Margaret A. Naeser, Ph.D., Lic.Ac., Dipl.Ac.
What points work best for my problem?
There are no specific, cookbook-type treatment protocols available
with low-level laser acupuncture, just as there are no specific, cookbook-type
treatment protocols with needle acupuncture. The practitioner needs,
rather, a sophisticated knowledge of Traditional Chinese Medicine,
and understanding of the actions of the acupuncture points, to be
a successful practitioner with laser acupuncture.
I do not recommend practicing only with laser acupuncture, rather,
I recommend adding it to the collection of acupuncture modalities
- i.e., acupuncture needles, microamps electrical stimulation, moxibustion,
cupping, Chinese herbal medicine, ion pumping cords, magnet therapies,
etc. In America, it is now required that one have a minimum of 1,725
hours of acupuncture training, before one can take the acupuncture
exam for certification in acupuncture, from the National Certification
Commission for Acupuncture and Oriental Medicine.
I hope the information provided below will be helpful. Thank you
for your interest in low-level laser acupuncture.
For a referral to a licensed acupuncturist who has studied laser
acupuncture, please call the
Association of Oriental Medicine, in Catasauqua, PA, 610-266-1433.
They can often sort referrals by zip code.
How does this work? How can I learn to do it?
The area of low-level laser acupuncture is complex. Unfortunately
there is no single laser that will do everything, and I do not recommend
any specific lasers, I conduct laser acupuncture research with carpal
tunnel syndrome, and formerly, with stroke patients with paralysis
(acupuncture and laser acupuncture to treat paralysis in stroke, referenced
at the end).
Licensed acupuncturists who want to know more about laser acupuncture
might consider purchasing one of the publications (listed
below) that have been published for this purpose or attending
a two-day class I teach for CEU's at the New England School of Acupuncture,
Watertown, MA, near Boston entitled:
Laser Acupuncture to Treat Paralysis in Stroke, Pain in Carpal
Tunnel Syndrome and Other Disorders.
The next class is in April of 2002. For registration, please contact
or: 617-926-1788, extension 114. I teach this class once a year. If
you're reading this page after this date, please contact Ken for future
dates of this seminar. Or, see their website at:
Another class, though much shorter in duration (four hours) will be held at the AAOM conference in Hawaii in early November, 2001. Contact the AAOM for more information on their annual get together.
Technical considerations of laser acupuncture
With painless, non-invasive laser acupuncture, we work with Class
IIIb lasers (5 to 500 mW). One can start to burn the skin at greater
than 500 mW (Class IV lasers). With laser acupuncture, we also primarily
only work with wavelengths in the red-beam range (600 - 700 nm) and
in the near infrared-beam range (800 - 1000 nm).
The red-beam laser has only a shallow penetration, around 0.8 of
one mm, direct energy - used on acupuncture points on the hand, foot
(not the heel), face, or sometimes the ear. The red-beam is fine for
the shallow Jing-Well points on the foot. For example, Bladder 67,
for breech position, 5 minutes per day, the last few weeks of pregnancy
(Jin, 1998). It has a 85% success rate according to Dr. Jin.
Jin Y. 1998. Handbook of Obstetrics & Gynecology in Chinese Medicine
- An Integrated Approach. Seattle, WA, Eastland Press. p. 114
The red-beam laser is usually 600 - 700 nm wavelength; and less
than 500 mW. How many joules do you want to use? How many joules per
cm square? These are all very important facts for you to know, before
you start using the lasers. For example, a 5 mW laser lecture pointer
pen with a 5 mm diameter aperture requires a minimum of 3 minutes
exposure time on an acupuncture point, to have approximately 4.59
joules per cm square. Some think that the anti-inflammatory effect,
and the improved circulation effect starts at a minimum of 4 joules
per cm square. This is especially so for wound healing (Mester, Mester,
Mester, 1984), and treatment of post herpetic neuralgia (Moore et
al., 1988; McKibben & Downie, 1990) and earlier stages of alopecia
areata (Trelles, Mayayo, Cisneros, 1984).
Mester E, Mester AF, Mester A. The biomedical effects of laser
application. Lasers Surg Med 1985;5:31-39.
Moore KC, Hira N, Kumar PS et al. A double blind crossover trial
of low level laser therapy in the treatment of post herpetic neuralgia.
Lasers in Medical Science, Abstracts Issue, July 1988; 301.
McKibben LS, Downie R. Treatment of postherpetic pain using a
904 nm low-energy infrared laser. Laser Therapy 1990; 2:20.
Trelles MA, Mayayo E, Cisneros JL. Treatment of the Alopecia Areata
with He/Ne laser. Tratamiento de la Alopecia Areata con laser He/Ne.
INVESTIGACION Y CLINICA LASER, 1984;1:15-17.
If you plan to be treating deeper acupuncture points on the limbs
or back, you need an infrared laser (800 - 1000 nm wavelength). The
infrared lasers tend to have a deeper effect, up to an inch or so.
Again, a very complex topic.
