Combining MLS Laser Therapy with Chiropractic Methods

Combining MLS Laser Therapy with Chiropractic Care

Abstract

This post explores the revolutionary field of photobiomodulation (PBM) therapy, often known as laser therapy, and its profound impact on cellular healing. Drawing from the latest research and my clinical experience, I will explain how light energy interacts with our cells to reduce inflammation, accelerate tissue repair, and alleviate pain. We will explore the specific biological mechanisms, such as mitochondrial activation and cytokine modulation, that underpin these therapeutic effects. Furthermore, this post will highlight the synergistic potential of combining PBM therapy with other regenerative approaches, like platelet-rich plasma (PRP), to enhance clinical outcomes. I will also explain how these advanced treatments are integrated within a multidisciplinary practice model at Injury Medical Clinic, where I, as a Doctor of Chiropractic and Family Nurse Practitioner, work alongside our Medical Director, Dr. Maria Guadalupe Cardenas, MD, to provide comprehensive, evidence-based care for our patients in El Paso, Texas.

Our Collaborative and Integrative Approach to Patient Care

At Injury Medical Clinic, our philosophy is rooted in a comprehensive, patient-centered model. We believe that the most effective path to healing involves a multidisciplinary team that can address health issues from multiple angles. This is why I, Dr. Alex Jimenez, with my dual credentials as a Doctor of Chiropractic (DC) and a board-certified Family Nurse Practitioner (FNP-BC), am proud to collaborate with Dr. Maria Guadalupe Cardenas, MD.

Dr. Cardenas is a board-certified internist with over four decades of invaluable experience. As the Medical Director of our clinic (NPI #1164426749, Texas MD License #J2933), she provides essential medical oversight and works collaboratively with our entire team. This integrated structure allows us to blend the best of different disciplines. My expertise in chiropractic care, which focuses on the body’s biomechanical and structural integrity, is complemented by Dr. Cardenas’s profound knowledge of internal medicine. Together, alongside our functional medicine and rehabilitation specialists, we offer a truly holistic approach.

This means that when a patient comes to us, they are not just seeing a chiropractor or a medical doctor; they are benefiting from a unified team that integrates:

• Chiropractic Adjustments: To restore spinal alignment, improve nervous system function, and address musculoskeletal imbalances.
• Medical Oversight: Guided by Dr. Cardenas, ensuring all treatments are safe, appropriate, and aligned with established medical standards.
• Functional Medicine: To identify and address the root causes of chronic conditions through advanced diagnostics and personalized lifestyle interventions.
• Photobiomodulation (PBM) Therapy: Using light to stimulate cellular healing, which is the focus of this post.
• Rehabilitation and Personal Injury Care: To restore function, strength, and mobility after an injury.

This collaborative model ensures that every patient receives a tailored treatment plan designed to optimize their body’s innate healing capabilities and achieve lasting wellness.

A New Perspective: From Mechanic to Biologist

For the first twenty years of my clinical practice, I approached the human body much like a mechanic. I was trained to identify a problem—a “condition”—and use specific tools to resolve it. However, the last decade has fundamentally shifted my perspective. I have transitioned from being a mechanic to becoming a biologist, focused on a much more profound question: How can we create the optimal environment for the body to heal itself?

This shift aligns perfectly with the principles of cellular therapy and the exciting field of photobiomodulation. It’s no longer just about treating symptoms; it’s about fostering cellular recovery and empowering our cells to orchestrate the healing response. This concept resonates deeply with those of us in the regenerative and functional medicine space.

The Science of Light: What is Photobiomodulation?

I often begin by asking people if they believe in photosynthesis. Of course, they do. The sun’s light provides energy for plants to grow, a fundamental process for life on Earth. We, as a species, have evolved over hundreds of thousands of years under that same sun. It should come as no surprise, then, that our cells, down to our very DNA, are sensitive to and can be influenced by light. We accept this readily when we learn that sunlight is necessary for Vitamin D synthesis. Yet there is a significant gap in modern medical education regarding the therapeutic use of light.

This is where photobiomodulation (PBM) therapy comes in.

