A move is afoot across the globe to make acupuncture high tech.1 As stated by acupuncture’s most innovative researcher, Gerhard Litscher, "[N]ovel biomedical and neuroscientific methods are of paramount importance for the fast and efficient modernization of the ancient Asian healing method.”2
By bringing modern biomedical engineering technology to the field, Litscher propelled enthusiasm for the quantification of biologic responses to a host of interventions, including electroacupuncture, needle stimulation and now, laser activation.3
A 2008 systematic review of laser acupuncture research found evidence to support its application for myofascial pain, postoperative nausea and vomiting, and the alleviation of chronic tension headache.4
"Laser acupuncture” shines laser light into acupuncture points instead of inserting needles. While any laser therapy unit may be used for laser acupuncture, the high-tech acupuncture laboratory at the Medical University of Graz, Austria, has studied multichannel laser needle acupuncture, which allows for the stimulation of several acupuncture points simultaneously by multiple semiconductor injection laser diodes.
Flexible optical fibers deliver the light to the site with minimal loss of intensity. Power density may reach 20 joules/cm2 per acupuncture points, with 30-40mW per needle, and 500 micron diameter spot size.5 Emission wavelengths vary, but have included 685 nm, 785 nm, and now violet laser (which appears blue to our eyes) at 405 nm.
In contrast to typical laser therapy treatments that target mainly injured areas, laser acupuncturists employ an equal or greater number of nonlocal sites.
In so doing, they recruit a variety of neural networks and fascial connections for participation in the healing process.6-9
For example, standard laser therapy approaches to temporomandibular joint (TMJ) disorders typically focus on the TMJ and/or muscles of mastication.10 In contrast, laser acupuncture for TMJ dysfunction may direct light to points on the forehead, hand, foot and leg in addition to the TMJ region.11,12
Although seemingly unrelated and extraneous to a laser therapist, this type of expanded treatment makes scientific sense to a medical acupuncturist. What’s more, an acupuncture-informed approach to laser therapy extends its clinical reach to a host of systemic and autonomic disorders, such as hypertension, depression and neuroendocrine dysfunction.13-16
Laser acupuncture has many advantages over traditional needling. Its noninvasive nature raises the already high safety profile of acupuncture, aside from the risk of inadvertent, unprotected ocular exposure. Patients, especially young ones,17,18 may more readily accept laser treatment, especially when approaches aim at sensitive sites on the face, ear or perineum. Infrared heating offers an alternative to moxibustion, i.e., the burning of an herb near acupuncture points.19,20
This eliminates not only the risk of burn but also the heavy smoke and marijuana-esque odor associated with moxa and the herb Artemisia vulgaris.
For brain research, laser acupuncture circumvents the hurdles of metal needles in the MRI suite, which may impair image quality and cause tissue heating.21 Needle-less acupuncture reduces risk of infection; certain types of laser light even inactivate bacteria or diminish their ability to reproduce.22,23
On the down side, eliminating the needle may reduce its effectiveness for trigger points, a staple of acupuncturists’ analgesic repertoire, meaning that many acupuncturists will want to maintain the metal instrument for musculoskeletal ailments.24 While laser acupuncture is showing effectiveness for a host of problems that needling traditionally treated, simply shining light cannot supplant the palpatory feedback delivered by a needle as it encounters the tone, tension and texture in muscle tissue.
Too, the stimulation itself may seem less robust to patients who have grown accustomed to the needle sensation, "de qi,” that creates the connective tissue grap leading to neuromodulation.25 That said, some argue that laser acupuncture, too, can produce a de qi sensation.26
Laser acupuncturists must guard against excessive heating of the skin with high power units, especially for neonates27 and others who cannot clearly communicate about sources or sites of discomfort, such as anesthetized or neurologically impaired patients and the veterinary population as a whole.
Nonetheless, research is building insight into ways to optimize treatment parameters for both laser therapy and acupuncture.28-32
For some problems, two or more wavelengths may offer roughly equivalent effects, such as red (660 nm) and infrared (830 nm) to improving muscle performance and reduce fatigue.33 On the other hand, 808 nm light reaches more deeply into tissue and thus may outweigh 980 nm for conditions such as spinal cord injury.34
Somatosensory evoked potentials change during high-dose laser irradiation when treating one locus along an axon as opposed to several sites along the same axon.35 This has relevance for laser acupuncturists who often select one or more points on an acupuncture channel, and channels commonly follow nerve axons.
