treating an acupoint

Although lasers are most popular for treating broad areas of damaged cells using a large-area emitter , there is a growing number of practitioners using lasers to stimulate the body through acupoints and trigger points. This guide was created to help practitioners understand how the requirements for a pinpoint laser are very different from broad lasers and help practitioners understand all the options available to them. Luckily books like "A Practical Guide to Laser Acupuncture" by VolkMar Kreisel and Michael Weber are showing practitioners that the possibilities for lasers are limitless. Dr. Weber also does LLLT training class across Europe. In the concluding remarks for his training classes, Dr. Weber says "LLLT is even more effective than metal needles in some studies," and he predicts that "LLLT will become mainstream in all fields of Medicine."

The maximum safe output for a small tip laser is 500mW. Because these systems are used statically, no one makes a system with more than 500mW at the tip because of the risk of tissue heating. On the low end, there are lots of low-cost 5mW lasers, but once you do the math, you will see that these lasers will not be as effective as properly designed acupuncture lasers (see table below).

We also sell a unique concept for acupuncture and trigger point therapy, the 3B Scientific multi-point laser systems . This system utilizes 12 fiber optic strands to treat up to 12 different point simultaneously. Each strand delivers 50mW of power. Since the strands are fixed to the body using stick adapters, the system can deliver higher dosages than most practitions would would have the patients for with an individual laser beam and it is the only system that can do unattended acupuncture or trigger point therapy.

Laser Acupuncture System Requirements
According to VolkMar Kreisel and Michael Weber (and many other authors), the typical acupuncture point takes .5 to 8 joules per point to clear it. The max of 8 joules could be required for dark skin individuals where the acupoint is on the body. The minimum dosage of 0.5 joules is appropriate for children with light skin. For this calculation, we will assume a typical dosage to be 5 joules for a body point and 2 joules for an ear/head acupoint. In order to calculate treatment times we use the following equation:

Treatment time = Dosage x 1000 / Laser power [a](mW) x adapter efficiency[b] x pulsing duty cycle[c]

[a]Laser power is the rated max output of the laser AT THE TIP and not the rated output at the laser diodes, which can sometimes be remote-mounted and require fiber optics to get the energy to the treatment area. Fiber optic connections can significantly reduce the available power.
[b]If the laser emitter requires an adapter to focus the energy down to a small point, these adapters typically have max 40% efficiency. Some small tip lasers have a point finder that focuses the energy into an even smaller area that is better for ear treatments.
[c]If the laser is set to pulsing, then the power must also be de-rated by the duty cycle.

Type of Treatment Points

Area / Type Depth Dosage Preferred Wavelength*
Trigger Points
Deep tender spots within a taut band of muscle tissue
2-8 joules 800 nm to 850 nm
Body Acupoint Deep meridians which form the main paths for the circulation of Qi 4 joules

800 nm to 850 nm or 600 nm to 660 nm

Infant or Toddler Body Any 1.5 joules 600 nm to 850 nm
Auricular Acupoints Shallow meridians 1 joule 600 nm to 660 nm

*If you do not have the option of multiple wavelengths, use whatever wavelength is available.

Treatment times for treating a single body or hand acupoint (4 joules)

 

OTC Laser Pointer

Older Systems

Avant LZ30z[2]

Avant LZ30x[2]

PowerMedic

Apollo 500[1]

Power 5mW Red 35mW RED 1400mW IR
1000mW Red
1000mW IR
250mW Red
1000mW IR 500mW IR
Adapter Efficiency N/A N/A

40%

40%

100%

100%

Pulse
Duty Cycle

N/A

100% CW
70% Pulsed

100% CW
70% Pulsed

100% CW
70% Pulsed

50%

N/A

Treatment Time Per Point

800 seconds or
13 minutes

114 seconds or 1.9 minutes

12 sec (CW Red)
16 sec (Pul Red)
12 sec (CW IR)
16 sec (Pul IR)

40 sec (CW Red)
48 sec (Pul Red)
3 sec (CW IR)
4 sec (Pulse IR)

8 seconds

10 seconds

Older systems include Omega™ or Thor™.
Laser pointers include QiLaser™, Laseronix™ and most OTC laser pointers.
RJ makes some higher-end acupuncture systems that are similar to the PowerMedic.
[1]The Apollo laser is continuous wave only and does not pulse.
[2]
The Avant Laser dial down the power level to a maximum 500mW at the tip. This is the max power at the tip for any system since a higher power level can cause heating.