• Photo: Light
• Bio: Life
• Modulation: To affect or change

In essence, PBM is the use of light to create a positive biological change. Light is energy, delivered in packets called photons. When these photons penetrate the body’s tissues, they transfer their energy to our cells, initiating a cascade of beneficial biological responses.

The Cellular Symphony: How PBM Therapy Works

So, what exactly happens inside our cells when we expose them to this light energy? The effects are profound and elegantly orchestrated, starting with the cell’s powerhouse: the mitochondria.

• Mitochondrial Activation and ATP Production

  The primary target for photons within our cells is an enzyme in the mitochondria called cytochrome C oxidase. This enzyme is a chromophore, meaning it is designed to absorb light. When photons of the correct wavelength strike this enzyme, it becomes more active. This activation supercharges the Krebs cycle, leading to a significant increase in ATP (adenosine triphosphate) production, the cell’s main energy currency. Think of it as providing the fuel needed for all cellular repair and regeneration processes.

• Immune Modulation: Shifting from Inflammation to Repair

  When an injury occurs, the body initiates an inflammatory response. While necessary for initial cleanup, a prolonged or “stalled” inflammatory state can prevent healing and lead to chronic pain, as seen in the thickening of the Achilles tendon in chronic tendinopathy. PBM therapy helps modulate this immune response.

  • It triggers a downstream cascade of messages that reaches the cell’s nucleus, influencing gene transcription.
  • This leads to a shift in cytokine production—the signaling proteins of the immune system.
  • Research clearly demonstrates that PBM therapy can increase the levels of anti-inflammatory cytokines, such as Interleukin-10 (IL-10).
  • Simultaneously, it reduces levels of pro-inflammatory cytokines, such as interleukin-6 (IL-6).

  Powerful Modulation

• Effectively guides the body out of a destructive, chronic inflammatory phase and into a constructive, reparative healing phase.
• Enhanced Blood Flow and Angiogenesis

  Healing requires a robust supply of oxygen and nutrients, which are delivered by our blood. PBM therapy promotes angiogenesis, the formation of new blood vessels, by upregulating cytokines such as galectin. This improves microcirculation, ensuring that damaged tissues receive the resources they need to rebuild and recover.

• Nerve Regeneration and Neurogenesis

  For patients suffering from nerve damage or neuropathic pain, PBM offers incredible hope. It has been shown to stimulate neurogenesis, the repair and growth of nerve cells. By promoting the growth of axonal cones and upregulating specific proteins (like HNRNP-K), PBM can help restore nerve function and reduce pain signals.

• Muscle and Tissue Recovery

  From elite athletes to post-operative patients, muscle recovery is crucial. Electron microscopy studies have confirmed that PBM therapy improves muscle cell development and increases myoglobin production, enhancing oxygenation and accelerating repair. It also stimulates fibroblasts, the cells responsible for producing collagen and building the structural framework of new tissue.

In summary, PBM therapy orchestrates a multi-faceted healing response by increasing cellular energy, rebalancing the immune system, improving blood flow, and promoting the regeneration of nerve, muscle, and connective tissues.

The Therapeutic Window: Wavelength and Penetration

For PBM therapy to be effective, the photons must reach the target tissue. The ability of light to penetrate the body is determined by its wavelength, measured in nanometers (nm). This is known as the therapeutic window.

• Very short wavelengths, like gamma rays, are destructive.
• Very long wavelengths, like radio waves, pass through the body without being absorbed.

The sweet spot for therapeutic applications lies in the red and near-infrared (NIR) spectrum, roughly from 600 nm to 1200 nm. However, three major obstacles block light penetration: skin (melanin), blood (hemoglobin), and water.

This is why the technology used matters. For instance, red light (around 630 nm) is excellent for skin health, but it only penetrates a few millimeters. To treat deeper musculoskeletal issues in the joints, muscles, or spine, we need longer wavelengths in the NIR spectrum that can bypass these absorbers and deliver energy where it’s needed most.

Clinical Applications and Validation

In my practice, I utilize PBM therapy across a wide spectrum of conditions.

