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Laser hand therapy. (Healing Options).

Margaret Naeser, Ph.D., Lic. Ac., a Boston University School of Medicine research professor and Department of Veterans Affairs (VA) investigator, has developed an effective alternative therapy for carpel tunnel syndrome (CTS) and spasticity-related hand-flexion problems. Dr. Naeser's therapy specifically stimulates hand acupuncture points with a low-energy laser beam and mild electrical current. You can perform this relatively simple, inexpensive therapy at home with some upfront guidance by a licensed acupuncturist.

As a mainstream neuroscientist who is also an acupuncturist, Dr. Naeser has the cross-disciplinary expertise necessary to integrate Eastern healing approaches with Western biomedicine, as is the case with her CTS therapy. Because of her unique viewpoint, at a 1997 policy-setting Consensus Development Conference, the National Institutes of Health (NIH) asked her to summarize acupuncture's use in treating central nervous system (CNS) paralysis.

Acupuncture

As noted in Dr. Naeser's NIH summary and in several Healing Options articles ("Acupuncture: An Alternative Therapy?" September 1998 and "The French Connection," September 2000), acupuncture has considerable potential to treat health problems associated with spinal-cord dysfunction (SCD), including improvement in spasticity, bladder and bowel control, and, in some cases, restoration of function.

Acupuncture's philosophy believes a life-force energy called qi (pronounced "chee") permeates all living things through channels called meridians. These are periodically punctuated by acupuncture points, which, under traditional theory, represent small skin areas that are energy vortexes, and, using modern scientific measurements, correspond to areas of greatly reduced electrical resistance. Stimulating these points through traditional needle insertion, heat, or pressure, or through contemporary energy-emitting devices promotes healthy energy flow. Because most meridians originate or terminate at finger or toe tips, hand and foot disorders seem especially amenable to acupuncture.

Although acupuncture was developed without the benefit of modern physiological and anatomical insights, scientists are now explaining the ancient discipline through mechanisms involving the stimulation of neural pathways, neurotransmitters, and key energy metabolites.

Laser Therapy

Dr. Naeser's acupuncture therapy uses a laser pointer powered by two AAA batteries. It emits a red light beam somewhat similar to a grocery-store checkout scanner and poses no risk unless you stare directly at the beam.

Lasers amplify light by producing coherent, single-frequency beams and are characterized by power and wavelength. Their power can vary greatly. For example, 100-watt surgical cutting lasers have 20,000-fold greater power than the 5-milliwatt laser pointer used in Dr. Naeser's program. Because light travels in waves, wavelength refers to the distance measured in nanometers (one-billionth of a 39.4-inch meter) between consecutive wave peaks. The laser pointer used in Dr. Naeser's program emits a 670-nanometer wavelength, corresponding to a red beam of light.

Because low-level lasers represent a noninvasive, painless mechanism for biostimulation, their potential therapeutic applications--including SCD--have grown greatly over time, especially in other countries. When lasers are directed toward acupuncture points, the therapy becomes laser acupuncture.

In spite of the innocuous nature of these low-energy lasers, the Food and Drug Administration (FDA) and state regulations are ambiguous and inconsistent. As a result, the availability of laser acupuncture may vary considerably depending upon where you live.

Electrical Stimulation

Dr. Naeser's therapy also employs a procedure called microamps transcutaneous electrical nerve stimulation (TENS) using a MicroStim 100 TENS device. In spite of its intimidating sound, TENS represents a straightforward procedure in which mild electric currents are applied to specific skin areas by two circular electrodes connected to a shirt-pocketsize power pack (see photos). TENS devices have a long history of safe use for treating localized pain, but don't use them with pacemakers.

Carpal Tunnel Syndrome

CTS is a painful hand condition created through compression of the median nerve as it passes through the carpal tunnel from the forearm to the palm. It is aggravated by repetitive motion, including pushing a wheelchair. Conventional CTS treatments include simple hand splinting; steroid injection into the carpel tunnel, which has marginal long-term efficacy; and surgical release of the impinging ligament.

Although CTS does not generate the visibility of life-threatening disorders, its impact on national healthcare and worker productivity is immense. For example, surgery is performed in approximately 40-45% of CTS cases, with estimates of more than 460,000 procedures done each year and a direct medical cost of more than $1.9 billion.

More than half of all workers afflicted with CTS miss more than 30 days of work. Clearly, these statistics warrant the consideration of less expensive, less invasive, and more effective CTS therapeutic alternatives such as Dr. Naeser's therapy.

Unlike many alternative and mainstream therapies, Dr. Naeser's approach is supported by substantial scientific evidence, including rigorously designed clinical studies. This research indicates that approximately 90% of people with mild-to-moderate CTS treated with her program three times a week for 4-5 weeks by a licensed acupuncturist will have significant, enduring relief from CTS pain.

Dr. Naeser believes these beneficial effects may be mediated through a number of mechanisms including augmented production of a key energy metabolite called ATP, increased levels of the neurotransmitter serotonin, decreased inflammation, and improved local blood circulation.

Although Dr. Naeser's research has focused on CTS, extensive anecdotal observations indicate the therapy helps spasticity-related hand-flexion difficulties, such as the fisted or clawed hand (see photo) associated with a variety of CNS disorders. After treatment, the hand relaxes, the fingers can open up more, and existing dexterity may improve. In addition, the therapy appears to help people who have cramping and spasticity problems in leg and foot muscles.

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Procedure

Dr. Naeser's straightforward therapy can be readily carried out at home after an acupuncturist has guided you through it, showing you the specific location of the relatively small acupuncture points to be targeted by the laser. Although simple to carry out, sufficient procedural details exist that cannot be adequately discussed in this article. As such, interested readers should consult the resources listed below and share the indicated procedures with licensed acupuncturists.

When treating CTS, the MicroStim 100 TENS device's blinking red light circular lead electrode is attached through a sticky patch to the center of the wrist crease, and the grounding pad to the opposite side of the wrist. The laser pointer is then directed to fingertip and hand acupuncture points (see figures and photo). Because a key acupuncture point is located on the wrist crease, this point is stimulated with the laser before electrode attachment. The 45-minute procedure should be repeated every other day for five weeks.

In the case of hand spasticity and flexion problems, the TENS lead electrode is attached to an acupuncture point in the palm (see photo) and the grounding pad placed over a point an inch or so above the wrist. Laser stimulation is essentially the same.

Conclusion

This laser-acupuncture therapy is a scientifically proven, highly effective CTS treatment and may also have considerable potential for treating spasticity-related hand-flexion difficulties. However, because the therapy's concepts of energy medicine are only beginning to be integrated into mainstream medicine, most conventionally trained physicians will have little appreciation of the therapy's potential, and you will have to educate yourself on this relatively simple therapy.

For a list of this article's references, which contain detailed procedural information and equipment sources, check out www.acupuncture.com/Acup /Naeser.htm. The American Association of Oriental Medicine, (610) 266-1433, can help you locate a licensed acupuncturist trained in laser therapy.

Information for this column is provided by S. Laurance Johnston, Ph.D., laurancejohnsto @aol.com.
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Author:Johnston, S. Laurance
Publication:PN - Paraplegia News
Geographic Code:1USA
Date:Nov 1, 2001
Words:1223
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