How can laser therapy (PBM) help?

This week, the newest member of Victory’s team, consultant osteopath Jonathan Grice, tells us why he loves lasers (the type known as photobiomodulation rather than the Goldfinger sort), and explains how they help to reduce pain.

Photobiomodulation, or Low Level Laser Therapy as it’s sometimes called, is a subject close to my heart. I first found out about it when I was procrastinating (instead of writing my osteopathy dissertation) at university.

I’d realised by this point that very few types of treatment have great evidence bases. Even common, well-researched treatments like antibiotics don’t always work. So when I read paper after paper of statistically significant outcomes for the use of photobiomodulation (PBM), I thought there must be something to it.

So today I’m going to explain how PBM works, and how (despite looking like science fiction technology), it’s grounded in science and evidence.

How cells work

Let’s start by talking about how your cells work. All cells contain mitochondria – essentially little power plants, which produce all the energy your cells need to function. Energy production is a long and complicated process, part of which involves a protein called Cytochrome C Oxidase, or CCOx. CCOx’s job is to capture oxygen, to help provide your cell with energy.

CCOx responds to light. When you shine light of a certain colour on CCOx it will vibrate; and if you shine an intense amount of the right coloured light on CCOx it will vibrate strongly enough to deform into a new shape and will no longer be able to capture oxygen (although it will go back to normal within about 72 hours). What PBM does is to shine the right colour of light at the right intensity to deform CCOx.

How does PBM help?

Why would we want to interrupt this process, and prevent CCOx from doing its job?

When cells become stressed (with inflammation, for example), they produce nitric oxide. Nitric oxide molecules are approximately the same shape as oxygen molecules, and CCOx can’t tell the difference. So if your cells are inflamed (for example, if you strain your ankle ligaments), then rather than finding oxygen and using it to produce energy, the CCOx receptors get attached to nitric oxide molecules, leaving you with cells full of nitric oxide instead of oxygen. The cells then suffer because without oxygen, the mitochondria can’t make enough energy to repair the inflammation damage. But as the PBM deforms the CCOx, it “shakes out” the nitric oxide out that’s stuck to it, allowing for the process to begin again – but this time with oxygen, rather than nitric oxide.

What does this mean and how can it be used clinically?

First, you need to know that sending a nerve impulse is very energy intensive for a neuron. You have to pump a lot of ions very quickly to maintain the ability to send a signal. All those ion pumps run on energy produced by your mitochondria.

Second, you need a minimum number of nerve signals from the periphery in order to send the signal all the way up the spine to the brain. If you can diminish the number of peripheral nerve impulses below the summation threshold, the pain signal will not be conveyed any further.

Third, if pain signals don’t reach your brain, then you don’t feel them!

So, if you apply a strong light of the right colour at the right anatomical point, you will reduce the ability of peripheral nerves to send a nerve signal to the central nervous system, because you will be reducing their ability to produce energy in the mitochondria. When you reduce the number of nerve signals, fewer of them will reach your brain, and therefore you will feel less pain.

In a nutshell, that’s how PBM helps with pain. But there is more to it. For more discussion on the clinical response to PBM, you’ll need to read my next blog… watch this space!

To experience Jonathan and his photobiomodulation machine for yourself, you can now book assessment appointments with him at our Sun Street clinic. To book, either fill in the form below or give us a call on 0207 175 0150. And if you call us to book an assessment with Jonathan before the end of May 2019, then we’ll give you 50% off the price of the first session.