10 | ChiropraCtiC produCts • issue NiNe 2018

It is no secret that laser technology, which is well known for its versatility, effectiveness and cutting-edge features, is at the forefront of medical treatments. And with a new year approaching, laser technology presents a new

opportunity to reposition your practice to be on the cutting edge of medicine and provide services that can benefit every patient that walks in your door. To do this, however, will require practices to make changes.

Recent developments in photobiomodulation technology are providing increased clinical and financial outcomes that can literally benefit every patient. If you currently do not have a photobiomodulation device, or you have one and it’s not getting optimal results, it is worth the time and effort to re-evaluate and research the newest technology now available on the market. Technology is rapidly changing al-most all electronic devices, e.g. few of us have cell phones, computers or even televisions that are older than 10 years, and yet many practices still use therapy lasers that are technologically outdated and even out of warranty. Why risk your patient care, and why risk your practice not growing and expanding?

Expand Your Practice By Serving A Critical NeedAccording to a report from the Institute of Medicine (IOM) more than 100 million Americans suffer from chronic pain. That’s nearly 1 in every 3 people. Chronic pain has serious effects on an individual’s quality of life. Beyond the dis-comfort of pain itself, people with chronic pain can have increased levels of anxiety, stress, depression, anger, and fatigue, each of which has its own impact on self-esteem or personal relationships. The IOM committee concluded that a coordinated effort must take place in order to transform how healthcare providers tackle this growing problem. (Nearly

$600 billion is spent every year in medical treatments and lost productivity because of chronic pain.)

What is the solution? A very viable and yet overlooked solution is photobiomodulation. With new advancements in technology, photobiomodulation is improving the success rates of treatments that can dramatically reduce pain and inflammation. Patients often choose this form of treatment over other modalities because it is painless, effective and affordable. And chiropractors have a unique opportunity to expand their practice by serving this critical need within their local communities.

Photobiomodulation An Ideal Therapeutic Modality Tool For ChiropractorsWhile increasing your bottom line is a concern, providing quality patient care should always be a top priority. Chronic conditions are frequently tough to treat because the cause can be difficult to pinpoint. Photobiomodulation can help heal a variety of conditions that may not be responding to other forms of care by treating the cause, and not just the symptoms. Incorporating photobiomodulation into your practice can benefit your patients by increasing results and providing them with relief that chiropractic alone may not be able to deliver. By adding photobiomodulation to your practice, you are integrating a treatment that can signifi-cantly improve patient outcomes, and, of course, better and long-lasting results make it easier to generate referrals and internally build your practice.

In comparison to other therapeutic modalities, photobiomod-ulation is a non-invasive, painless, “feel good” treatment that typically takes less than 10 minutes. There are nominal space requirements to operate the device, and no recurring costs from disposable accessories or limited-use components. Staff can be trained and certified to operate the device and provide safe and effective treatments, freeing up the doctor to focus on other aspects of care. Typically, once patients see the benefits from the treatments, they will request addi-tional treatments as needed for their condition or for new injuries or surgeries.

Doctors Can Differentiate Their Practice WithA Branded Photobiomodulation Pain CenterHistorically referred to as Cold Laser, Low Level Laser Thera-py or High-Power Laser Therapy, the recommended termino- logy today is Photobiomodulation. In a crowded chiropractic

How Photobiomodulation Technology Can Increase Your Clinical And Financial Outcomes

by Justin Vorwaller, MBA

Acute And Chronic Pathologies

issue NiNe 2018 • ChiropraCtiC produCts | 11

market, determining a specialty can be difficult; Photobiomodulation provides a way to carve out space in the market and generate patient referrals. Instead of looking to provide laser therapy as one of many clinical services, or to continue marketing laser therapy the same way that you have been doing in the past, it is time to think big and to re-position your practice as the local “Leader In Photobiomodulation” with a branded Photobiomodulation Pain Center.

Your medical practice is a business, too, and to grow it needs branding. Branding will not only differentiate your practice from your competitors but will also instill trust and confidence in your patients. Active branding is necessary to ensure your medical practice is perceived well by your patients; you’ll be able to create a strong brand when you choose to promote photobiomodu-lation, making you different and better than others.

Clinical Benefits For Patients Clinical studies and research using photobiomodulation indicate the follow-ing beneficial clinical effects on tissues and cells:

Reduced inflammation. Photobio-modulation is anti-inflammatory and increases the inflammatory mediators such as macrophages, neutrophils, and lymphocytes that accelerate and resolve the inflammatory process. Research has documented effects at reducing inflammation producing cyto-kines such as Interleukin-1. At the same time photobiomodulation has shown to reduce damaging free radical levels by increasing SOD levels (Super Oxidase Dismutase). This helps get painful inflammation under control by targeting the cells and enzymes that can worsen inflammation.

Faster pain reduction with longer lasting relief. Photobiomodulation provides an anti-pain or analgesic benefit. It decreases nerve sensitivity by decreasing bradykinin, a pain eliciting chemical. It normalizes ion channels (cellular gatekeepers) and releases endorphins (the body’s natural pain reliever) and enkephalins (related to

endorphins) from the brain and adre-nal gland that produce an analgesic effect. Photobiomodulation also has a pain-blocking effect on certain nerve fibers and decreases nerve sensitivity.

