The Scoop on “COLD” Laser

By Kateri Kane PT, DPT

Have you ever experienced a chronic neck or back issue that nothing seems to fix, or been in acute pain after a recent injury?  These are just a couple of conditions that “cold” or low level laser therapy (LLLT) claims to help.  So, are the claims valid? Does LLLT truly work?

According to The Department of Labor and Industries’ technology assessment in 2004, low level laser therapy is defined as follows: “a light source treatment that generates light of a single wavelength.  LLLT emits no heat, sound, or vibration.  Instead of producing a thermal effect, LLLT may act via nonthermal or photochemical reactions in the cells, also referred to as photobiology or biostimulation.”  It benefits the tissues by altering cell and tissue function, stimulating collagen production, altering DNA synthesis, and improving function in damaged nerve tissue.  Several theories exist as to cold laser’s underlying mechanism for healing and these can be reviewed here.

Unlike corticosteroids and other medications that may be used to relieve symptoms of pain, LLLT has NO known side effects.  It is only contraindicated for direct usage over the eyes, pregnant uterus, carcinomas, the thyroid gland, and hemorrhages.  It also should not be used for patients who are taking immune suppressant drugs and over the sympathetic ganglia, vagus nerves, and the cardiac region in patients with heart disease.

Several studies have been performed to test the effectiveness of LLLT.  In the past 3 years, six different systematic reviews (highly reliable research) found evidence in favor of LLLT for conditions including frozen shoulder, myofascial pain, tennis elbow, Achilles’ tendonitis, and neck pain.  Unfortunately, despite the number of studies that have shown positive responses, insurance companies do not typically reimburse for this form of treatment.  It is deemed to be investigative because there is not enough overwhelming evidence in favor of the benefits of LLLT.  One possible explanation for the mixed evidence found in the literature is the need for very specific parameters when treating certain conditions with LLLT.  Any study that does not utilize the appropriate parameters will not conclude in positive results.

Due to the lack of reimbursement, many providers have been forced to charge through self-pay routes in order to receive payment for the laser therapy services provided.  Treatment costs average between $50 and $150 per visit and treatment lasts about 10-15 sessions.  LLLT may not be right for everyone, but there have been positive findings for certain specific conditions.  Advanced Physical Therapy and Fitness is proud to announce that we are currently in possession of a Thor Laser and have begun using this treatment on a self-pay basis.  If you believe LLLT may benefit you, contact us to find answers to your specific questions or are curious about costs.

So do you feel like you have a better understanding of laser?  Feel free to leave any comments or suggestions regarding laser or any other topic in which you are interested.  Our next blog will discuss stress management and how exercise can help.  Thank you for reading and stay active.

Resources:

WA Gov

Thorlaser

NCBI

JOS PT

The Lancet

Spine Journal

The “Secret Weapon” for Fighting Diabetes

By Kateri Kane PT, DPT

If you’ve been living with either type I or type II diabetes, by now you probably know the general gist of what it is.  For those of you who don’t or those of you who have never lived with diabetes, we’ll start with a brief overview.

According to Taber’s Cyclopedic Medical Dictionary, diabetes mellitus (DM) is “a disorder of carbohydrate metabolism, characterized by hyperglycemia [excess glucose in the blood] and glycosuria [excretion of glucose in urine] and resulting from inadequate production or utilization of insulin.”  The important thing to note here is that insulin maintains the balance of your blood sugar levels; so when it’s affected, blood sugar is no longer controlled naturally by the body.  In type I DM, insulin is not produced by the body and typically occurs prior to the age of 25.  This form of DM is difficult to regulate.  Type II DM is the result of cellular resistance to insulin and the inability of the body to regulate compensatory secretions of insulin.

The key with these forms of diabetes is that they are PERMANENT.  This does NOT mean you are doomed to fall into a diabetic coma nor have your legs amputated simply because you have diabetes.  However, these are very REAL risks if you do not MANAGE your condition.

So, what is this “secret weapon” for fighting diabetes (description coined by The Hormone Foundation)?  If you haven’t guessed it yet, it’s EXERCISE!  According to several sources, exercise does all of the following in relation to diabetes:

  • Lowers blood sugar, blood pressure, and cholesterol
  • Improves circulation
  • Reduces the need for insulin and oral medications
  • Prevents weight gain and promotes weight loss (excess body fat can worsen diabetes)
  • Strengthens the heart, muscles, and bones
  • Improves strength, flexibility, and endurance
  • Improves brain function and mood
  • Lowers stress

Prior to starting an exercise program, speak to your doctor so that he/she can do any testing that may be necessary to rule out medical complications.

