LOW LEVEL LASER THERAPY TREATMENT RECOMMENDATIONS FOR TREATMENT WITH THE LASERNEEDLE TOUCH

LOW LEVEL LASER THERAPY TREATMENT RECOMMENDATIONS FOR TREATMENT WITH THE LASERNEEDLE TOUCH

INTRODUCTION & GENERAL INFORMATION For over 12 years, LASERNEEDLE has been working on the development and manufacture of low level laser therapy systems, concerning itself intensively with their application and the scientific evidence behind them. In order to translate scientific results into clinical treatment protocols, we edited a LASERNEEDLE treatment recommendations handbook. This is the second edition. To compile these treatment recommendations, we have brought together evaluations from top-ranking scientific publications, results from a panel of scientific experts, and specific application recommendations from numerous experienced practitioners. These treatment recommendations relate to low level laser therapy with the LASERNEEDLE Touch device equipped with red and infrared lasers. The device is specially designed for the treatment of all musculoskeletal indications in orthopedics, physiotherapy and sports medicine. All treatments can also be carried out with red lasers. The treatment recommendations shown here are intended to highlight options and are not to be understood as treatment instructions. LASERNEEDLE GmbH, the manufacturer of this medical product, does not prescribe the application of this or other technologies. The user alone is responsible for the diagnosis and selection of the therapy as well as the individual treatment of a patient. Details about protective measures and the maintenance of the device can be found in the operating instructions. QM02/9.2017

TABLE OF CONTENTS PAGE Preperation and application instructions, duration and expected results 5 JOINTS BONES MUSCLES & TENDONS & LIGAMENTS Osteoarthritis and rheumatoid arthritis: 1. Heberden s nodes and Bouchard s nodes (finger joint arthrosis)*application video available 6 2. Carpometacarpal osteoarthritis (saddle joint arthrosis) 7 3. Arthralgia of the temporomandibular joint, rheumatoid arthritis and osteoarthritis 8 4. Arthrosis of the ankle joint (traumatic or degenerative) 9 5. Gonarthrosis (knee joint arthrosis)*application video available 10 6. Omarthrosis (shoulder arthrosis) 11 7. Coxarthrosis (arthrosis of the hip joint) 12 Other types of joint dysfunction: 8. Meniscus injuries (grade 1 and grade 2) 13 9. Hypertrophy of the infrapatellar fat pad 14 10. Patellofemoral pain syndrome 15 11. Sacroiliac joint dysfunction 16 12. Fractures 17 13. Periostitis (MTSS) 18 14. Osteochondritis 19 15. Osteitis pubis 20 16. Lumbar spine syndrome *Application video available 21 17. Bone edema 22 Tendinopathy & tendinitis: 18. Biceps brachii tendinopathy 23 19. Supraspinatus tendinopathy 24 20. Achilles tendon tendinopathy and insertion variants *Application video available 25 21. Patella tendinopathy / patella apex syndrome 26 22. Epicondylitis*Application video available 27 23. Carpal tunnel syndrome*application video available 28 24. Plantar fasciitis 29 25. Partial rupture of tendons 30 3

TABLE OF CONTENTS (CONTINUED) PAGE MUSCLES & TENDONS & LIGAMENTS OTHER S Ligament injuries (e.g.): 26. Collateral ligaments 31 27. Ankle joint ligament injuries 32 Muscle injuries (e.g.): 28. Muscle regeneration *Application video available 33 29. Myofascial pain syndrome 34 30. Torn muscle fibers/ muscle bundles 35 31. Tension headaches and cervical spine syndrome *Application video available 36 32. Supination trauma *Application video available 37 33. Impingement syndrome *Application video available 38 34. Bursitis 39 35. Hematomas 40 36. Osgood-Schlatter disease 41 37. Post-operative treatment 42 38. Iliolumbar ligament irritation 43 39. Nerve regeneration 44 40. Scars 45 41. Minor slipped disk 46 *APPLICATION VIDEOS Accompanying application videos can be viewed at www.laserneedle.eu under the applications Joint as well Muscles and Tendons. 4