Concerned about acupuncture losing its exotic Asian heritage by becoming high tech? If so, take heart.
Some of the earliest clinical research in laser acupuncture came from China (1979) when an oral surgeon irradiated acupuncture points for analgesia during minor procedures of the face and mouth, although it was first discussed by a Canadian in 1973.36,37
Dr. Robinson, Dipl. ABMA, FAAMA, oversees complementary veterinary education at Colorado State University.
Litscher G. Integrative laser medicine and high-tech acupuncture at the Medical University of Graz, Austria, Europe. Evid Based Complement Alternat Med. 2012;2012:103109.
2 Litscher G. Modernization of traditional acupuncture using multimodal computer-based high-tech methods – recent results of blue laser and teleacupuncture from the Medical University of Graz. J Acupunct Meridian Stud. 2009;2(3):202-209.
3 Litscher G, Gao X-Y, Wang L, et al. High-tech acupuncture and integrative laser medicine. Evid Based Complement Alternat Med. 2012;2012: 363467.
4 Baxter GD, Bleakley C, and McDonough S. Clinical effectiveness of laser acupuncture: a systematic review. J Acupunct Meridian Stud. 2008;1(2):65-82.
5 Litscher G, Gao X-Y, Wang L, et al. High-tech acupuncture and integrative laser medicine. Evid Based Complement Alternat Med. 2012;2012: 363467.
6 Anzinger A, Albrecht J, Kopietz R, et al. Effects of laserneedle acupuncture on olfactory sensitivity of healthy human subjects: a placebo-controlled, double-blinded, randomized trial. Rhinology. 2009;47:153-159.
7 Bjordal JM, Lopes-Martins RAB, Joensen J, et al. A systematic review with procedural assessments and meta-analysis of Low Level Laser Therapy in lateral elbow tendinopathy (tennis elbow). BMC Musculoskelet Disord. 2008;9:75. DOI: 10.1186/1471/2474-9-75.
8 Bjordal JM, Couppe C, Chow RT, et al. A systematic review of low level laser therapy with location-specific doses for pain from chronic joint disorders. Australian Journal of Physiotherpay. 2003;49:107-116.
9 Dostalova T, Hlinakova P, Kasparova M, et al. Effectiveness of physiotherapy and GaAlAs laser in the management of temporomandibular joint disorders. Photomed Laser Surg. 2012;30(5):275-280.
10 Dostalova T, Hlinakova P, Kasparova M, et al. Effectiveness of physiotherapy and GaAlAs laser in the management of temporomandibular joint disorders. Photomed Laser Surg. 2012;30(5):275-280.
11 Ferreira LA, de Oliveira RG, Guimaraes JP, et al. Laser acupuncture in patients with temporomandibular dysfunction: a randomized controlled trial. Lasers Med Sci. DOI 10.1007/s10103-013-1273-x.
12 Hotta PT, Hotta TH, Bataglion C, et al. EMG analysis after laser acupuncture in patients with temporomandibular dysfunction (TMD). Implications for practice. Complementary Therapies in Clinical Practice. 2010;16:158-160.
13 Zhang J, Marquina N, Oxinos G, et al. Effect of laser acupoint treatment on blood pressure and body weight – a pilot study. J Chiropr Med. 2008;7(4):134-139.
14 Quah-Smith I, Smith C, Crawford JD, et al. Laser acupuncture for depression: a randomised double blind controlled low intensity laser intervention. Journal of Affective Disorders. 2013;148:179-187.
15 Wu J-H, Chen H-Y, Chang Y-J, et al. Study of autonomic nervous activity of night shift workers treated with laser acupuncture. Photomedicine and Laser Surgery. 2009;27(2):273-279.
16 Zhang J, Marquina N, Oxinos G, et al. Effect of laser acupoint treatment on blood pressure and body weight – a pilot study. J Chiropr Med. 2008;7(4):134-139.
17 Fontana CR and Bagnato VS. Low-level laser therapy in pediatric Bell’s palsy: case report in a three-year-old child. J Alt Complement Med. 2013;19(4):376-382.
