Tissue Regeneration Insights Using Therapeutic Approaches

Learn how therapeutic approaches that use photobiomodulation can aid tissue regeneration and shorten recovery times.

Abstract

In this educational post, I will guide you through the sophisticated world of Multiwave Locked System (MLS) Laser Therapy, a cornerstone of modern, evidence-based treatment for pain and inflammation. We will delve into the underlying science of photobiomodulation, exploring how specific wavelengths of light can trigger profound healing responses at the cellular level. I will explain the critical distinction between total energy (Joules) and energy density (Joules/cm²), and why the latter is the gold standard for therapeutic dosing. We will explore the “clinical multimodal approach,” which involves treating not just the site of pain but the entire kinetic chain, including surrounding connective tissues. The discussion will cover the practical applications of both robotic and handheld laser devices, highlighting their unique benefits and how they can be used in conjunction to provide comprehensive care. Furthermore, we will examine the exciting integration of MLS laser therapy with orthobiologics like Platelet-Rich Plasma (PRP), outlining protocols for pre- and post-injection treatments to optimize patient outcomes. Finally, this post will tie these advanced concepts into the framework of integrative chiropractic care, showcasing how this technology complements our holistic approach to restoring function and enhancing patient well-being.

Understanding MLS Laser Therapy: A Foundation for Healing

As a clinician dedicated to integrative and functional medicine, my primary goal is to harness the most effective, evidence-based therapies to help my patients achieve optimal health. One of the most exciting advancements in this field is Multiwave Locked System (MLS) Laser Therapy. Today, I want to take you on a journey into how this technology works and how we apply it in our practice to manage conditions such as chronic joint pain, stiffness, and soft-tissue injuries.

Let’s start with a common scenario I see daily in my clinic: a patient presenting with low back pain and stiffness, particularly around the L4-L5 facet joints, with some discomfort radiating to the right. The first step in any treatment, especially when using our advanced robotic laser system, is to ensure patient comfort. This isn’t just a courtesy; it’s a clinical necessity. For the robotic laser to deliver its precise dose of light energy to the target tissue, the patient must remain still. If they are uncomfortable and shift their position, the entire therapeutic field moves, potentially compromising the treatment’s effectiveness.

For low back pain, a prone (face-down) position is ideal. We need direct skin contact or, with the robotic applicator, a precise distance from the skin. Once the patient is comfortably positioned, we can begin the setup.

The Clinical Multimodal Approach: Treating the Source, Not Just the Symptom

The philosophy behind our application of laser therapy is our clinical multimodal approach. This is a significant departure from simply pointing a laser at the spot that hurts. Pain is often the result of a complex cascade of biomechanical and physiological dysfunction. Merely treating the symptomatic area is like silencing a fire alarm while the fire continues to burn.

Instead, we take a more global view. Our goal is to treat the primary source of the issue while also addressing the surrounding connective tissue. The body is an interconnected web; a problem in one area can create compensatory strain and inflammation in adjacent muscles, ligaments, and fascia. By treating this entire kinetic chain, we support the body’s holistic healing process, reduce the likelihood of recurrence, and promote more resilient, long-term recovery.

Using the robotic laser interface, I can precisely define the treatment area. I start by zeroing out the X and Y axes, which essentially creates a stationary starting point. I then center the laser over the patient’s primary area of pathology—in this case, the L4-L5 region. From there, I expand the treatment perimeter to encompass not only the facet joints but also the surrounding paraspinal muscles, ligamentous attachments, and fascial planes. This ensures we deliver therapeutic light energy to the entire dysfunctional segment.

The Science of Dosing: Energy Density vs. Total Joules

A crucial concept in laser therapy, and one that is often misunderstood, is the dosing method. You will often hear about lasers in terms of total power (Watts) or total energy delivered (Joules). However, the most clinically relevant and scientifically validated metric is energy density, measured in Joules per centimeter squared (J/cm²).

Think of it this way: watering a large garden with a single, powerful fire hose (high total Joules) might deliver a lot of water, but it will likely damage the plants in one spot while leaving the rest of the garden dry. Using a sprinkler system that distributes the water evenly (optimal energy density) ensures the entire garden gets the right amount of hydration without causing harm.

Laser therapy works similarly. The goal is to deliver a specific dose of light energy to the cells within the target tissue. Too little energy, and you won’t stimulate a therapeutic response. Too much energy in one spot can lead to a phenomenon known as the bioinhibition paradox, where the therapeutic effect is diminished or even negated. This concept is supported by the Arndt-Schultz Law, which states that weak stimuli increase physiological activity, whereas very strong stimuli inhibit or abolish it.

Leading research, including guidelines from the World Association for Laser Therapy (WALT), points to an optimal therapeutic window of 4 to 10 J/cm² for most musculoskeletal conditions. For our patient’s back pain, the protocol calls for a density of 6 J/cm². The advanced software in our M6 robotic laser automatically calculates the required treatment time to deliver this precise energy density across the entire area I’ve defined, even if I adjust the area size mid-treatment. This is a significant technological advancement that ensures every patient receives an accurate, effective, and safe dose.

Dual Wavelengths and Peak Power: The “Secret Sauce” of MLS Laser

What makes MLS laser therapy unique is its patented technology that delivers two therapeutic wavelengths of light—808 nm and 905 nm—simultaneously.

• The 808 nm continuous wave is excellent for reducing inflammation and edema. It works on a more superficial level and has a powerful anti-inflammatory effect.
• The 905 nm pulsed wave has a strong analgesic (pain-relieving) effect and can penetrate deeper into tissues.

