|HAND Laser Acupuncture Treatment Protocol|
Dr. Margaret Naeser, Ph.D., Lic.Ac., Research Professor of Neurology, Boston University School of Medicine and Neuroimaging/Aphasia Research Program, VA Boston Healthcare System
Return to parent article LASER-ACUPUNCTURE THERAPY FOR CARPAL TUNNEL SYNDROME & HAND SPASTICITY
This therapy requires some upfront training by a licensed acupuncturist. If you are interested in this therapy, this is the detailed protocol you would show your acupuncturist. The American Association of Oriental Medicine (610-266-1433) can help you to locate a licensed acupuncturist trained in laser acupuncture. No medical claims are made.
may be used with Carpal Tunnel Syndrome; mild-moderate
hand paresis (weak, clumsy hand), where some improved hand function may
occur after three months of treatment; or stiff hand in spasm
("fisted" hand in flexion), where probably no improved hand
function will occur after treatment, but may help in lessening
contractures due to stroke, head injury, encephalitis, or MS. It also
may help for Raynaud's or peripheral neuropathv in the hands, rheumatoid
arthritis (especially earlier stages), or osteoarthritis.
Treat at least 3-6 times per week, preferably daily, for 3 months. This
protocol includes microamps TENS and low-energy laser.
Microamps TENS (A TENS device may not be used with a patient with a pacemaker.)
5. Set the frequency knob to F4 (292 Hz) for the first frequency to use.
6. Turn the microamps TENS "On," and SLOWLY turn up the mA power until the patient reports feeling a tingling sensation from either electrode placement. Now, turn the power down, until the PATIENT DOES NOT FEEL ANY STIMULUS AT ALL. This will be the correct setting (it should be around only 300 or 500 mA, or less). If the patient does not report any tingling sensation at all, this is OK. In this case, just set the power to maximum mA. Leave at these settings for 2-5 minutes.
7. Then decrease the frequency knob to F1 (0.3 Hz). Now leave it at F1 for at least 15 minutes. I sometimes leave it on for even 45 minutes, or more. If you leave the TENS device on for more than that time, the patient may complain of a burning sensation at the grounding pad electrode. This means that the water disappeared from the grounding pad, and a small irritation or burn may develop on the skin. The "MicroStim 100" TENS device turns itself off after 20 minutes; you can then re-start it.
Low-Energy Laser Lecture Pointer
While the microamps TENS device is in place, a 5 mW, 670 nm (red beam) laser lecture pointer can be used to "point" to the Jing-Well points, and other points, for at least three minutes per point, on the affected hand orwrist area. The tip of the laser pointer must physically touch the skin, but do not press so hard that the tip leaves a very deep indentation on the skin. These points include:
1. Lu 11, LI 1, PC 9, TW 1, Hrt 9, SI 1. These are the most important points.
2. Optional points for severe finger cases include extra points at ends of all major finger creases at the joints, on edges of fingers. These are the proximal and distal interphalangeal joints. There are four of these extra points on each finger, and two on each thumb. Dr. So refers to them as "Wen Tao."
3. Distal Ba Xie points in the webs between the fingers; or proximal Ba Xie points.
4. Lu 9, PC 7, Hrt 7. These are especially important for Carpal Tunnel syndrome, especially PC 7. If the microamps TENS is used directly on the wrist crease, treat PC 7 BEFORE attaching the microamps TENS at the wrist. If you have time, use 7 joules (21 minutes) at PC 7, especially in first few weeks.
5. Other hand points include LI 4 or TW 3, but remember, use the laser pointer to point to only shallow points, on adults. (On babies and children, any body points can be used; use for only 5-10 seconds per point. It is forbidden to shine the laser onto the unclosed fontanelles on the head of a baby.)
6. It is, of course, recommended that acupuncture needles be used for other appropriate acupuncture points, especially non-shallow points on adults, such as LI 11, LI 1 5, TW 9, etc.
7. The laser may be used for even 12-21 minutes (4-7 Joules) on very painful joints/areas.
8. If positive response is observed with 3 minutes of laser stimulation per point, during later treatments, only 1 or 2 minutes could be tried, in an attempt to reduce the total treatment time.
Note: Poor results are often observed if the patient's wrist joint has previously been injected with Bo-tox; or if the patient takes certain medications, e.g., Tegretol, Phenobarbitol, or Steroids (Prednisone).
For Further Information on the Equipment see www.acupuncture.com/Acup/Naeser.htm
(Also see Naeser & Wei, Laser Acupuncture-An Introductory Textbook, Boston, Boston Chinese Medicine, 1994, p.40)