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Top 5 Reasons to Try Laser Therapy for Pain Relief Before Cortisone Injections

Posted May 26 2010 1:39pm

Cortisone Injections (also know as Corticosteroid Injections or Cortisol Injections) can be effective at reducing pain associated with inflammation. time to learn about laser therapyCortisone is an anti-inflammatory medication that mimics the effects of a naturally existing hormone in our bodies known as Cortisol. Cortisol is released by the body during times of emotional stress or injury. Most spine injections, back pain injections, and arthritis injections involve corticosteroids. Prolotherapy is a type of injection but does not use corticosteroids.

Blocking inflammation often provides significant, albeit temporary, pain relief. However, inflammation is the primary healing mechanism of the body. Inhibiting the inflammatory process with cortisone injections or anti-inflammatory medications (Advil, Motrin, Ibuprofen, Aleve, etc.) can delay or even stop the healing process.

Delayed healing of injured tissue usually leads to the over-accumulation of scar tissue and weakening of the muscles, ligaments and tendons. This can make the injured tissue more susceptible to injury in the future.

  • High Power Laser Therapy (HPLT) increases the function of local blood vessels through a process called vasodilation allowing more oxygen and nutrient-rich blood to flow to the injured area.
  • Laser Therapy activates the lymphatic drainage system which allows waste products and damaged cells to be removed more readily. This decreases the painful “swelling” component of inflammation while allowing the “healing” aspects of inflammation to proceed without interference.
  • The photons of light from Laser Therapy deliver high amounts of bioavailable energy directly to the injured tissue which accelerates the cellular reproduction and growth and repair of tendons, ligaments and muscles.

Pain following a trauma is often triggered by pressure created by swelling and inflammation. Cortisone Injections reduces this inflammation oftentimes creating significant pain relief. That’s the good news.

The bad news is that pain is also a vital part of the healing process. Pain functions much like a smoke detector. When the detector senses a problem it sends out a piercing alarm to warn anybody in the vicinity that they are in danger. Pressure and pain receptors (nociceptors) also send alarm signals to the brain in the form of pain. The pain is there for a reason – mainly to make sure you don’t participate in any activities that might cause you more harm.

Blocking the pain with Cortisone injections can be compared with taking the batteries out of the smoke alarm – the fire (tissue injury) still rages on creating lots of smoke (inflammation) while the occupants of the house remain unaware and in danger.

If you can’t feel the pain then you don’t know when it is time to stop an activity that may be placing your tendons and other soft-tissues in danger. In extreme cases the tendons, ligaments or muscles can actually suffer a complete rupture. An example of this is when basketball great Wilt Chamberlain ruptured a tendon after several Cortisone injections.

  • High Power Laser Therapy (HPLT) reduces pain dramatically just like Cortisone injections.
  • Laser Therapy relieves the pain caused by swelling while allowing the healing aspects of inflammation to continue. Cortisone blocks both the positive and negative aspects of inflammation which provides pain relief while sacrificing the healing process.
  • Laser Therapy also reduces pain by decreasing nerve sensitivity. If we use the smoke detector example above, Cortisone Injections take the batteries out of the smoke detector while Laser Therapy turns down the sensitivity of the device. Therefore, your body can still “warn” you if you are overexerting yourself while allowing most of your daily activities to continue without pain.

When the healing process in interrupted, interfered with or stopped, the result is more than just a delay in healing. The quality of the injury repair suffers in nearly every circumstance. Healing damaged connective tissue is a race against time. Both inflammation and the tearing of nearby blood vessels drive the building materials necessary for healing to the injured area. When the healing is nearly completed phagocytes (microscopic garbage collectors) consume any unnecessary debris leftover from the repair process. If the healing process proceeds without interruption then the phagocytes do a great job and leave very little scar tissue when they leave. Cortisone injections can slow this process to such a degree that more debris is created than can be cleared away leaving a large (macroscopic) pile of scar tissue.

  • High Power Laser Therapy (HPLT) stimulates fibroblast development. Fibroblasts build collagen which is the predominant building block of wound and injury healing.
  • Laser Therapy actually accelerates the healing process (mentioned in Reason #1). The faster the healing process proceeds the less scar tissue is produced as a byproduct.
  • HPLT increases metabolic activity by stimulating the production of healing enzymes and improving the oxygen and nutrient carrying capacity of blood cells. Both of these factors contribute to increased phagocyte activity and efficiency. As mentioned above phagocytes consume and recycle excess scar tissue.

