Treat Shoulder Joint Pain with Red Light and Infrared Therapy

Treat Shoulder Joint Pain with Red Light and Infrared Therapy

 Light in the visible red spectrum has noted therapeutic benefits, and it does this by enhancing cellular energy and signaling reactions involved in tissue healing.  When an injured cell has more available energy, it can repair itself faster and activate certain other biological processes involved in healing.  Red light in this wavelength does not generate heat, so heat isn’t doing the healing.  It’s photobiomodulation at work– a human version of photosynthesis, the process by which plant life creates food for itself using sunlight.

Because of its wavelength range (about 620-880 nm) red light tends to get absorbed by water-dominant human tissue, especially red blood cells.  Just beyond the visible red on the spectrum of light is infrared light (IR), which is not visible to the human eye, but still has therapeutic benefit (most of the heat radiating from the earth is infrared).  Infrared has a higher wavelength and can penetrate deeper into human tissue.  In fact, acupuncturists and physical therapists rely on infrared heat lamps to apply heat to deep joints such as the shoulder, hip and knee.

Since they are considered generally save for use, the FDA allows manufacturers of red light and infrared therapy devices to sell directly to the consumer, without a doctor’s prescription.   Those who have photosensitive skin however my want to speak with their doctor first before trying red light therapy, as it may cause pigmentation.

There are numerous red light and infrared devices on the market for personal use; some better than others.  They include hand held devices, mats and lamps.  There are even portable infrared saunas.    For small areas such as an ankle, wrist or shoulder, you can use a portable, hand-held red light device..  This is a stainless steel, high quality compact device resembling a small flashlight.   It uses three (3) diodes; each putting out a different red light frequency, which means it penetrates to different depths in your tissues thus bathing a larger area with red light.   3-4 three- minute doses, twice a day for three days is a good protocol for most conditions.

For larger areas such as low back pain or spasm or leg pain after running, try an infrared lamp or sauna.

The Shoulder Joint – A Complex Joint Vulnerable to Breakdown

Ok, let’s talk about treating common shoulder joint pain.  The shoulder joint, or glenohumeral joint is a ball and socket type synovial joint.  Unlike the hip joint, the shoulder joint has a shallower articulation point with the scapula that allows it to move as it does — in wide arcs and in multiple planes (try doing that with your knee!).  It is enclosed by the rotator cuff, which is basically formed by the several tendons attached to the humeral head (the proximal end of your humerus, or upper arm bone) and capsular ligaments that connect the humerus to the other end of the shoulder joint, the glenoid fossa of the scapula, a shallow bowl-shaped indentation.

There are six muscles that move the shoulder, and therefore six tendinous attachment points. Above and around the ball of the shoulder joint are bursae, which are jelly-like pads that serve to reduce friction during shoulder movement.   Inside the shoulder joint capsule itself is the synovial lining (this is the tissue that gets inflamed in cases of rheumatoid arthritis), the cartilage lining the ends of the ball and socket surfaces and the labrum, a rigid cartilaginous support structure that helps position and stabilize the humeral head onto the glenoid fossa. As you can see, your shoulder joint has many structures involved in its function.  This means there are more chances for something to go wrong– a tear, a strain, a malposition, compared to a simpler joint like a knuckle.

If you have pain and/or clicking noises (called crepitus) in your shoulder or have restricted movement such as limited ability to raise your arm above shoulder level, something is obviously wrong.  It could be a rotator cuff tear (tear of tendons and or capsular ligament); labral tear, bursitis (inflammation of a bursa), thickening of the supraspinatous ligament due to shoulder subluxation (malposition of joint), arthritis or fluid build up. Stretching alone may not be feasible, especially in cases like adhesive capsulitis (frozen shoulder) due to the pain. This is where red light therapy and infrared can help.

