive power so that the energy is blocked out and the laser becomes less effective.4
  • Frequency is the number of pulses or interruptions per second applied to the wave. Any type of wave—whether it is a sound, electrical, radio, or light wave—can have frequencies applied to that wave. Frequency is altered by movement so the best results are achieved with frequency programmed instruments when the laser is held still and not in continuous motion.
  • Joules is the amount of energy delivered by one watt of power in one second. It is the measurement of the dose of energy produced by lasers. The formula is: output x time divided by area. By changing any one of these values, the benefits of the laser are altered. Laser output, like that on all 110 volt power lines varies unless controlled by some type of surge protection or computer. Since low level lasers produce a linear beam that is not collimated, the spot size gets larger and less powerful the farther away it is moved from the skin. This makes measuring joules of energy difficult and inaccurate if the instrument is not held in contact with the skin during treatment. Some believe that wavelength regulates success and others believe that success of low level laser therapy is more dependent on the total joules of energy, more so than wavelength. Lasers that have computer, or other reliable, control of the laser output produce superior results. Some protocols attempt to get the energy deeper into the body tissues by increasing the total joules of energy to an extent where it becomes too much energy and activates the body’s protective mechanism and thus ends up limiting the results. This puts a negative connotation in the user’s mind that low level lasers don’t work when, in reality, they have exceeded the beneficial joule range or used the wrong laser. More is not necessarily better.
  • Constructive Interference exists when the combined amplitude of multiple similar waves is greater than the individual amplitude of a single wave. Constructive interference makes the signal stronger. Constructive interference intensifies the signal which, in turn, increases the amplitude, speed, and quality of the wave and thus penetrates deeper.
  • Destructive Interference, also called canceling waves, is the opposite of constructive interference. Destructive interference occurs when the waves are out of phase, that is, one wave is peaking as the other is toughing. Destructive interference waves, like constructive interference waves, have increased amplitude and speed and, when combined to form soliton waves, are able to penetrate deeper without losing their benefits. If we know the frequency of bacteria, virus, or fungus, and program that frequency into an instrument we can form a canceling frequency. Canceling frequencies render the agent harmless or inactive, but does not kill it. The canceling principle does not imbalance the flora of the body as would killing with higher powered lasers or drugs. Destructive interference is dependent upon computer technology and is dependent upon combining wavelengths to produce soliton waves, as well as applying exact control of frequency and power density so the body does not set up a resistance to the incoming energy.12


All lasers are not created equal and one laser cannot do it all. The mentality of the laser world has been “if the laser doesn’t get results — increase the power.” This concept is incorrect. One laser cannot efficiently be used for all disorders. For example, laser beams need to be large enough to cover larger areas for burns, large bruises, bed sores, etc. Bones, nerves, joints, tendons, cartilage, and ligaments require more joules of energy and the energy needs to be more concentrated at the pain site. Soft tissue such as bellies of muscles, organs and glands need a larger wider beam but the energy needs to be delivered in very subtle amounts. Lasers used for acupuncture—called acupoint lasers—get the best results when 2-4 joules of energy is concentrated to a small point no larger than a pencil eraser.

Resonating Low Level Laser

A resonating low level laser is any laser that operates under 5mW. It can be either a single wavelength laser or a multiple wavelength diode laser, but clinical results appear better with multi wavelength lasers that operate under 5mW. Resonating lasers are best for releasing stress in the bellies of muscles, glands, and organs. If the pain is in an organ or gland, a resonating laser may be all that is needed to control the pain.

Stimulating Low Level Laser

A stimulating low level laser can be a single wave length or a multiple diode instrument that operates from 5mW to 1000mW or one watt. Most stimulating low level lasers do not operate above 500mW because if they surge over 1000mW they are no longer considered a low level laser and fall under different regulations. Most stimulating lasers available today are single wavelength lasers or multiples of the same wavelengths. Stimulating low level lasers are used for nerves, bone, joints, tendons, cartilage, ligaments, and acupoint therapy. Acupoint laser therapy is best accomplished with a single wavelength laser. However, to treat pain associated with any of these conditions, it is best to first release the tight muscles related to the bone or joint with a resonating low level laser first, and then apply the stimulating laser directly to the affected nerves, bone, joints, tendons, cartilage, and ligaments.


Low level laser therapy is a valuable tool for pain management. It should be considered as the first line of intervention for any type of pain. To maximize results use resonating lasers that produces 5mW of energy to release tight muscles and then apply a stimulating laser that applies more joules of energy directly to the painful nerves, bone, joints, tendons, cartilage, and ligaments.


Last updated on: January 28, 2012
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