The “secret sauce” is how these wavelengths are delivered. The MLS system uses a very high peak power—up to 50 watts—delivered in extremely short pulses (in the nanosecond range). This high-intensity “punch” of energy drives the photons deep into the tissue. This is immediately followed by a period of rest, allowing the cells to absorb the energy without overheating the surface tissue. This is why patients typically feel little to no sensation during treatment, perhaps a gentle warmth or tingling at most. If a laser generates significant heat in the skin, it often means the target tissues are not effectively absorbing the energy and instead dissipating it as thermal energy at the surface.

This sophisticated delivery system ensures that we can maintain a constant, safe tissue temperature over time while delivering the right dose of energy to the right place.

Integrating Robotic and Handheld Lasers for Comprehensive Treatment

Our clinic uses both a robotic laser arm and a handheld applicator, which operate on separate channels, allowing simultaneous use. This combination is a cornerstone of our integrative approach.

• The M6 Robotic Laser: my workhorse for treating larger areas. Its three diodes are positioned at a specific focal distance (typically 6 inches) from the body, allowing it to cover a broad area, such as the lower back, shoulder, or knee. It’s ideal for the global approach I mentioned earlier, treating the primary pathology and all the surrounding connective tissues.
• The Handheld Applicator: This device is designed for direct skin contact and is perfect for targeting very specific, punctual points. I use it to address trigger points (hyperirritable knots in the muscle), specific joint spaces, or areas of nerve entrapment.

While the robot is running its pre-programmed 8- to 12-minute session, I can use the handheld piece to deliver a more dynamic treatment. For instance, I can palpate the patient’s muscles to find what I sometimes call the “cooked meat”—the dense, knotted tissue of a trigger point, as opposed to the soft “raw meat” of healthy muscle. Applying the laser directly to these knots while the robot treats the wider region provides a powerful, synergistic effect. This dual approach allows us to be both broad and specific, maximizing the therapeutic benefit within a single session.

Synergizing MLS Laser with Orthobiologics like PRP

One of the most exciting frontiers in regenerative medicine is the combination of MLS laser therapy with orthobiologics, such as Platelet-Rich Plasma (PRP) injections. PRP therapy involves concentrating a patient’s own platelets and injecting them into an injured area to stimulate healing. Laser therapy can significantly enhance the outcomes of this procedure. Our clinical observations, supported by emerging research, suggest we observe about a 15-20% greater efficacy when combining MLS with PRP than when using PRP alone.

The protocol is strategic and multi-phased:

1. Preparation Phase (Pre-Injection): We recommend two to three laser sessions before the PRP injection. The goal here is to “prepare the soil.” The laser therapy reduces local inflammation, increases blood circulation, and begins to optimize the cellular environment. This creates a more receptive and healthier tissue bed for the injected platelets to do their work.
2. Day of Injection: A laser treatment is performed on the same day as the PRP injection. This session is designed to augment the initial pro-inflammatory healing cascade initiated by the PRP and further enhance local blood flow.
3. Regeneration Phase (Post-Injection): We typically administer six laser sessions after the injection, usually at a rate of three times per week (e.g., Monday-Wednesday-Friday). This phase is critical. The laser’s effect on mitochondrial function becomes paramount here. By stimulating the mitochondria—the powerhouses of the cell—we dramatically increase the production of ATP (adenosine triphosphate), the cellular energy currency. This provides the immense energy required for tissue repair and regeneration processes initiated by the PRP.

This progressive protocol leverages the full spectrum of laser therapy’s benefits, from anti-inflammatory and analgesic effects to profound cellular bio-stimulation, to maximize the regenerative potential of orthobiologics.

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Exploring Integrative Medicine- Video

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The Role of Chiropractic Care in an Integrative Model

It’s essential to understand that advanced technologies like MLS laser therapy do not exist in a vacuum. In our practice, they are woven into a comprehensive framework of integrative chiropractic care. While the laser is working on a cellular level to reduce pain, decrease inflammation, and accelerate tissue healing, chiropractic adjustments are simultaneously addressing the foundational biomechanical and neurological aspects of the patient’s condition.

A chiropractic adjustment restores proper motion to restricted spinal or extremity joints. This has several immediate benefits:

• It reduces mechanical stress on the joints, discs, and surrounding soft tissues.
• It improves nervous system function by removing interference.
• It helps to normalize movement patterns, preventing the compensatory strain that contributes to pain cycles.

By combining MLS laser therapy with chiropractic adjustments, we are tackling the problem from two different but complementary angles. The laser optimizes the cellular environment for healing, while the adjustment restores the system’s structural and neurological integrity. This synergy is what allows us to achieve superior, lasting results for our patients. A condition that began weeks, months, or even years ago won’t be solved in a single 12-minute session, but this integrated approach creates a powerful cumulative effect. We typically recommend packages of 6 to 12 treatments, delivered as quickly as possible (with a minimum of 24 hours between sessions), to build momentum and guide the body through a complete healing cycle.

Ultimately, my role as an integrative practitioner is to use every tool at my disposal to create a personalized, effective treatment plan. MLS Laser Therapy is a remarkable technology that empowers us to promote healing at a fundamental level, helping our patients move beyond pain and live a more optimized, functional life.

References

1. Anders, J. J., Lanzafame, R. J., & Arany, P. R. (2015). Low-level light/laser therapy versus photobiomodulation therapy. Photomedicine and Laser Surgery, 33(4), 183–184. doi.org/10.1089/pho.2015.9848
2. 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). doi.org/10.15406/mojor.2015.02.00068
3. Hamblin, M. R. (2017). Mechanisms and applications of the anti-inflammatory effects of photobiomodulation. AIMS Biophysics, 4(3), 337–361. doi.org/10.3934/biophy.2017.3.337
4. World Association for Laser Therapy (WALT). WALT Dosage Recommendations. Retrieved from waltpbm.org/dosage-recommendations/

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