How to Apply Red Light to Your Shoulder Joint Where It’s Needed

The challenge when applying red light to your shoulder joint is getting it to the damaged structures, which is not straightforward. The glenohumeral joint is covered by the deltoid muscle, which can be quite developed especially in men.   It is thickest in the belly of the muscle (center, meaty part) but thinner on its tendinous ends where it inserts into the scapula and collar bone.  Avoid the belly of the deltoid as red light cannot pass through it, and apply the red light over the thinner areas noted.  Also, don’t forget that you can access the shoulder joint underneath, via your axilla (arm pit).  This is a great technique, as there are no muscles obstructing it (see third image below).

Below is a diagram of shoulder anatomy to give you a  better idea on how to target critical structures like the shoulder bursae, tendons and capsular ligaments when using red light therapy.  You’ll want to use a hand-held red light therapy device that can focus the light over a small area of about 2 cm.

shoulder-images

 Palpate your shoulder and locate the locus of pain.  Internally and externally rotate your shoulder joint and press in front, on top underneath and behind it with your index finger to find tender spots. Once you’ve found one, keep your shoulder in that position and apply the red light for 60 seconds.  Do this 3-4 times.  You may want to move to areas around the sore spot, for good measure.  The thin, small space just under the “cliff” of the acromion process is an ideal spot to focus the light.  It will get absorbed by the subacromial bursa and supraspinatous tendon, common sources of shoulder pain and stiffness. Do this over a week to ten days, and you should notice improvement.  Avoid overly-stressing your shoulder joint during this time period to allow proper healing. Below is a video where I show you how to do it.

In summary, you can accelerate tissue healing in sprains, strains, bruises and minor cuts using red light therapy.  These devices are a great addition to your home therapy devices, as they do not require a medical license to acquire.

 

Laser Therapy for Chronic and Acute Musculoskeletal Pain

tendlightLow level laser therapy, or LLLT is the application of low-powered lasers or light emitting diodes for the purpose of pain relief and/or injury repair.  The therapy is typically done transdermal; meaning through the skin into the target tissue, such as a sore shoulder joint (no surgical incisions).  While some research studies show that LLLT can result in immediate pain reduction in rheumatoid arthritis, osteoarthritis, tendinopathies, acute and chronic neck pain, temporomandibular joint (TMJ) pain and other joint disorders there is currently a lack of consensus on the best parameters to use; i.e. power, dosage, time, pulsing, and type of laser.  The therapeutic wavelength appears to be between 800-1,000 nm; and dose to be around 6-10 joules/cm2.

LLLT may reduce pain related to inflammation by lowering levels of COX-2 and tumor necrosis factor-alpha (enzymes associated with inflammation);  oxidative stress, edema, and bleeding.  It is also believed to cause cellular mitochondria to produce more ATP– a cell’s basic energy unit, resulting in increased metabolic activity.

Low level laser therapy is offered by some chiropractors, sports physicians, and acupuncturists.   Lasers are classified according to how much damage they can do to the eye, which basically means how powerful they are in terms of wattage.  The wattage rating of a laser determines how long it takes to deliver a dose, and how deep the light penetrates tissue (important if you are treating thick areas of the body such as the hip or knee joint).  At 10 watts max output, the LiteCure and K-Laser are two of the strongest lasers in the market for this purpose.  Lasers with output of 500mW or less will not penetrate as deeply, and will require a longer treatment time to administer a therapeutic dose.

A typical treatment regimen will be 10-15 minutes of laser; six to eight sessions.  Sometimes that is all it takes to take care of an acute or chronic problem.  Many practitioners including myself incorporate soft tissue therapy, joint mobilization and rehab exercises to fully deal with the painful condition.

So if you are experiencing a recent injury such as a sports injury; or have chronic pain such as tendinitis, sciatica,  plantar fascitis, rotator cuff tear, or knee pain, consider trying low level laser therapy.  It is generally safe, and faster-acting than manual therapies alone (chiropractic, PT, occupational therapy).  Be cautious and tell your practitioner if you are taking photosensitive medications, or have light sensitive skin, as the treatment can be uncomfortable and may even cause pigmentation.

UPDATE ON THIS TOPIC: Can Red Light Heal Injuries and Lessen Pain?

 

Dr. Dan

 

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