Vascular System: increased angio-genesis and neovascularization. Photobiomodulation provides an anti-edemic effect causing the blood vessels and the lymphatic vessels to widen in a process called vasodilation. The treated area undergoes a process of angiogenesis, or the growth of new small blood vessels. This allows more nutrients to be supplied to the injured area and also aids removal of waste from dead or damaged cells. Improv-ing the drainage through the lymphatic vessels and veins also helps with removing the excessive swelling.

Cells: metabolic growth increased. Photobiomodulation creates higher outputs of specific enzymes, greater ox-ygen and food particle loads for blood cells. This results in energizing cells and stimulates the right molecules in the target area while increasing tissue oxygenation, ATP (adenosine-tri-phos-phate), synthesis (energy creation) and intercellular exchanges. This process in-creases the energy available to the cell so that the cell can take on nutrients faster and get rid of waste products. As a result the cells of tendons, ligaments, nerves and muscles are repaired faster.

Stem cells: increased activation. Photobiomodulation increases the num-ber of stem cells, which enhances the healing process.

Immune System: immunoregulation stimulated. Photobiomodulation has a direct effect on the immune system by stimulation of immunoglobulins and lymphocytes. Laser energy is absorbed by chromophores (molecule enzymes) that react to the laser light. The enzyme flavanone-nucleotide is activated and starts the production of ATP (adenos-ine-tri-phosphate) which is the major carrier of cell energy and the energy source for all chemical reactions in the cells.

Nerves: improved function and regeneration. Photobiomodulation

increases the proliferation of growth factors that promote neuronal sprouting and myelin formation for optimal nerve recovery. Nerves allow your brain to communicate with your body and your body to communicate with your brain. When your body is in pain, particularly if it’s chronic, the nerves stop working as well. Slow recovery of nerve functions in damaged tissue can result in numbness and impaired limbs. Photobiomodulation helps nerve signal transmission improve and speeds up the process of nerve cell reconnection, increasing the amplitude of action potentials to optimize muscle action.

Muscles: tissue repair and regen- eration. Photobiomodulation pene-trates deep into tissue and stimulates cellular reproduction and growth that result in the repair of damaged muscle fibers and activation of myogenic satellite cells that lead to regeneration of muscle tissue.

Scar Tissue: collagen production. Photobiomodulation increases colla-gen production that allows proper alignment and remodeling of collagen, which reduces the formation of scar tissue following tissue damage from re-petitive motion injuries, cuts, scratches, bumps or surgery. By getting treatment early, it can prevent the build-up of scar tissue and is beneficial for torn liga-ments, tendons or muscles, or post-sur-gery. With less tissue scarring there is

Inflammation Reduced

Pain Reduced

12 | ChiropraCtiC produCts • issue NiNe 2018

reduced chronic pain often associated with scars.

Joints: cartilage production. Photobiomodulation pro-duces an increase in chondrocyte and collagen production which facilitates improved cartilage deposition and joint function.

Wounds: healing accelerated. Photobiomodulation stimu-lates fibroblast development in damaged tissue. (Fibroblasts are the building blocks of collagen, which is predominant in wound healing). Collagen is the essential protein required to replace old tissue or to repair tissue injuries. Additionally, greater strength of new tissue (better tensile strength) occurs which protects against further breakdown or tissue damage.

Bones: repair accelerated. Photobiomodulation creates proliferation of osteocytes and remodeling of bone extracel-lular matrix resulting in accelerated bone repair.

Trigger and acupuncture points: stimulated. Photobio-modulation is effective in eliminating painful trigger points. It is also another treatment option of stimulating acupuncture points without the discomfort associated with needling.

Acute and chronic pathologies: resolved. Both acute and chronic pathologies respond well to the photochemical mechanism of action provided by photobiomodulation, and are often resolved or made manageable, resulting in a sig-nificantly improved quality of life.

Financial Benefits Of A Cash Service Photobiomodulation with the proper equipment and treat-ment techniques can achieve remarkable results and is ideal to add as a cash service to your practice, as patients are willing to pay for results. (Every practice can use additional cash income.) Practices that currently bill 50% or more to a third-party insurance should seriously consider incorporating a cash-based service into their practice; cash programs, when properly set up and managed, can be profitable by reducing practice overhead and increasing net income. Reimbursement is always 100%, and no additional staffing is required for collections.

Today is an exciting time to be in medicine. American healthcare is facing a slew of challenges that are large and extraordinarily complex, but also solvable. Successfully tack-ling these issues will require all healthcare providers, payers, regulators, and patients to work together with a positive attitude in trying new approaches. Change is both necessary and unavoidable, but the result will be better outcomes, resulting in better healthcare practices and patients who are more satisfied and more willing to embrace continued care.

About The Author: Justin M. Vorwaller, MBA is the chief oper-ating officer of Aspen Laser Systems, a medical device comp-any and emerging global leader in innovative photomedicine technology. Justin holds a Bachelor of Science degree from the University of Colorado and a Master of Business Administration degree from Utah State University. He can be reached at justin@aspenlasers.com.

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