“Doctors tell you that steroids (cortisone, prednisone) only cause side effects after many years. But new research shows that permanent damage is immediate and devastating. Studies show that steroids cause permanent, debilitating effects after a single dosage. Steroids are probably the most sleazy of modern day medications.”

John Mills, former professor of medicine at the University of California, San Francisco and chief of infectious diseases at San Francisco General Hospital.

In  #3 we learned that Cortisone Injections create more scar tissue than is necessary for proper healing.
Why is this important? It is important because scar tissue is MUCH less flexible than healthy connective tissue. More flexible healthy tissue can S-T-R-E-T-C-H farther before tearing while less flexible scar tissue will TEAR relatively easily in comparison.

Multiple studies in animals have demonstrated dramatic reductions in tensile strength of connective tissue injuries that healed in the presence of Cortisone and other anti-inflammatory medication.  Dozens of studies have demonstrated reductions in tissue strength between 22% and 41% on body regions ranging from knee ligaments to abdominal muscles.

Extrapolate that data in to real life and it may not be inaccurate to say that “people receiving a Cortisone Injection in a particular part of the body (low back for instance) may be 22-41% more likely to re-injure the same body part because of the tissue weakening caused by the medication.”

  • High Power Laser Therapy (HPLT) enhances and accelerates the inflammatory process. Weakening of soft tissue caused by Cortisone occurs because the inflammatory healing process is stopped in its track. Laser Therapy keeps the process on track and actually speeds it up!

In Reason #2 we learned that pain actually fills an important role in the healing process. The same is true of Muscle Spasm. Muscle Spasms work to physically protect the injured tissue by limiting motion and mobility that would otherwise cause harm. In fact, the terms “Protective Muscle Spasm” and “Muscle Guarding” are commonly used to describe this “protective” role that muscle spasms play.

It is commonly believed that muscles spasm due to direct trauma or injury. Although this does happen, it is far more common for both pain and the pressure of inflammation to trigger this protective response. Cortisone Injections generally reduce inflammation which, in turn, alleviates pain. This tends to lessen the “warning signals” that the body relies upon when deciding whether to spasm up a muscle defensively or not.

Without protective muscle spasm the injured body part is now prone to further injury from actions that would normally be prevented by their efforts. Further injury is always associated with delayed healing, increased accumulation of scar tissue and less complete recovery. (Can you say ‘vicious cycle?’)

  • High Power Laser Therapy (HPLT) reduces muscle spasm dramatically just like steroid injections. The muscular pain and spasm is relieved through stimulation of muscle trigger points and acupuncture points. It provides non-invasive musculoskeletal pain relief without preventing the body’s inborn protective response.
  • Laser Therapy also reduces muscle spasm by decreasing nerve sensitivity. If we use the smoke detector example above (Reason #2), Cortisone Injections take the batteries out of the smoke detector while Laser Therapy turns down the sensitivity of the device. Therefore, your body can still offer protection with a muscle spasm if an action is performed that could cause harm while still providing significant pain relief during “safe” daily activities.

Part of me has a hard time even bringing this up but it is extremely relevant to this conversation. If you live in Denver, chances are you knew or heard of Leslie Fishbein, a prominent business woman here in the Denver, Colorado. She suffered from chronic back pain. She received a bak pain injection and had a “serious reaction,” that caused her to later be placed on life support. Two weeks later, she died.

Shane Ellison, M.Sc  a medicinal chemist in Santa Fe, New Mexico was asked to comment on how this could have happened…

“Could have been any number of steroids – likely cortisol – or opioid mimics that killed her. Happens all the time. This time it was a celeb, so we hear about it…People need to stop letting physicians stab them.”

High Power Laser Therapy if offered at our Lakewood, CO chiropractic clinic.

You can see some of patients who have benefited from laser therapy here .


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Dr. Ron Spallone, DC is the clinic director at Evocare Center for Physical Health . His passion is the driving force behind Denver Chiropractor dot com. He's been a Colorado chiropractor for over13 years.
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