1. Acute Injuries: For our athletes, we use laser therapy immediately after an injury. It significantly reduces swelling and pain, accelerating their return to play.
2. Post-Operative Care: Surgery is, in essence, a controlled iatrogenic injury. Applying PBM therapy post-operatively improves incision healing, reduces bruising (ecchymosis), and minimizes pain, leading to higher patient satisfaction.
3. Chronic Inflammatory Conditions: For conditions such as osteoarthritis, tendinopathies, and plantar fasciitis, PBM therapy helps break the cycle of chronic inflammation and stimulates a true healing process.

This isn’t just anecdotal. There are over 7,000 published studies on PBM therapy. Major health organizations are taking note. The Centers for Disease Control and Prevention (CDC) mentions “laser photobiomodulation” approximately 40 times in its revised opioid guidelines as a recommended non-pharmacological treatment for acute, subacute, and chronic pain. This represents a major validation of its efficacy and safety.

Combining PBM Therapy with Orthobiologics

This brings me to one of the most exciting frontiers: the synergy between PBM therapy and orthobiologics like platelet-rich plasma (PRP).

When we perform a PRP injection, we are delivering a concentrated dose of growth factors and anti-inflammatory proteins directly to the site of injury. This is a powerful message that signals local cells to begin the repair process.

Now, imagine providing the fuel for that process.

By applying PBM therapy in conjunction with PRP, we are doing just that. We are turning on the mitochondria, ramping up ATP production, and creating an energy-rich environment. This “fuel” allows the cells to fully respond to the “message” delivered by the PRP, potentially leading to a more robust and efficient healing response. We are essentially preparing the cellular engine to make the most of the regenerative signals.

This concept is already being proven. A fantastic randomized controlled trial in the veterinary field (which is often ahead of us) examined dogs with knee osteoarthritis. Each dog served as its control, receiving PBM alone, then PRP alone, and finally, the combination of both. The results were clear: the combination of PBM therapy and PRP yielded significantly better outcomes than either treatment alone.

The Future is Biology: A Glimpse into Our Research

To further validate these principles, we must continue to produce high-quality science. I am incredibly proud to share a recent study conducted by my son, Zachary Jimenez, at the Mass General Brigham BioSkills Lab.

We took human tendon cells (tenocytes) and treated them with PBM therapy. The results were remarkable: we demonstrated a 20% increase in tenocyte proliferation from PBM alone. We were literally able to show, at the cellular level, that we can make these crucial healing cells multiply with light. We are now proceeding with qPCR and ELISA to analyze gene expression and protein levels, which will further elucidate the mechanisms at play.

This is the future of orthopedics and musculoskeletal care. We are moving away from purely symptomatic treatments and toward true disease modification. By intervening earlier and using therapies that enhance our bodies’ own biological processes, we can potentially prevent progression to end-stage conditions requiring invasive surgery. PBM therapy works, and its combination with integrative chiropractic and regenerative medicine represents a paradigm shift in how we approach healing.

References

• Cotler, H. B., Chow, R. T., Hamblin, M. R., & Carroll, J. (2015). The Use of Low-Level Laser Therapy (LLLT) For Musculoskeletal Pain. MOJ Orthopedics & Rheumatology, 2(5). https://doi.org/10.15406/mojor.2015.02.00068
• Dowell, D., Ragan, K. R., Jones, C. M., Baldwin, G. T., & Chou, R. (2022). CDC Clinical Practice Guideline for Prescribing Opioids for Pain — United States, 2022. MMWR. Recommendations and Reports, 71(3), 1–95. http://dx.doi.org/10.15585/mmwr.rr7103a1
• Ferreira, D. M., Zidan, N., & Rabelo, R. E. (2020). Photobiomodulation with platelet-rich plasma in the treatment of canine osteoarthritis. Lasers in Medical Science, 35(8), 1709–1717. https://doi.org/10.1007/s10103-020-02980-2
• Hamblin, M. R. (2017). Mechanisms and applications of the anti-inflammatory effects of photobiomodulation. AIMS Biophysics, 4(3), 337–361. https://doi.org/10.3934/biophy.2017.3.337
• Zein, R., Selting, W., & Hamblin, M. R. (2018). Review of light parameters and clinical efficacy of low-level laser therapy in oncology. Journal of Photochemistry and Photobiology B: Biology, 189, 190-201. https://doi.org/10.1016/j.jphotobiol.2018.10.012