Here are some sample treatment times for various lasers for treating an auricular acupoint (1 joule)

 

OTC Laser Pointer

Older Systems

Avant LZ30z

Avant LZ30x

PowerMedic Pro

Apollo 5001

Power 5mW IR 35mW RED 1400mW IR
1000mW Red
1000mW IR
250mW Red
1000mW IR 500mW IR
Adapter Efficiency 100% N/A 40% 40% 40% (point finder) 40% (point finder)
Pulse
Duty Cycle
N/A 50% 100% CW
70% Pulsed
100% CW
70% Pulsed
50% N/A

Treatment Time Per Point (Seconds)

200 seconds or
3 minutes

28 seconds

3 sec (CW Red)
4 sec (Pul Red)
3 sec (CW IR)
4 sec (Pulse IR)

10 sec (CW Red)
12 sec (Pul Red)
3 sec (CW IR)
4 sec (Pulse IR)

2 seconds

2 seconds

 

It is obvious from this analysis that OTC (over-the-counter) laser pointers will be marginally usable for auricular therapy but not realistically usable for other points.

Cold Laser System Design Factors

Tip Size

For trigger point therapy, a 6 mm tip size is great. The larger treatment area means you need less accuracy. In order to reach the trigger points in the ear, you typically need a 2 or 3 mm tip. This smaller tip (pointfinder) is also just the right size to slip into the dent that is typically used to locate the acupoint. Fine-tip adapters typically have an efficiency of 20 to 50%, so most stronger lasers are de-rated to an appropriate level when they are using an adapter.

Emitter Types
Laser manufacturers make 2 distinct styles of emitter on cold laser systems; broad coverage probes for treating structural problems and pinpoint probes to for treating acupoints or trigger points. Most systems require the purchase of separate laser emitters for each application. Two laser manufacturers (TerraQuant and Avant) make adapters that focus the energy from a broad coverage emitter into a small point. This can significantly reduce the cost of a dual broad/pinpoint system. PowerMedic and Apollo offer both fine point and broad coverage packages.
Many practitioners use the same a broad probe that they would for treating structural problem but use it over the general area of the acupoints or trigger point and just reset them all. This is OK for people with less experience who might not be able to find the correct point with enough accuracy to get good results. We still recommend this strategy for home users who want to experiment.
On the flip side, users of pinpoint probes may also use them to treat large problems by painting the laser over an area. The system is not optimized for this kind of therapy but it allows user to get some energy to the damaged area and in many cases, this is enough to get a good reaction.

Wavelength
Another variable to consider is wavelength. The infra-red (800 to 850nm) wavelength is best for deeper penetration. This makes it more ideal for trigger point therapy and some body acupoints but the energy must go through the shallow areas on the way down to the deeper tissue so you get the equivalent of a long needle of energy with an infra-red probe. The red wavelength (600nm to 660nm) is quickly absorbed near the surface and by the blood flowing through the area. This is similar to a short needle with the extra advantage of treating the blood that might flow through to area of the body controlled by the treatment point.
The selection of the best wavelength is mainly a preference decision. In general, RED is more slightly ideal than IR for auricular acupuncture but it is still very common for practitioners to IR. We see this from companies like Thor and Avant who have probes in different wavelengths but they recommend RED for acupuncture. In the world of lasers, Avant systems stand out because they offer high power levels (near the safe maximum for acupuncture) in both IR and RED.

Pulsing and Continuous Wave
Pinpoint lasers can be either pulsing, continuous wave (CW) or both. Continuous wave lasers put out energy faster so they can produce the fastest treatment times. Pulsing the laser may provide an added benefit by stimulating the cells and some manufacturers state the tissue is less likely to adapt and stop chemically reacting to a pulsing input. The option for pulsing does make the setup more complex since there does not seem to be very clear guidelines about what pulsing frequency is the best for each treatment. The use of Nogier frequencies is very popular in Europe. The Avant laser and RJ system are the only systems that have built-in Nogier pulsing frequencies.