Pulsed Laser Settings, and Some Possible Therapeutic Indications
These pulse rates (pulses per second) and indications, for each
rate are based on P.F.M. Nogier, M.D., Lyon, France. Here, I am referring
to them as used with the infrared (904 nm) pulsed, Respond Laser 2400,
Respond Systems, Branford, CT. No medical claims are made.
||Acute injury, non-union fracture, Tonification
of Acupuncture Points, Wound Healing
||Sub-acute injury and yellow scar tissue
||For outermost layer of tissue (Ectodermal), Chronic
conditions, Acupuncture Points, Arthritis, Scar Tissue
||For inner most layer of tissue (Endodermal), Circulatory
||For tissue of Mesodermal origin, For Acupuncture
Points on limbs, Scar tissue
||For chronic conditions, For Sedation of Acupuncture
Points, Pain control. Very Dispersive, recommend following up
with F4 for a few minutes, and then F1 for a few minutes at the
end of a pain treatment.
Examples of Laser Protocols using Pulsed Infrared laser, as listed
Often with cases who have a Traditional Chinese Medicine diagnosis
of Deficiency, I do not use F6 at all. For example, with Heel Spurs
in a case with Deficiency (often Ki Def.), I try F4 for 5 or 10 minutes;
then F3 for 5 minutes; then F2 for 5 minutes; then F1 for 5 minutes.
The patient can simply rest the heel onto the laser block (four laser
diodes in an array, in the 4-inch by 3-inch laser block that is part
of the Respond laser equipment), while sitting up, using pillows for
support. The exact treatment times are probably not known, but it
seems to be important to use primarily the F4 down to F1 with Deficient
cases (I have observed that using too much of F6, alone, Disperses
too much, and the patient has no effect from the treatment at all.
The number of treatments may be 12 (every other day) or less, depending
on the case. I learned this treatment from Jennifer Blahnik, L.Ac.,
Wausau, WI (715-854-9234) and Beloit, WI (608-365-6771) -M. Naeser,
The Respond Systems Co. also manufactures an infrared (IR), 904
nm, continuous wave, single probe which has a higher power output,
than the pulsed probe. The continuous wave probe is 500 mW. This probe
delivers 1 joule per cm square every 2 seconds.
Ten seconds with the continuous wave, 500 mW IR probe may also help
to improve the circulation at the tender spots in the fascia, on the
heel spurs. If the 500 mW IR probe is used first, on the tender spots,
it is also recommended to follow up with some Tonification on these
areas, with lower Nogier frequencies with the pulsed IR laser, for
a few minutes, as mentioned above.
Low Back Pain:
Also, when treating low back pain, for example, while the acupuncture
needles are in Bl 23, place/tape the laser block (4 laser diodes in
an array, in the 4-inch by 3-inch laser block that is part of the
Respond System laser equipment) next to the needles, either in between
L and R, Bl 23 (across the spine), or lateral to Bl 23, especially
if pain is there. The IR laser local stimulation next to the acupuncture
needle seems to improve the circulation there. I learned this from
Ken Branco, L.Ac., Westport, MA (email@example.com).
Ten seconds with the continuous wave, 500 mW IR probe may also help
to improve the circulation at the tender spots on the back, prior
to initiating work with the pulsed laser probe. When the 500 mW IR
probe is used first, it should be followed up with Tonification -
either with the lower Nogier pulsed frequencies with the IR laser,
or with acupuncture needles or moxa. This is also a method used successfully
by a licensed acupuncturist in Hull, MA, Jeanne Christianson, L.Ac.,
Legal issues regarding the practice of low-level laser therapy
Low-level laser therapy is considered investigational by the FDA,
and no medical claims of cures are permitted in the US, at this time.
It is my understanding, however, that if low-level lasers are defined
within the state scope of medical practice (as it is in Massachusetts
for licensed acupuncturists), then the FDA will not interfere, as
long as the licensed acupuncturist does not make any medical claims
We do have an independent institutional review board (IIRB) for
laser acupuncture (research) in Massachusetts, with which the licensed
acupuncturist may register his/her laser and his/her laser acupuncture
treatment protocols, for a specific disorder, etc. This board is limited
to licensed acupuncturists in Massaschusetts, only. The licensed acupuncturist
also obtains informed consent from each patient.
I have published a laser acupuncture, introductory textbook (listed
below), and there is a 48-page addendum to the textbook which
explains FDA regulations from written materials in the 1980's. The
information regarding the issue of low-level laser therapy being within
the scope of medical practice per state regulations, per state, is
only from verbal conversations with the FDA in the last year or so
- I have nothing in writing. The information regarding investigational
use, and the issue of being within the scope of medical practice per
state regulations, per state, is only from verbal conversations with
the FDA in the last year or so - I have nothing in writing. In theory,
if the licensed acupuncturist uses the low-level lasers, without registering
with an IIRB, and there is a complaint by a patient directly to the
FDA (there have been none since we started in Mass., 6 years ago),
then the FDA has the right to take away the lasers from the acupuncture
office, as I understand it. This is fairly complex and I cannot speak
for the FDA.
Where can I get a laser?
Some laser vendors are the following, and I repeat that I do not
endorse any lasers, nor do I make any medical claims of cures for
President, Respond Systems, Inc.
