It's not news that many chiropractors want to be on the cutting edge of providing services to their patients. Having the latest high-tech gear can broaden your patient base, improve results and make your practice unique. And it doesn't come much more high-tech than laser therapy. If results are to be believed, a simple beam of light can cure patients of many ailments.
Well, before you invest in a piece of equipment that comes with an operating manual the size of a phone book, take a moment to read what our vendor experts have to say about purchasing laser therapy equipment. All of them agree that the most important thing is to have an understanding of the technology involved. Once you understand the tech, it is much easier to make a decision on the right laser for your needs.
(Editor's Note: In preparing this story, Dynamic Chiropractic PracticeINSIGHTS asked a panel of industry experts how they would go about investigating laser therapy equipment if they were in the market to buy one themselves. Obviously, an expert allied with a particular company will tend to be biased to that company's products. Therefore, in this series, we report the comments that reflect a consensus on the general characteristics that make for a good product in order that you may make an informed decision as you do your research into a particular product or service.)
The Future Is Now
Let's face it, a vast array of knobs, dials, buttons and levers can be intimidating. On top of that, you need to have a clear picture of what a laser device actually does, as well as how it performs that task. As Doug Johnson of Multi Radiance Medical (www.multiradiance.com), based in Solon, Ohio, explains: "Clinicians need a clear understanding of the technical aspects [of a laser device] to effectively evaluate devices and avoid overpaying for a device that is nothing more than a flashlight."
Keep in mind that from your patients' standpoint, a laser is something futuristic. Therefore, you want to invest in the best possible product to give your patients the best results. Phil Harrington, DC, CMLSO, of K-Laser (www.k-laserusa.com), in Franklin, Tenn., stresses the importance of making sure you have the best-quality product for your investment. He noted, "If you choose to implement laser therapy into your practice, you will be offering a service that seems far out and futuristic to most of your patients. As the adage says, 'If you are going to do it, do it right.' A quality therapy laser should be able to give consistent clinical results, with changes that are noticeable in just a few visits."
Getting the Best Results
So let's get down to the nuts of bolts of what a laser does (as well as what it doesn't do). At a very basic level, a laser device has a biological effect on tissue that can have such results as faster wound healing or reducing pain. In the consumer magazine To Your Health, Harrington provided a very neat summary of laser therapy: "Laser therapy is the application of low levels of laser light to areas of the body that have been injured or damaged. Contrasted with high-powered lasers used in health care that cut tissue, such as surgical or hair-removal lasers, therapy lasers produce beneficial photochemical and photobiological interactions that can help relieve pain and repair injured/damaged tissue.
"The photons of laser light penetrate through your skin and are absorbed by special components in your body's cells called chromophores. Just as photosynthesis creates energy for plants, the absorption of the photons by your cells causes increased production of cellular energy. In areas of injury or damage, this means there is more energy available to improve the rate and quality of healing. This is called biostimulation.
"Because of its biostimulatory nature, laser therapy has the potential to help any scenario whereby the body's cells are not working to their optimum potential. Studies on tissue cultures reveal a wide range of beneficial physiological effects, including increased levels of endorphins, prostaglandins and other beneficial components; reduced levels of harmful compounds including C-reactive protein and interleukin-1; pain modulation through a variety of mechanisms; and increased rate and quality of tissue healing."
However, there is more to it than just that. As Johnson said, "Choosing the right laser therapy device not only dictates understanding the mechanism of how light interacts with biological tissue but the diverse set of parameters necessary to produce therapeutic effects. Though critics of laser therapy may continue to debate its overall effectiveness, the overwhelming scientific and clinical outcomes support the successful use of this new modality. It should no longer be a question of whether light has a biological effect on tissue, but rather what are the optimal parameters for the successful uses of these light sources."
[pb]But which parameters should you be looking at? Johnson explained that experts agree on five parameters that define a phototherapy device: power and energy density, wavelength, diode construction, frequency and safety classification.
Johnson explained, "The output of power will be, by far, the most talked-about parameter. Sales representatives will continually discuss and debate the device's power as if it was the sole factor of consideration. While the power is extremely important, its impact determines treatment time needed to deliver an adequate dosage at the target. Laser, like ultrasound, can stimulate at low levels. At higher levels, it becomes destructive.
"Mean output of power is the most common measure of the device's power. However, peak power and energy density need to be taken into consideration. Peak power is a measure of the device's maximum output and affects not only overall photon density, but also the absolute depth. Devices that have similar mean outputs of power may vary greatly on peak pulse powers."
Curtis Turchin, DC, president of Apollo PT (www.apollopt.com), based in Redwood City, Calif., focused in on laser therapy power as the most important parameter. He likened it to a classic fairy tale we all remember from childhood.
"When choosing the right laser for your practice it is important to remember the tale of Goldilocks and the Three Bears. You want a laser that is not too hot and not too cold. If it is too cold, the power is too low and the effectiveness will be limited. If it is too hot, there is a risk of burns and eye damage."
Of course, the type of treatments you intend to use the laser for will also dictate which one you select. Turchin explained, "If you primarily treat back pain, neck pain, sports injuries, wounds and large animals [for a veterinary practice], purchase an infrared laser If you treat acupuncture points or practice auriculotherapy, consider purchasing a point probe. The most common point probes for this purpose emit 200 mW to 500 mW, which is ideal for treating small points in the ear, acupoints, for delicate extremity work, or inside the mouth."
Looking Forward
So now you have purchased a brand new laser therapy system. You understand what a laser can do for you. Now, as Harrington notes, the other half of the equation comes into play. In short, if you aren't sure what that little red button does, will the company be able to help you sort it out? Harrington stated, "Find a company that knows your profession. Yes it is important to have a quality piece of laser therapy equipment, but there is much more to it than just the equipment. Does the company offer education and training? Do they have multiple channels to offer you clinical support? Who is giving the support? Is it someone who has been in practice just like you? Does the company offer multiple avenues of marketing support?"
Ultimately, as our experts all noted, selecting the right laser therapy equipment comes down to what sort of treatments you intend to perform. The key is to make sure you understand what you are getting for your investment in the future of health care. As Harrington explained, "Laser therapy is an exciting, progressive modality which can invigorate your practice and dramatically increase your patient satisfaction levels. Adding laser therapy to your practice can be a substantial investment. Is your laser prepared to meet the challenges of the future? Wouldn't it be a tragedy if you spent a lot of money on a laser today, and five years down the road it did nothing more for you?"