PREPARATION Position the patient in such a manner that he can comfortably hold the chosen position throughout the entire treatment. Complete immobility is not required. Please note Before starting the treatment, ensure that the skin of the patient is dry, clean, free of grease and not covered by too much hair. If necessary, clean with alcohol and / or shave. Hair or lotion on the skin might prevent the optical fibers from being attached properly and reflect the laser light. Attachment of the optical fibers The reusable blue silicone applicators are attached directly onto the skin with the special perforated tape. Alternatively the optical fibers are attached using the white, self-adhesive disposable applicators. APPLICATION These treatment recommendations are to be understood as an outline. The exact positioning as well as the type and the number of lasers are to be selected on an individual basis for each patient by the user. If the device should not be fitted with infrared lasers, red lasers can be applied in their place. Rule of thumb Position the infrared channels directly onto the lesion, inflammation, and main pain points; arrange red channels around this or gradually. Hinweis: Das infrarote Licht ist nicht sichtbar. Die ungenutzten Kanäle sollten vor der Behandlung aus Sicherheitsgründen deaktiviert werden. Tip To save time, strips with perforated tape can be fitted with silicone applicators before the treatment. 1. Pull the optical fiber at the bend protection upwards out of the holder and then towards the patient. Avoid bending it too strongly. 2. Carefully insert the front end of the optical fiber into the applicator until it touches the patient s skin.this is best done by gently twisting the fiber back and forth. 3. As far as possible, the tip of the fiber must be positioned so as to ensure rectangular irradiation into the tissue. Additional fixing of the optical fiber can be helpful. The treatment can begin. AND EXPECTED RESULTS Treatment sessions should be held 2-3 times / week for 20 to 30 minutes per session, with a total number of 8-10 sessions. Improvement can be expected after 2-3 sessions for swellings or edema and after 4-6 sessions for all other indications. Please note: The infrared light is not visible. The unused channels should be deactivated before the treatment for safety reasons. 5

1. HERBERDEN S NODES AND BOUCHARD S NODES INFRA Heberden s nodes and Bouchard s nodes (finger joint arthrosis) 15-20 min 2 x weekly / 7-10 sessions on the joint space on the joint space 6 Exemplary treatment points Heberden s nodes and Bouchard nodes (finger joint arthrosis)

2. CARPOMETACARPAL OSTEOARTHRITIS INFRA Carpometacarpal osteoarthritis (saddle joint arthrosis) 15-20 min 2 x weekly / 7-10 sessions on the joint space on the joint space Exemplary treatment points Carpometacarpal osteoarthristis (saddle joint arthrosis ) 7

3. ARTHRALGIA OF THE TEMPOROMANDIBULAR JOINT RHEUMATOID, ARTHRITIS AND OSTEOARTHRITIS INFRA Arthralgia of the temporomandibular joint, rheumatoid arthritis and osteorthritis 20 min 2 x weekly / 7-10 sessions on the triggerpoints on the temporomandibular joint and the joint space 8 Exemplary treatment points arthralgia of the temporomandibular joint, rheumatoid arthritis and osteoarthritis

4. ARTHROSIS OF THE ANKLE JOINT (TRAUMATIC OR DEGENERATIVE) INFRA Arthrosis of the ankle joint (traumatic or degenerative) 20-25 min 2-3 x weekly / 8-12 sessions around the ankle on the joint space Exemplary treatment points Arthrosis of the ankle joint (traumatic or degenerative) 9

5. GONARTHROSIS (KNEE JOINT ARTHROSIS) INFRA Gonarthrosis (knee joint arthrosis) 30 min 2-3 x weekly / 10-15 sessions in the course on the joint space / main pain lateral und medial 10 Exemplary treatment points Gonathrosis (knee joint arthrosis)

6. OMARTHROSIS (SHOULDER ARTHROSIS) INFRA Omarthrosis (shoulder arthrosis) 25 min 2 x weekly / 8-10 sessions in the course directly onto the joint space Exemplary treatment points Omarthrosis (shoulder arthrosis) 11

7. COXARTHROSIS (ARTHROSIS OF THE HIP JOINT) INFRA Coxarthrosis (arthrosis of the hip joint) 30 min 2 x weekly / 12-20 sessions above the trochanter major in the inguinal crease 12 Exemplary treatment points Coxarthrosis (arthrosis of the hip joint)

8. MENISCUS INJURIES (GRADE 1 AND GRADE 2) INFRARED CHANNES Meniscus injuries (grade 1 and grade 2) 20 min 2 x weekly / 8-10 sessions surrounding tissue central on the joint space of the lesion Exemplary treatment points Meniscus injuries 13