20 Baldwin Dr.
Branford, CT 06405
1-800-722-1228 or 203-481-2810
Don Hudson builds two types of lasers, continuous wave, and
pulsed, infrared (IR) lasers (904 nm). The continuous wave laser
is 500 mW, and emits one joule per cm square every two seconds.
The pulsed laser (9.4 W, with 180 nanoseconds on-time) is configured
to emit the Nogier pulsed frequencies (73 pps, 146 pps, 292 pps,
584 pps, etc., and a very high frequency pulse of 3,500 pps, see
above table). At 3,500 pps, the laser is only emitting 5.92 mW
equivalent, and it is, of course, emitting a much lower mW equivalent,
at the lower pulsed frequencies. An example of the different pulse
frequencies and their indications
in this article.
- Phil Passy,
President, LaserPath, Inc.
Oakville, Ontario, Canada
Phil Passy also builds excellent lasers, they are 785 nm, and
easy to use (can be strapped into place at the wrist, instead
of holding them).
- Melyni Worth, Ph.D., in Virginia, who uses lasers from Australia
and the UK
Melyni Worth, Ph.D. PAS,
THOR, LTU and
Equilaser Therapy Lasers, FOXDEN
EQUINE,(Lasers for sale or rent)
TEL or FAX (540)-337-2264 EMAIL:
Expert sources for more information:
Licensed acupuncturists in the U.S. who have a great deal of
experience with low-level laser therapies, especially for Carpal
Tunnel Syndrome are
Branco, Lic.Ac., Westport, MA, and
Ranft, Lic.Ac., Hot Springs, Arkansas, firstname.lastname@example.org.
Another licensed acupuncturist in the U.S. who has a great deal
of experience with low-level laser therapies is Peter Courtnage,
Ph.D., Lic.Ac., in Englewood, CO.
A chiropractor who has extensive experience with low-level laser
therapies is Scott Deuel, D.C., Castle Rock, CO.
There is also the North American Association for Laser Therapies,
newly formed (NAALT). Contact Lynda Woodruff, Ph.D., P.T. the
President of NAALT for more info:
Dr. Woodruff is located in Dahlonega, GA, North Georgia College
State University. She is also conducting low-level laser research
there with treating pain in carpal tunnel syndrome. She uses lasers
manufactured by Phil Passy, at LaserPath, Inc. His email is:
Laser Acupuncture Teaching Publications:
Naeser MA, Wei XB: Laser Acupuncture - An Introductory
Textbook for Treatment of Pain, Paralysis, Spasticity and Other
Disorders. Clinical and Research Uses of Laser Acupuncture from
Around the World. Boston: Boston Chinese Medicine. 1994.
This laser acupuncture textbook ($44.95) can be ordered from
a company in Pittsfield, MA, called Spanda Medical Co. email:
Telephone: 413-448-2022, 1-800-772-6320
Or, the American Association of Oriental Medicine (AAOM),
in Catasauqua, PA, also sells this laser acupuncture textbook.
Naeser MA, Hahn C, Lieberman BE: Booklet: Naeser Laser
Home Treatment Program for the Hand©. An Alternative Therapy to
Treat Painful Symptoms of Carpal Tunnel Syndrome and Repetitive
Strain Injury. Catasauqua, PA: The American Association
of Oriental Medicine. 1996. Portions of this booklet are available
at the following URL:
The AAOM has published this booklet, Naeser Laser Home Treatment
for the Hand. The cost is $24.95. Half of the proceeds from sales
of this booklet are donated to our laser acupuncture research
project in Boston, to treat pain in carpal tunnel syndrome. email:
Other laser acupuncture publications include:
Naeser MA, Alexander MP, Stiassny-Eder D, Galler V, Hobbs J,
Bachman D, Lannin L: Laser Acupuncture in the Treatment of
Paralysis in Stroke Patients: A CT Scan Lesion Site Study.
American Journal of Acupuncture, 23(1):13-28, 1995.
Naeser MA: Acupuncture and Laser Acupuncture in the Treatment
of Paralysis in Stroke Patients, Carpal Tunnel Syndrome and Alopecia
Areata. Frontier Perspectives. 5(1):8-15, 1996.
Naeser MA: Neurological Rehabilitation: Acupuncture and Laser
Acupuncture to Treat Paralysis in Stroke and Other Paralytic Conditions
and Pain in Carpal Tunnel Syndrome. Paper in Proceedings,
National Institutes of Health Consensus Development Conference
on Acupuncture sponsored by the Office of Alternative Medicine
and the Office of Medical Applications of Research. Bethesda,
MD, November 3-5, 1997. pp. 93-109.
Branco K and Naeser MA: Carpal tunnel syndrome: Clinical
outcome after low-level laser acupuncture, microamps transcutaneous
electrical nerve stimulation, and other alternative therapies
- an open protocol study. The Journal of Alternative and
Complementary Medicine, 5(1): 5-26, 1999.
Naeser MA & Deuel SK: Review of Second Congress, World Association
for Laser Therapy Meeting (WALT), September 2-5, 1998, Kansas
City, MO, U.S.A. The Journal of Alternative and Complementary
Medicine 55(2):177-180, 1999.