18 Gottschling S, Meyer S, Gribova I, et al. Laser acupuncture in children with headache: a double-blind, randomized, bicenter, placebo-controlled trial. Pain. 2008;137:405-412.
19 Hsiu H, Hsu W-C, Hsu C-L, et al. Microcirculatory changes by laser Doppler after infrared heaing over acupuncture points – relevance to moxibustion. Photomedicine and Laser Surgery. 2009;27(6):855-861.
20 Shen X, Zhao L, Ding G, et al. Effect of combined laser acupuncture on knee osteoarthritis: a pilot study. Lasers Med Sci. 2009;24:129-136.
21 Beissner F, Noth U, and Schockert T. The problem of metal needles in acupuncture-fMRI studies. Evid Based Complement Alternat Med. 2011;2011:808203.
22 Dai T, Gupta A, Murray CK, et al. Blue light for infectious diseases: Proprionibacterium acnes, Helicobacter pylori, and beyond? Drug Resist Updat. 2012;15(4):334-346.
23 Fonseca AS, Geller M, Filho MB, et al. Low-level infrared laser effect on plasmid DNA. Lasers Med Sci. 2012;27:121-130.
24 Robinson NG. Laser vs. acupuncture and massage. Veterinary Practice News. Accessed on 08-13-13.
25 Langevin HM, Churchill DL, Wu J, et al. Evidence of connective tissue involvement in acupuncture. FASEB J. 2002;16(8): 872-874.
26 Litscher G. Yes, there is deqi sensation in laser acupuncture. Evid Based Complement Alternat Med. 2013;2013:198254.
27 Raith W, Litscher G, Sapetschnig I, et al. Thermographical measuring of the skin temperature using laser needle acupuncture in preterm neonates. Evid Based Complement Alternat Med. 2012;2012:614210.
28 Baxter GD, Bleakley C, and McDonough S. Clinical effectiveness of laser acupuncture: a systematic review. J Acupunct Meridian Stud. 2008;1(2):65-82.
29 Bergamaschi M, Ferrari G, Gallamini M, et al. Laser acupuncture and auriculotherapy in postural instability – a preliminary report. J Acupunct Meridian Stud. 2011;4(1):69-74.
30 Cunha RG, Rodrigues KC, Salvador M, et al. Effectiveness of Laser treatment at acupuncture sites compared to traditional acupuncture in the treatment of peripheral artery disease. 32nd Annual International Conference of the IEEE EMBS. Buenos Aires, Argentina, August 31-September 4, 2010.
31 He W, Wedig D, Wang L, et al. Violet laser acupuncture – Part 5: an investigation of different stimulation frequencies on heart rate and variability. J Acupunct Meridian Stud. 2012;5(6):290-294.
32 De Almeida P, Lopes-Martins RAB, De Marchi T, et al. Red (660 nm) and infrared (830 nm) low-level laser therapy in skeletal muscle fatigue in humans: what is better? Lasers Med Sci. 2012;27:453-458.
33 De Almeida P, Lopes-Martins RAB, De Marchi T, et al. Red (660 nm) and infrared (830 nm) low-level laser therapy in skeletal muscle fatigue in humans: what is better? Lasers Med Sci. 2012;27:453-458.
34 Hudson DE, Hudson DO, Wininger JM, et al. Penetration of laser light at 808 and 980 nm in bovine tissue samples. Photomedicine and Laser Surgery. 2013;31(4):163-168.
35 Chow R, Yan W, and Armati P. Electrophysiological effects of single point transcutaneous 650 and 808 nm laser irradiation of rat sciatic nerve: a study of relevance for low-level laser therapy and laser acupuncture. Photomedicine and Laser Surgery. 2012;30(9):530-535.
36 Zhou YC. An advanced clinical trial with laser acupuncture anesthesia for minor operations in the oro-maxillofacial region. Lasers Surg Med. 1984;4(3):297-303.
37 Litscher G and Opitz G. Technical parameters for laser acupuncture to elicit peripheral and central effects: state-of-the-art and short guidelines based on results from the Medical University of Graz, the German Academy of Acupuncture, and the scientific literature. Evid Based Complement Alternat Med. 2012;2012: 697096.