9. HYPERTROPHY OF THE INFRAPATELLAR FAT PAD INFRA Hypertrophy of the infrapartellar fat pad 20 min 2 x weekly / 8-12 sessions surrounding directly on the joint space 14 Exemplary treatment points Hypertrophy of the infrapatellar fat pad

10. PATELLOFEMORAL PAIN SYNDROME INFRA Patellofemoral pain syndrome 25 min 2-3 x weekly / 8-12 sessions in the course and surrounding to the main pain points Exemplary treatment points Patellofemoral pain syndrome 15

11. SACROILIAC JOINT DYSFUNCTION INFRA Sacroiliac joint dysfunktion 25 min 2 x weekly / 10 sessions in the course and surrounding to the main pain points 16 Exemplary treatment points Sacroiliac joint dysfunction

12. FRACTURES INFRA Fractures 25 min 2-3 x weekly / 10-12 sessions surrounding tissue directly on the fracture Exemplary treatment points Fractures 17

13. PERIOSTITIS (MTSS) per session INFRA Periostitis (MTSS) 20 min 2 x weekly / 10-12 sessions in the course to the main pain points 18 Exemplary treatment points Periostitis (MTSS)

14. OSTEOCHONDRITIS INFRA Osteochondritis 20-25 min 2 x weekly / 10-12 sessions in the course to the main problem Exemplary treatment points Osteochondritis 19

15. OSTEITIS PUBIS INFRA Osteitis pubis 20 min 2 x weekly / 6-8 sessions in the course / surrounding tissue to the main pain points 20 Exemplary treatment points Osteitis pubis

16. LUMBAR SPINE SYNDROME INFRA Lumbar spine syndrome 20-25 min 2 x weekly / 8-12 sessions around the infrared channels and the tissue surrounding the acute area directly to the acute area Exemplary treatment points Lumbar spine syndrome 21

17. BONES EDEMA INFRA Bones edema 20 min 2 x weekly / 6-10 sessions surrounding tissue directy to the edema The infrared channels are applied directly on the edema. The red channels surround the tissue in question. 22

18. BICEPS BRACHII TENDINOPATHY INFRA Biceps brachii tendinopathy 20-25 min 2-3 x weekly / 8-12 sessions around the infrared channels and the tissue surrounding the acute area directly to the acute area Exemplary treatment points Biceps brachii tendinopathy 23

19. SUPRASPINATUS TENDINOPATHY INFRA Supraspinatus Tendinopathy 20-25 min 2-3 x weekly / 8-15 sessions surrounding directly on the tendon 24 Exemplary treatment points Supraspinatus tendinopathy

20. ACHILLES TENDON TENDINOPATHY AND INSERTION VARIANTS INFRA Achilles tendon tendinopathy and insertion variants 20 min 2 x weekly / 8-12 sessions on both sides behind the Achilles tendon directly to the pain site Exemplary treatment points Achilles tendon tendinopathy and insertion variants 25

21. PATELLA TENDINOPATY / PATELLA APEX SYNDROME INFRA Patella tendinopathy / patella apex syndrome 20-30 min 2-3 x weekly / 8-12 sessions surrounding tissue centrally on the patella tip - on the course of the tendon 26 Exemplary treatment points Patella tendinopathy / patella apex syndrome

22. EPICONDYLITIS INFRA Epicondylitis 20 min 2x weekly/ 8-10 sessions surrounding tissue along the course of the pain tendon approach along the course of pain Exemplary treatment points Epicondylitis 27

23. CARPAL TUNNEL SYNDROME INFRA Carpal tunnel syndrome 20 min 2 x weekly / 7-10 sessions surrounding infrared channels (IR) and / or extends the IR-line along the carpal tunnel 28 Expemplary treatment points Carpal tunnel syndrome

24. PLANTAR FASCIITIS INFRA Plantar fasciitis 20-30 min 2-3 x weelkly / 8-12 sessions surrounding (foot sole, transition heel) directly to the acute area Exemplary treatment points Plantar fasciitis 29

25. PARTIAL RUPTURE OF TENDONS INFRA Partial rupture of tendons 30 min 2-4 x weekly / 12-18 sessions around the IR and the tissue surrounding the rupture directly to the area of the rupture 30 Exemplary treatment points partial rupture of tendons