When you begin an exercise program, checking your blood sugar level is VERY important.  Certain general guidelines exist to help steer your level of exercise and amount of food intake prior to exercise depending on what your blood glucose level reads.  A good basic guideline is to make sure your glucose level is at least 100 mg/dL but less than 300 mg/dL before beginning exercise.  If it’s higher than 300 mg/dL, get your blood glucose under control before exercise.  Those with diabetes should exercise 30 minutes on most days of the week adding up to 150 minutes of moderate aerobic exercise and 90 minutes of vigorous activity at least.

Diabetics should take special precautions when exercising.  Wear shoes and socks and check your feet daily for sores or blisters.  Don’t exercise alone, especially if you use insulin.  Know the signs of hypoglycemia and keep hard candies with you when exercising (take food with you for prolonged activities like hiking).  Check your sugar level before and after exercise and every half hour if exercise exceeds 1 hour.  Also, make sure to stay hydrated because dehydration can mimic low sugar levels.

I hope this information helps clear up some questions or misconceptions about diabetes.  Feel free to leave any comments or suggestions.  Our next blog will be related to the benefits of laser treatment.  Find out if this treatment may help you.  Thank you for reading and stay active.

Resources:

 JCEM

One Touch

BMJ Group

http://www0.sun.ac.za/kampusgesondheid/wp-content/uploads/2010/09/Diabetes-and-exercise.pdf

Taber’s Cyclopedic Medical Dictionary

Goodman & Fuller’s Pathology: Implications for the Physical Therapist

Can Exercise Save You from Breast Cancer?

By Kateri Kane PT, DPT

Many people in this country have either known an immediate relative or a friend who has battled breast cancer.  This particular cancer is the most common cancer diagnosis in women and the second leading cause of cancer death following lung cancer.  Risk factors include:

Key Risk Factors

Additional Risk Factors

Gender (female)

History of benign breast disease

Age 60 or older

Ethnicity (whites: increased incidence; blacks: more deaths)

Age at first menstruation (increase risk if <12 years old), especially when combined with late menopause (>55 years)

Late menopause (>50 years)

Nulliparity, infertility; 1st child born after age 30

Diethylstilbestrol exposure

Age at first live birth (increased risk if >35 years)

Alcohol (?2 drinks/day of beer, wine, hard liquor)

2 or more first degree relatives (mother, sisters, or daughters) with breast or ovarian cancer

Postmenopausal weight gain (20-30 lb. or more since age 18); obesity

Male relative with breast cancer

High doses of chest radiation before age 30 (e.g. Hodgkin’s disease)

Number of previous breast biopsies (whether positive or negative)

Environmental exposures (under investigation)

High-fat diet

As least 1 biopsy with atypical (ductal or lobular) hyperplasia or radial stars

Long term use of first-generation oral contraceptives before 1975 (high does e.g. EstrAval) or recent (last 5 years) combined hormone replacement therapy

Previous personal history of breast cancer

High bone density (postmenopausal women); circulating estrogen promotes bone formation

To check out your risk, click here.

Several of these risk factors are modifiable, meaning that your lifestyle can affect your level of risk for getting breast cancer.  Many studies have been performed particularly on the effects of weight gain as a risk factor.  The American Cancer Society found that 20-30 pounds of weight gain after the age of 18 produces a 40% greater likelihood of developing breast cancer than for women who either gain only 5 pounds or have been overweight since childhood.  So what can you do to reduce your risk?  45-60 minutes of moderate-to-vigorous activity 5+ days per week is recommended.  For those of you who don’t think you have time to exercise 5 days a week, activity does not just mean exercising on the elliptical at your local gym.  Moderate to heavy yard work or house work could also be classified under this description.  The key term here is ACTIVITY.

But what if you already have breast cancer? Is exercise still recommended?  The answer is yes!  A meta-analysis, one of the most highly reliable forms of research, was performed on the effects of exercise on breast cancer patients and survivors.  This study found that women with breast cancer who participated in exercise had significant improvements in quality of life as well as physical functioning, peak oxygen consumption, and reduced symptoms of fatigue.

The take home message here is that exercise is good for both preventing breast cancer and for managing your condition if you already have it.  Different levels of activity may be recommended depending on your stage of cancer, so if you are unsure at what level of intensity you should be exercising, contact a health care professional for guidance.

Resources:

Goodman & Fuller’s Pathology: Implications for the Physical Therapist

Canadian Medical Journal

Journal of the National Cancer Institute

 

Become a Fan on Facebook Watch us on YouTube Join our mailing list

Copyright © 2018 Advanced Physical Therapy and Fitness. All Rights Reserved. | Privacy Notice |  feed-image Feed Entries

  Disclaimer:  The information in this medical library is intended for informational and educational purposes only and in no way should be taken to be the provision or practice of physical therapy, medical, or professional healthcare advice or services. The information should not be considered complete or exhaustive and should not be used for diagnostic or treatment purposes without first consulting with your physical therapist, physician or other healthcare provider. The owners of this website accept no responsibility for the misuse of information contained within this website.