Doctorate of Chiropractic degree (D.C.) in 1977 from the Canadian Memorial Chiropractic College in Toronto.
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Conditions Treated At Dr. Fuller's Clinic
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When To Consult A Chiropractor
Laser Therapy & Phototherapy
Saayman et al in Journal of Manipulative & Physiological Therapeutics
March 2011,34(3):153 studied 60 ambulatory women between ages 18-40 with cervical (neck) facet joint pain of more than 30 days duration, randomized to receive either a) chiropractic manipulative therapy of the neck, b) low level laser therapy, c) both therapies.

Conclusions were that all 3 groups showed significant improvement in pain and disability but that a combination of manipulative therapy and laser therapy was the most effective.
 
Laser Therapy for Disc Herniations
Inflammatory markers such as IL,-1, IL-6 and TNF-a are present at the site of disc herniations leading to higher prostaglandin E2 concentrations.

Two studies have shown that laser therapy is effective in reducing prostaglandin E2 concentrations (Lim et al in Laser Surgery Medicine 2007;39(7):614.
Bjordal et al in British Journal of Sports Medicine 2006;40(1):76) demonstrated that inflammation is greatly reduced 75,90 and 105 minutes after active laser therapy.
 
Additional recent research has demonstrated effectiveness of laser therapy on lumbar disc herniations and low back....
- Toya et al in Laser Therapy 1994;6:143
- Soriano et al in Laser Therapy 1998;10:175
- Gur et al in Laser Surgery Medicine 2003;32(3):233
- Djavid et al in Australina Jounral Physiotherapy 2007;(3):155
- Tosteson et al in Spine 2008;33(19):2108 reported that 85% of back pain patients can be treated successfully with laser therapy.
 
- Dr. Fred Kahn, M.D., FRCS at the University of Toronto, Faculty of Medicine reported in Proceedings of SPIE 2006;6140 that low intensity laser therapy is noninvasive, has no reported adverse effects in more than 3,000 publications, and is an effective therapeutic approach for disc hernations.
 
These forms of therapy serve one more avenue of natural healing in a chiropractor’s office.
 
PHOTOTHERAPY is a therapeutic physical modality using photons (light energy) from the visible and infrared spectrum for tissue healing and pain reduction as defined by the North American Association of Laser Therapy.
 
It is also known as “low level laser therapy (LLLT), cold or soft laser therapy, low energy laser or just laser therapy. “Laser” means light amplification by stimulated emission of radiation.” The therapeutic light energy can be produced by either LED (light emitting diodes), SLD (superliminous diodes, or super bright LEDs), or low level laser diodes.
 
How does “light energy” affect the body and its functions?
Just as we know that sunlight is absorbed by plants which convert the light energy into energy to grow (photosynthesis), light energy penetrates through the skin and is absorbed by the mitochondria of cells of all types in the body. This light energy is converted in the body into biochemical energy, and restores normal cell function. More technical explanations are available, and include increasing the permeability of cell membranes which leads to triggering immune response, increased synthesis of procollagen in fibroblasts, increasing number of mast cells, serotonin synthesis, endorphin synthesis, decreasing C-nerve fibre activity (reduces pain), decreasing bradykinin, and more.
 
When using SLDs and laser in the 600-1,000nm range, the effects on bodily cells are :
increased production of ATP (adenosine triphosphate)
vasodilation of capillary micro-circulation
decreased nociception (pain generation)
inhibiting prostaglandin production involved in inflammation
increasing microcirculation, resulting in production of helpful nitric oxide and release of growth factors.
 
(references….. Tiziano in Pain Management, 2004;37-42 and Richard in Laser-Accelerated Inflammation/Pain Reduction and Healing, 2003;2-25).
 
What does phototherapy / laser do for the body?
increases blood circulation and angiogenesis
reduces or eliminates acute and chronic pain
reduces inflammation and swelling
stimulates and improves nerve function
strengthens and repairs bone and soft tissues
increases mobility and muscle function
does NOT adversely affect normal body cells and tissues… it is photon energy in the visible and infrared regions of the electromagnetic spectrum.
 
What conditions can be treated with phototherapy / laser?

arthritis (osteoarthritis & rheumatoid arthritis)

carpal tunnel syndrome and other repetitive overuse syndromes

acute and chronic pain conditions

soft tissue injuries, strains, sprains
wound healing after injury and surgery
swelling and edema
inflammation conditions in general (tendonitis, bursitis, capsulitis, etc.) bone fractures and orthopaedic implants
 
What is the “depth” of therapeutic effect?
The wavelength, power (dosage measured in joules), and energy delivered determine the depth of penetration of the light and therefore the therapeutic effect.
Visible red (600-700 nanometers {nm}) penetrates up to 1 cm for SLD and laser devices.
Infrared (700-1,000 nm) penetrates deeper, from 2-5 cm.Both SLD and laser have direct and indirect effects. Deeper body tissues to be targeted require more energy to achieve therapeutic effects.
 