Laser System Styles
Pinpoint lasers may be either cordless or desktop. A desktop laser has more of a scientific/ laboratory feel so it can provide a patient experience. A cordless laser can be easier to handle and is a better option for practitioners with multiple treatment rooms or a mobile practice. Some systems like the PowerMedic just fit better into your hand and their pro system also vibrates to give a secondary stimulation to the patient and feedback to the practitioner.

Summary of Lasers for acupuncture and trigger point therapy
The following table shows all the laser options that we recommend for acupoint and trigger point therapy. Here are a few key points that help explain some of the anomalies in the table. This table shows both peak power and typical power when pulsed. The TerraQuant systems have extremely high peak power levels but they are turned off much more than they are turned on so the typical power is much lower than the peak. All the other pulsing lasers in the table have a pulsing duty cycle of more than 50% (the laser is on 50% of the time and off 50%). The power has been reduced for any system that uses optics to focus the energy since the adapter is not 100% efficient. The prices include the probe adapter if required and only includes the pinpoint probe and controller on 2-part systems. We do not sell Omega or Thor but we have included them there because they are very common for this application. Most acupuncturists will select a Class 3b laser. In order to treat the acupoints in the ear, you might need a 2mm probe. A 6mm probe is good for trigger point therapy.

Brand Class Peak Power Out Av. Pulse Power 1 Pulse / CW Wavelength Probe Size / Style Price
Terraquant TQ Solo 1m 15,000mW 150mW (estimated) Pulsed Only 905nm 2mm Cordless with acupuncture adapter $2924
TerraQuant Pro 1m 25,000mW 180mW (estimated) Pulsed Only 905nm 2mm Desktop with acupuncture adapter $4424
PowerMedic PL500 3b 1,000mW 500mW Pulse 810nm 1mm Cordless single probe with pointfinder $2995
PowerMedic PLp500 3b 1,000mW 500mW Pulse 810nm 1mm Cordless single probe with pointfinder $3995
Avant LZ30p
Home Use Only
3b 900mW IR & 80mW Red 400mW IR
40mW Red
Both 810nm & 637nm 2mm Cordless with acupuncture adapter $3950
Avant LZ30x 3b 900mW IR & 250mW Red 400mW IR
120mW Red
Both 810nm & 637nm 2mm Cordless with acupuncture adapter $4950
Avant LZ30z 3b 900mW IR & 950mW Red 400mW IR
420mW Red
Both 810nm & 637nm 2mm Cordless with acupuncture adapter $5650
Vectra Genisys 3b 300mW 210mW Both 850nm 6mm Desktop with single diode probe $3695

Omega™

(we do not sell it)

3b 50mW 35mW Both 660nm 2mm Desktop with single diode probe $8795
Thor 3b 450mW IR & 30mW Red 315mW IR
21mW Red
Both 810nm Or 660nm Desktop with 4mm IR & 2mm Red probes $11,000
3B Scientific 660nm Multipoint 3b 12 @ 50mW 12 @ 50mW Both 660nm 12 individual fiber optic probes $10,300
3B Scientific 785nm Multipoint 3b 12 @ 50mW 12 @ 50mW Both 785nm 12 individual fiber optic probes $10,300
3B Scientific LaserPen 500 3b 500mW 500mW @ 808nm Pulse 808nm

3 mm Cordless

0.1 to 10,000 Hz Pulsing

$4,950
Apollo DT 4 500mW N/A -500mW CW CW 810nm 6mm Desktop (Optional 1mm pointfinder) $3995
Apollo PT 4 500mW N/A -500mW CW CW 810nm 6mm Desktop (Optional 1mm pointfinder) $4499

The Pilot laser is a broad laser that can also be used as a pinpoint laser or hot (tissue cutting) laser so practitioners must be very careful when using it as a pinpoint laser and turn down the power. This is not a good option for daily use but could be used on a rare occasion.