26. COLLATERAL LIGAMENTS INFRA Collateral Ligaments 20-30 min 2-3 x weekly/ 8-12 sessions surroundign IR and the tissue around the acute area directy to the acute area Exemplary treatment points Collateral ligamentents 31

27. ANKLE JOINT LIGAMENT INJURIES INFRA Ankle joint ligament injuries 20-25 min 2-3 x weekly / 8-12 sessions surrounding IR and the tissue around the acute area directly to the acute area 32 Exemplary treatment points Ankle joint ligament injuries

28. MUSCLE REGENERATION INFRA Muscle regeneration 20 min after exhaustion alternating with IR onto the muscles to be regenerated to possible hypotonic areas Exemplary treatment points muscle regeneration 33

29. MYOFASCIAL PAIN SYNDROME OVERALL TREATMEN INFRA Myofascial pain syndrome 20-25 min 2 x weekly / 8-10 sessions pain area or myofascial trigger points to myofascial trigger points 34 Exemplary treatment points Myofascial pain syndrome

30. TORN MUSCLES FIBERS / MUSCLE BUNDLES INFRA Torn muscles fibers/ muscles bundles 20-30 min 2-3 x weekly / 8-12 sessions surrounding IR and the tissue around the acute area directly to the acute area Exemplary treatment points Torn muscles fibers / muscle bundles 35

31. TENSION HEADACHES AND CERVICAL SPINE SYNDROME INFRA Tension headaches and cervical spine syndrome 20-25 min 2 x weekly / 8-12 sessions surrounding IR and the tissue around the acute area directly to the acute area between C3 and C4 C7 36 Exemplary treatment points tension headaches and cervical spine syndrome

32. SUPINATION TRAUMA INFRA Supination trauma 20-25 min immediatly after the injury, 2-3 x weekly (moreoften if possible) / 8-12 sessions surrounding centrally onto the affected ligaments/swelling Exemplary treatment points Supination trauma 37

33. IMPINGEMENT SYNDROME INFRA Impingement syndrome 25-25 min 2-3 x weekly / 8-15 sessions in the course to the joint space / primary pain 38 Exemplary treatment points Impingement syndrome

34. BURSITIS INFRA Bursitis 20 min 2 x weekly / 6-10 sessions surrounding tissue central to the inflammation Exemplary treatment points Bursitis 39

35. HEMATOMAS INFRA Hematomas 20 min daily if possible/ 8-12 sessions circle hematoma alternately with IR see column left 40 Exemplary treatment points hematomas

36. OSGOOD-SCHLATTER DISEASE INFRA Osgood-Schlatter disease 20-25 min 2-3 x weekly / 10-12 sessions group around the acute treatment area on the patellar ligaments on the tibia Exemplary treatment points Osgood-Schlatter disease 41

37. POST-OPERATIVE TREATMENT INFRA Post-operative treatment 20 min 2 x weekly / 8-12 sessions surrounding direct to the operating area 42 Exemplary treatment point Post-operative treatment

38. ILIOLUMBAR LIGAMENT IRRITATION INFRA Iliolumbar ligament irritation 20 min 2 x weekly / 8-10 sessions surrounding the IR centrally on the ligament Exemplary treatment points Iliolumbar ligament irritation 43

39. NERVE REGENERATION INFRA Nerve regeneration 20-30 min 2-3 x weekly / 8-12 sessions surrounding or in the course along the nerves 44 Exemplary treatment points Nerve regeneration

40. SCARS INFRA Scars 20-30 min 2-3 x weekly / 8-12 sessions surrounding IR and the tissue around the acute area directly to the acute area For the treatment of fresh surgical scars, place the channels on the left and right of the seam. After pulling the threads and closed wound, place the channels directly on the scar. Scars could be suppressed. 45

41. MINOR SLIPPED DISK INFRA Minor slipped disk 20-25 min 2 x weekly / 8-10 sessions surrounding tissue directly to the band disk 46 Exemplary treatment points Minor slipped disk

LASERNEEDLE GmbH Oranienburger Chaussee 31 33 16548 Glienicke/Nordbahn Germany Tel: +49 (0) 33056 / 41 43 10 Fax: +49 (0) 33056 / 41 43 11 info@laserneedle.eu www.laserneedle.eu

LASERNEEDLE GmbH 2017