Hey everyone! I will be out of town for a week on laser therapy training business. Filming an instructional DVD on clinical protocols for Class 4 lasers. Should be really cool! So don’t miss my posts too much. Just go through the past issues and learn from the beginning. In the meantime I hope this holds you over. Enjoy. Remember with laser therapy you are treating the PAIN associated with any injury!
Imagine an average sized apple. If you cut it in half, the surface area on one of the two halves is about 50 cm2.
Biostimulation occurs when 0.5-1 J/cm2 is delivered to tissue. (Let’s use 1)
Pain control requires 4-10 J/cm2 (Let’s use 5)
A superficial wound 3-4 cm large will require treating a total area of 50 cm2 to include a small amount of healthy surrounding tissue. Most wound protocols are programmed to deliver 2 watts with variable frequencies to stimulate a proper tissue response. (Average 1 watt) This delivers 1 Joule/second. We would need about 50 seconds to treat this area if it were a single cell layer. Wounds are multiple cell layers thick. Therefore, I usually would double the dose/treatment time for a wound of this size.
For example, I would treat this injury for 1.5 to 2 minutes maximum. You can extrapolate this same dose by imagining how many “apples” large each pain area is.
This same calculation works for deeper pain management. Let’s say you are working on the lumbar spine, treating an area four apples large. Therefore I need 200 cm2 X 5 Joules/cm2, or 1000 Joules. About half of the energy delivered penetrates below the dermis – we should multiply the dose by 2 to account for this. We need to deliver at least 2000 joules to the area for deep pain control. You can extrapolate this quick reference to treat larger areas.
Dr. Perry Nickelston
www.painlasercenter.com 1-866-595-7749 Ext. 102