- The laser is one of the technological wonders invented during the past century. It took the genius of Einstein and Kastler, then the competition between many brilliant minds of the time, including Townes, Schawlow, Maiman, and Gould, to emit the first laser beam from a ruby in 1960. Since then, applications have continuously increased in various fields of research, industry, and medicine. But the laser has also been diverted to give a boost to a practice as ancestral as inefficient: acupuncture.
An Advanced Technology
A laser is made of spatially and temporally coherent light radiation, which means that the energy is transported within a single frequency inside a very narrow light beam. Lasers are used in many medical disciplines. Depending on its characteristics and target, a laser beam can cause four types of effects on biological tissues:
- A thermal effect, which exploits the ability of radiation to be absorbed and transformed into heat by biological tissues. This type of effect is used in particular in the treatment of superficial vascular lesions such as angiomas.
- A photochemical effect, exploited in photodynamic therapy, which consists of injecting the patient with a photosensitive substance that easily binds with lipids of cells, which, exposed to the laser, become the place of chemical reactions that cause their destruction. The phenomenon is used to kill cancer cells.
- A mechanical effect, appearing when the intensity of the electric fields of light is sufficient to create locally a microplasma and a shock wave that breaks the biological tissues. This effect is used in urology, for example, to destroy kidney stones.
- A photoablative effect, related to the ability of proteins to absorb ultraviolet radiations and to photo-dissociate. Photoablation is used, for example, in eye surgery to correct the corneal curvature.
These four phenomena alone can explain all the mechanisms involved in a laser intervention on the human body. All … or almost. Information on the internet will tell you that there is a new therapy known as LLLT, or low-level laser therapy. On PubMed, the leading bibliographic search engine in biology and medicine, typing the keyword “LLLT” will give you a list of several thousand research articles dedicated to the behavior of our cells under low laser irradiation and the application that can be made especially for cancer treatment (for example, Robijns et al. 2017) or pain management (for example, Clijsen et al. 2017). Caution is required, however, because these studies are not always very solid. For example, concerning the LLLT treatment of pressure ulcers, a recent analysis of the available data (Machado et al. 2017) considered only four articles out of 386 valid. The effect of low laser irradiation is therefore a subject of clinical research, but the relevance and effectiveness of treatments, or the mechanisms of possible actions, are not firmly scientifically established. Yet it was enough for some to consider the laser as a tool to do everything and seek to include it in the most inefficient pseudo-therapies.
Servicing an Ancestral Therapy
This is the case with laser acupuncture, a special form of acupuncture that uses a laser instead of needles to stimulate acupuncture points, which would be ideal for people afraid of the needles or for when the needles’ placement is contraindicated. It would be particularly useful to treat arthritis, carpal tunnel syndrome, eczema, herpes, tinnitus, ear infections, face wrinkles, smoking, etc. This list of varied indications leaves you puzzled as to the validity of this practice. Supporters of laser acupuncture can assure you that there are some studies proving its effectiveness. For example, an analysis published in the Journal of Acupuncture and Meridian Studies, which includes studies of “application of low intensity laser radiation (i.e., non-thermal intensities) to classical meridian points or trigger points” (Baxter et al. 2008), with the aim in particular of identifying the relevant treatment parameters and proposing an improvement of protocols.
Another example is an article from a medical doctor, published in the French journal Acupuncture & Moxibustion, which claims to discuss the anti-inflammatory, analgesic, and anti-allergic effects of lasers according to the wavelengths or the amount of energy deposited on acupuncture points (Stephan 2014). It’s enough to convince suffering patients that laser acupuncture is a true branch of evidence-based medicine and that its therapeutic validity has been demonstrated, especially because many “healthcare” centers now offer laser acupuncture treatments, encouraging the argument that the treatment has been scientifically demonstrated. The centers highlight numerous testimonials from former patients who, thanks to laser acupuncture, are said to have succeeded in stopping smoking or treating low back pain, neuralgia, or fibromyalgia. For people suffering white coat syndrome, who might be afraid of entering such a “healthcare” center, it is even possible to rent or buy acupuncture lasers, some of which have an “integrated acupuncture finder [that] simply and accurately locates acupuncture points on the skin surface, even for the layperson” (Biolas soft laser for laser acupuncture at praxidienst.com).
The ‘Tower of Pisa’ Effect
Alas for its supporters, laser acupuncture suffers from a characteristic fault of pseudo-therapies, one I name the “Tower of Pisa” effect: the architecture is flashy, but the foundations are fragile, and the construction will eventually collapse on its own. Laser acupuncture, which seeks to demonstrate its effectiveness through publications in peer-reviewed journals, is based on an outdated assumption: that points exist along meridians through which vital energy flows and that stimulating these points may have a therapeutic effect on the human being. But neither the meridians nor the vital energy have any scientific basis. As Harriet Hall (2016; 2019) and others have pointed out in the Skeptical Inquirer, acupuncture care is a theatricalized placebo effect. Laser acupuncture is only a high-tech version of this therapeutic staging. Therefore, complex technical discussions about, for example, the optimal laser fluence1 to apply on acupuncture points to provoke some positive health effects only indicate ignorance of how science functions, advancing by confirmation or refutation of testable hypotheses and considering valid only those theories supported by evidence. Never has the evidence demonstrated the anatomical reality of acupuncture points. Therefore, seeking to determine the best ways to stimulate them is like trying to improve the design of chimneys to facilitate the passage of Santa Claus.
Pseudoscience has been a frequent and longtime “hijacker” of new technologies; at the beginning of the twentieth century, the fervor surrounding emerging electrical technologies led to the design of absurd and quirky devices, including purple ray tubes intended to heal asthma or obesity. A century later, it claims to cure anything and everything with laser acupuncture, a more current technology. Although the material has changed, the result remains the same: fictitious, except perhaps for the wallet and ego of some pseudo-caregivers.
- Fluence is the energy deposited by the laser radiation per unit of area.
- Baxter, G.D., et al. 2008. Clinical effectiveness of laser acupuncture: A systematic review. Journal of Acupuncture Meridian Studies 1(2): 65–82.
- Clijsen, R., et al. 2017. Effects of low-level laser therapy on pain in patients with musculoskeletal disorders. A systemic review and meta-analysis. European Journal of Physical Rehabilative Medicine. doi:10.23736/S1973-9087.17.04432-X.
- Hall, H. 2016. Stick it in your ear! How not to do science. Skeptical Inquirer 40(3) (May/June). Available online at https://skepticalinquirer.org/2016/10/stick_it_in_your_ear_how_not_to_do_science/.
- ———. 2019. Science envy in alternative medicine. Skeptical Inquirer 43(4) (July/August): 21–23.
- Machado, R.S., et al. 2017. Low-level laser therapy in the treatment of pressure ulcers: Systematic review. Lasers in Medical Science. doi:10.1007/s10103-017-2150-9.
- Robijns, et al. 2017. The use of low-level light therapy in supportive care for patients with breast cancer: Review of the literature. Lasers in Medical Science 32(1): 229–242.
- Stephan, Jean-Marc. 2014. Laser de faible puissance et utilization en acupuncture. Acupuncture & Moxibustion 13(2). Available online at www.meridiens.org/acuMoxi/treizedeux/STEPHAN-LASER.pdf.