1 The pulsing power levels are based on a 70% duty cycle except where noted.

Buyer Recommendations

Our first recommendation is for less experienced practitioners or home users. The TerraQuant lasers offer optional probe adapters so they can be used as an acupuncture device. These lasers offer both pinpoint and broad coverage in a superpulsing laser that is so safe that there is no risk of eye damage. In general, finding acupoints takes a high level of training so this is not for everyone. Lasers are much easier and safer than using needles at home, but it is still best to work directly with an acupuncturist to develop a successful therapy plan with needles and then switch it over to laser.

If you will be doing only acupuncture with the laser, the 3b Scientific laser systems are optimized for this type of therapy. Use the 500mW LaserPan for both auricular and standard treatments. If you are doing auricular only, the 200mW system costs less. It can do a variety of pulsing frequencies.

Another great option for an acupuncture-only laser is the PowerMedic PLp 500. This pulsed system was really designed specifically for this application. It has a tiny vibrator that goes off every 2 joules. If you are treating someone's ear, you simply move to the next point every time the laser buzzes. If you are treating a body point that requires 4 joules, you simply go through 2 cycles. The buzzing also generates a positive sensation for patients. This system has optimum dosages in less than 25 seconds per point.

Our recommendation for a Class 3b dual-purpose (broad/pinpoint) laser is the Avant LZ30z. As you can see in the table above, it has the highest power at the tip of any system, and it operates in the slightly better RED wavelength and has options for both pulsing and continuous wave. You can interchange the light pipe adapter and hood easily and the system recognize the change and optimizes the output to do a great job at both pinpoint and broad coverage. This Avant kills systems like the Thor system (21mW RED) and Omega (35mW RED) that would up to 2 minutes per point. If you are on a budget, the LZ30x or LZ30p, are also great options. The Avant lasers also has Nogier pulsing frequencies built in.

Our only recommendation for class 4 acupuncture system is the Apollo laser for everyday use. Apollo builds systems with a separate emitters for acupuncture and another emitter for broad coverage. This is one way to keep a higher-power broad & pinpoint system safe.

Of course, the ultimate system in this category is the 3B Scientific 12 channel laser system . This system is the only system that can be used for unattended acupuncture and trigger point therapy. It is also the only system that can deliver higher dosage to simultaneous point in a reasonble time and the patient expereince is so good, you will have patients asking if you can use the system on them.

Also check out the following book about how to use laser for acupuncture. We will include a free copy with every new acupoint laser sales.

Laser Acupuncture

A Practical Guide to Laser Acupuncture
by VolkMar Kreisel and Michael Weber

This is the ultimate book for anyone who want to learn more about using a laser for acupuncture.

 

 

$174Buy Now

What is up with the Cold Laser Market

Over the past 3 decades, the use of lasers in the US to treat structural problems has grown rapidly (with the main advocates being chiropractors and physical therapists) but the acceptance of lasers for other applications has been stunted. Outside the US, there has been a lot of growth in using lasers for treating a wider range of problems including all the conditions treated by an acupuncturist. Because Europe is not regulated by the FDA, they are free to advertise for services using a laser for a wide variety of conditions. Here in the US, you must be part of an IRB (Investigational Review Board) to advertise for any non-cleared laser service. This is slowing down laser adoption in the US, but there is an even bigger economic roadblock stopping any further FDA cleared applications.
When Microlight got the first FDA clearance for a cold laser, they spent millions of dollars getting the clearance through the FDA but they had a long period where they were the only FDA cleared laser company so they could recover the cost of the clearance program. Over the years, new companies were created and got their FDA clearance by applying for a 510k saying that their laser is just like a laser is already cleared and Microlight sales have dropped. This reduces the cost of clearance to 5% to 10% of the cost paid by originator. Today, with over 50 different laser companies already in operation, no one want to be the first to push through a multi-million dollar clearance program for a new application because they will only have a market advantage for a few month before all the competing companies get the same clearance using a 510k. It just doesn't make financial sense for any company to take a financial loss to advance the entire market when there is not payback on their clearance project. For this reason, the development of lasers for non-pain related applications has been essentially shut down.
None the less, there is a huge need for alternative care options in the US and we can learn a lot from the development in the other parts of the world. If you consider that 50% of the people who are good candidates for acupuncture are afraid of needles, acupuncturists and energy workers can increase their potential customer base by adding laser to their practice.

 

If you have any questions or need advice on selecting the best laser, please call us at 800-388-0850.

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