'Magic' laser said to relieve pain,
promote healing

St. Mary's is the first hospital in the world using the Erchonia laser in a burn unit. In a study, it reduces pain an average of 60 percent.

ANNE T. DENOGEAN
Tucson Citizen
http://www.tucsoncitizen.com/index.php?page=local&story_id=022104a1_erchonia

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Dr. Jeffrey Nelson uses low-level laser therapy on foot and ankle injuries Matthew Shannon received in a motorcycle accident. Shannon says the treatments have reduced inflammation and given him increased mobility.

When Luis Gonzalez recently burned his hand with Freon while fixing an air conditioner, the searing pain of his blistering skin wasn't quelled by the morphine shot doctors gave him at an emergency room.
It kept him awake the entire night, and when he reported the next day to the burn unit at St. Mary's Hospital and the wound was scrubbed and washed, he rated his pain a 12 on a scale of 1 to 10.

Within minutes, however, as a doctor waved a unique, cool red laser over the wound, Gonzalez's pain dissipated until it was bearable - a small miracle as anyone who's ever experienced the intense pain of a burn injury will understand.

"It was a big difference," Gonzalez, 50, said.

The Erchonia laser, made by a company in Mesa, is among the most amazing new developments in medicine, said Dr. Jeffrey Nelson, medical director of the burn unit and a plastic surgeon with a private practice.

The Erchonia - a low-level or cold laser that brings to mind the space-age medical gadgetry used by Dr. McCoy in "Star Trek" - reduces pain and promotes healing by stimulating the body's cells through the skin.

Doctors are finding a variety of uses for the laser, originally approved for musculoskeletal pain.

And St. Mary's is the first hospital in the world using the laser in a burn unit.

"From my end, this is one of the most important things that I've been able to do for patients in the last five years that doesn't require I stick a needle in them, that doesn't require I give them a prescription for a pain medication. It's a very noninvasive thing that takes a couple of minutes to do but can give patients a great deal of comfort," Nelson said.

Use of the hand-held laser on surgical and burn patients reduces their pain, bruising and swelling - in some cases, dramatically - while speeding up the healing of their wounds and improving the range of motion of the injured body part, he said.

The treatment consists of passing the laser over the afflicted area and related nerves for a set number of minutes.

Studies of the device in varying applications show it reduces pain on average by 60 percent to 70 percent, Nelson said.

The relief can last from hours to days. For Gonzalez, for example, the pain relief lasted seven hours. There are no known side effects.

"I'm not even sure what to tell the patient. It's like magic. It is Dr. McCoy type of stuff," Nelson said.

When most people think of lasers, what comes to mind are the high-power beams that use heat to burn off cancers, moles and polyps or for cosmetic procedures such as skin resurfacing.

The Erchonia is a low-energy laser that doesn't burn the tissue. Exactly how low-level lasers work is a bit of a scientific mystery, but the simplest explanation is that they increase the energy output of cells and thus accelerate healing.

Burn injuries, such as the one Luis Gonzalez suffered in a Freon accident, are also helped by Nelson's laser therapy through a reduction of pain.

The light penetrates the skin, hitting the cells with low-level photonic energy that sets off a cascade of signals within the cells that initiates, slows down or speeds up biological processes associated with swelling, healing and pain, explained Charlie Shanks, vice president of sales and marketing for Erchonia Medical Inc.

Low-energy lasers have been studied by scientists for many years.

Practitioners around the world have used low-level laser therapy for various medical conditions since the early 1980s, but its use in the United States is recent.

In January 2001, the Erchonia became the first such laser approved by the Food and Drug Administration when the agency OK'd its use for treating chronic neck and shoulder pain, Shanks said.

Since then, doctors have been broadening the applications in "off-label" uses, or uses not approved but also not banned by the FDA.

Nelson said he uses it in every arena of his practice, from burn and wound care to hand surgery patients to reconstructive and cosmetic surgery patients. He's used it on a woman with a snake-bite on her foot. Five minutes after the treatment, she was wiggling her toes with much greater ease, he said.

Nelson, along with a number of plastic surgeons around the country, has incorporated the laser into the presurgical preparation of liposuction patients.

The laser causes the cells to shrink and dump fat into the surrounding tissue areas, making it easier to suction out the fat, he said.

"It's a little less vigorous to do, and they tend to bruise less," he said.

He uses the laser on patients to treat their postsurgical pain and said it's his impression that patients are reporting less pain, using less pain medication and getting back to work faster.

"Typically when I did a big liposuction, tummy tuck or breast lift, patients would take narcotic pain medications for five to seven days. If you take the last four liposuction patients I did that got Erchonia laser, all four of them said they took the pain pills for one day," he said.

Shanks said Erchonia is nearing FDA approval on the use of its laser for liposuction. He also said the company is interested in Nelson's work with the laser in the burn unit.

"The burn patients often have to get wound care every day, and each time you do wound care, it hurts," Nelson said. "So if you laser somebody and they get some pain benefit that's going to last 24 hours, that's pretty good."

A study he conducted of 25 patients showed an average reduction in pain of 60 percent, he said.

"You can go to the burn unit and if a patient knows they are going to get lasered after the wound care, the anxiety goes down because they know they are going to feel better," Nelson added.

Nelson said he first heard of Erchonia during a cosmetic surgery meeting in Vail, Colo., last March.

One of the presenters mentioned the laser was being used by some plastic surgeons for liposuction, adding that it seemed silly and looked to him like flashing a penlight over the patient. Everybody, including Nelson, chuckled.

Two weeks later, Nelson found himself hobbling around his office with Plantar fasciitis, an inflammation of the sole of the foot.

A certified laser technician who works in his office treated him with the laser. Before 15 minutes passed, his pain was down 75 percent and the relief continued for three weeks, he said. That was when he knew he wanted to learn more about the laser.

Since then, he has lasered more than 200 patients. He said about 98 percent get some benefit, ranging from pain relief to improved blood flow to the injured area.

Among his patients is Matthew Shannon, 33, who suffered severe injuries to his lower right leg in a motorcycle accident Dec. 19.

In addition to four broken bones and a ruptured tendon, the top of his foot was "degloved." The covering of skin and flesh separated from the tendons, muscles and nerves and rolled to one side like a burrito.

Shannon doesn't remember the laser treatments he received in the hospital, but said the treatments he has had in the two weeks since the removal of a device to stabilize his leg and foot have helped reduce the inflammation and possibly improved his mobility.

At a recent visit to Nelson's office, Shannon looked down on a foot that was a healthy pink color and swollen to about twice normal size. Two weeks earlier, Shannon said, his foot was blue and swollen to four times normal size, his toes didn't touch the ground when he stood and he was in constant pain and couldn't put any weight on his foot.

Nelson said injuries and healing are unique to an individual, but the level of Shannon's recovery is impressive.

"This is the type of injury, where we see patients that are barely hobbling around three, four, six months afterward," he said.

Shannon walked into Nelson's office on one crutch, which he said he was using only as a safety net. When he left the office after a laser treatment, he walked to his car without using the crutch.

"It felt pretty good," he said.

IMPACT OF LASER:

In a study of 25 burn and wound patients at St. Mary's Hospital, pain was reduced an average of 60 percent after treatment with the Erchonia laser.

In treating more than 200 patients with the laser, Dr. Jeffrey Nelson said about 98 percent showed some effect, whether it was pain relief, reduction in swelling, increase in range of motion or visually obvious increased blood flow to the injured region.

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