What equipment is used in Dr. Fuller’s clinic?
We employ BOTH SLD (two superliminous diodes) which deliver 1 joule of energy per centimeter squared for 40 seconds and which provide broad-based, less deep, even distribution of energy, specifically, 500 (mW) milliwatts of visible red light (633 nm) plus infrared (880 nm), + hand-held laser (deeper, focused delivery of 1 joule of energy via 200 mW of infrared energy (785 nm). The manufacturer is Tanda Professional.’ (website is www.pharoslife.com).
 
Can phototherapy / laser be used in conjunction with other treatment approaches?
Yes. One should use these after ice therapy, or before any heat-based therapy such as uiltrasound, phono or iontophoresis. It can also be used in conjunction with electrical muscle stimulation, hands-on therapies, etc.
 
Are there any contraindications?
Yes. Laser should not be used directly into the eyes, over pregnant abdomen, over any suspicious or active carcinoma, over thyroid gland, over areas recently injected with steroids or other anti-inflammatory drugs. Phototherapies can be used on people with pacemakers, but of course not over the pacemaker itself, and can used on people with surgical hardware implants.
 
What about research?
While much research ahs been conducted by the dentistry and oral surgery fields, there is also much to read about tendonitis and other inflammation conditions.

eg. Achilles tendonitis was successfully treated by laser therapy (British Journal Sports Medicine 2006;40(1)76);; also promoted neovascularization of partially ruptured Achilles tendons (Photomed. Laser Surg. 2005;(5):470; also in Lasers Surg. Med. 2005(4):293).

eg. swelling of finger flexor tendons was significantly reduced with laser (J. Clin. Laser Med. Surg. 2004(2):105).

eg. laser therapy  was proven to significantly accelerate healing of surgically-induced medial collateral knee ligament damage (Laser Surg. Med. 20004;34(3):285 and same journal 2003;32(4):286 and 2002;31(2):91).

eg. laser has rapidly increased healing of wounds in rabbits and humans and other injuries (J. Clin. Laser Med. Surg. 2000(2):67).

eg. bone repair was accelerated (Photomed. Laser Surg. 2005;232:212).

eg. bone nodule formation is enhanced with laser (J. Clin. Laser Med. Surg. 2003(5):271 and in Lasers Med. Sci, 2003;18(2):89)

eg. carpal tunnel syndrome – laser therapy was deemed as promising conservative treatment for CTS (Photomed. Laser Surg. 2006(2):101 and Archives Physical Medicine Rehab. 2002;83(7):978).

eg. chronic neck pain can be improved (Pain 2006;124(1-2)20.

eg. Journal of Oral Rehab. 2005;32(11)800

eg. Photomed. Laser Surg. 2005;232:177

eg. Oral Surgery 2006;102(5).

eg. Journal of Photochem. Photobiology 2006

eg. 39 patients with TMJ (jaw) pains reported statistically significant reduced pain and increased jaw mobility with laser therapy (Photomed Laser Surgery 2006;24(5)637and same journal 2006;(24)1:45).

eg. post-traumatic nerve regeneration was proven accelerated with laser (Lasers Med Sci.2004;19(1)

eg. Microsurgery 2005;25(1):83

eg. American Journal Physical Medicine 2004(10):758 reported helping osteoarthritis

eg. In Vivo 2004;18(5):585

eg. Journal Invest. Dermatol. 1996;107(4):593

eg. laser increases chondrocyte density and glucoaminoglycan content which resulted in greatly reduced pain in osteoarthritic knees (Biomed. Tech. 2006;51(3)31

eg. laser reduces osteoarthritis neck pain (Int. Tissue React. 2004;25(4):131

- Sharma et al in The Journal of Bone & JointSurgery 2005;87:187 (healing and repair of tendon injury and tendonopathy)

- Astrom et al in Clinical Orthopaedics 1995;(316):151 – survey of surgical and histopathological findings.

- Cooper et al in Oral Disease 1999;5:329 tempormandibular joint tissue studies.

- Fung et al in Laser Surgery Med. 2003;32(4) compared effect of low level laser on the ultrastructural morphology of medial collateral ligament.

- Oliviera et al in Lasers Surg. Med. April 2009;41(4):271 Laser therapy for tissue repair of partial lesion of calcaneal tendon.

- Bjordal et al in BMC Musculoskeletal Disorders May 2008;(9);75 laser therapy for lateral epicondylitis of elbow.

- Lam et al in Photomed Laser Surg. 2007;(2):65 effects of 904 nm low level laser therapy for lateral epicondylitis, randomized controlled trial.

- Simunovic et al in Journal Clinical Laser Surg. 1998;16(3):45 multicentre double blind placebo-controlled clinical study of 324 patients.

- Oken et al in Journal Hand Ther. 2008; Jan.-March  comparison of laser/ultrasound/brace for lateral elbow epicondylitis; randomized controlled clinical trial.

- Stergioulas in Photomed Laser Surg. 2007;June 25(3):205 laser for lateral epicondylitis.

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