Pain Doc - Ask Dr. P - The Pain Doc

What Does Fine Particulate Matter Do to Your Lungs?

by Pain Doc | Sep 30, 2023 | air filtering for health

What Happens in the Lungs When You Breathe in Fine Particulate Matter?

Breathing is a natural process that ensures our body gets the oxygen it needs to function. Oxygen’s main function is to convert your food to energy inside each cell, which needs a constant, uninterrupted supply.

fine particulate matter illustrated t to scale The quality of the air we breathe can have significant effects on our health, particularly when it contains fine particulate matter (abbreviated “PM2.5”). Understanding the consequences of inhaling PM2.5 can underscore the importance of maintaining air quality and safeguarding our respiratory health.

What is Fine Particulate Matter?

Fine particulate matter, or PM2.5, refers to tiny particles or droplets in the air that are 2.5 micrometers (also called microns) in diameter or smaller, which is one millionth of a meter, and which can be man-made or natural.

To put it into perspective, a human hair has a diameter of about 70 micrometers, making PM2.5 particles nearly 30 times narrower than a human hair. These particles can originate from various sources, including vehicle emissions, industrial processes, power plants, wood-burning, and certain natural processes such as wildfires and volcanic eruptions.

fine particulate matter from wildfires, San Francisco in August 2020 In late summer of 2020, the Bay Area of California experienced very dangerous levels of PM2.5 due to wildfires; so bad that people were instructed to remain indoors. And on the day of and weeks following the 9-11 terrorist attacks on the World Trade Center, thousands of people, especially first responders, breathed in the tons of fine particulate matter that were produced from the destruction. Many are suffering from chronic lung problems, and many have died from ingesting these toxins into their lungs.

Air Dog™: Discover the Next Generation of Home and Office Air Purifiers

How Does PM2.5 Enter the Lungs?

When we breathe, air travels through our nose or mouth, down the trachea, and into our lungs via a network of progressively smaller tubes called bronchi. These further divide into tiny air sacs called alveoli, where the exchange of oxygen and carbon dioxide takes place between your blood and the atmosphere.

alveoli of lungs

Due to their minuscule size, PM2.5 particles can bypass the body’s natural defense mechanisms, such as nasal hairs and the mucociliary escalator: the constant upflow of a thin layer of mucus lining the upper and lower respiratory tract, done by cilia, a hair like structure on the surface of all respiratory tract cells. Foreign debris entering with the air gets trapped on this moving layer of mucus, and triggers you to spit it out, or swallow. However, P2.5 is so light and tiny, many of them escape the mucus layer and make it all the way deep into your lungs, down to the alveoli.

Effects of PM2.5 on the Lungs

Inflammation: Once PM2.5 particles reach the alveoli, they can cause inflammation. The body recognizes these particles as foreign invaders and activates immune responses. Inflammatory cells rush to the site, releasing various chemicals that can damage lung tissues.
Aggravation of Respiratory Diseases: People with pre-existing respiratory conditions, such as asthma or chronic obstructive pulmonary disease (COPD), can experience exacerbations when exposed to high PM2.5 levels. The inflammation and irritation caused by the particles can constrict airways, leading to symptoms like wheezing, shortness of breath, and coughing.
Decreased Lung Function: Chronic exposure to PM2.5 can lead to a decline in lung function over time. The damage and inflammation can lead to scarring of lung tissues, which reduces the lungs’ efficiency in oxygen exchange.
Deep Systemic Effects: PM2.5 doesn’t just stay in the lungs. Some particles, especially those carrying toxic substances or heavy metals, can enter the bloodstream through the alveoli. This means that the effects of PM2.5 can be systemic, impacting other organs and systems like the heart and the vascular system.
Increased Risk of Respiratory Infections: The inflammation and damage caused by PM2.5 can weaken the lungs’ defense mechanisms, making individuals more susceptible to respiratory infections like pneumonia.
Lung Cancer: Extended exposure to high levels of PM2.5 has been linked to an increased risk of lung cancer. Some particulate matter can carry carcinogenic substances, which, when inhaled over time, can lead to DNA damage and cancerous growths.

Protecting Yourself from PM2.5

Given the potential risks associated with PM2.5 inhalation, it’s crucial to take steps to minimize exposure, especially in areas with frequent high PM2.5 levels.

Monitor Air Quality: Stay informed about local air quality levels through apps, websites, or local news.
Stay Indoors: During days with high PM2.5 levels, limit outdoor activities, especially strenuous ones like jogging or cycling.
Air Purifiers: Consider investing in air purifiers with HEPA filters that can effectively remove fine particles from indoor air. Even better, get the higher performing models that also include charged electrical fields to trap dangerous, cancer-causing fine particulate matter.
Ventilation: Ensure that homes and offices are well-ventilated. Use exhaust fans, especially when cooking, to reduce indoor PM2.5 levels.
Masks: In severely polluted environments, consider wearing masks like N95 respirators that can filter out fine particulate matter. I would recommend using masks whenever you do things around the house that stir up fine particles, such as sawing wood, spray painting, cleaning up a dusty area, and even working with flour and finely ground spices.

Conclusion

The presence of fine particulate matter in the air poses a genuine health concern. If you live in an area that gets wildfires, or downwind of an industrial zone, or a building demolition site, chances are, you are ingesting more P2.5 than the average person. These tiny particles can deeply penetrate the lungs, and depending on their nature, can lead to a range of health problems from immediate respiratory symptoms to long-term conditions like lung cancer and emphysema. As global urbanization and industrialization continue, understanding the implications of PM2.5 and taking protective measures become increasingly vital for maintaining public health.

Could This be the Best Home Air Purifier Ever Made?

Understanding Impingement Syndrome in the Shoulder: Causes and Rehabilitation

by Pain Doc | Sep 25, 2023 | Chronic Pain, Joint Pain, Shoulder Pain

The shoulder is a marvel of human anatomy, offering an impressive range of motion. However, this mobility comes at a cost, as the shoulder joint is highly susceptible to various conditions and injuries, one of the most common being impingement syndrome. In this article, I will discuss the causes, symptoms, diagnosis, and treatment options for shoulder impingement syndrome, with a primary focus on rehabilitation techniques to help individuals recover and regain full shoulder functionality.

Introduction to Shoulder Impingement Syndrome

Shoulder impingement syndrome is a painful and often debilitating condition that occurs when the tendons of the rotator cuff and the subacromial bursa become pinched or impinged between the bones of the shoulder, primarily the acromion (a part of the scapula or shoulder blade) and the humerus (the upper arm bone). This impingement leads to inflammation, pain, and restricted shoulder movement.

Anatomy of the Shoulder

Before delving into the causes and rehabilitation of shoulder impingement syndrome, it’s crucial to understand the intricate anatomy of the shoulder joint. The shoulder comprises three bones: the humerus, the clavicle (collarbone), and the scapula (shoulder blade). The glenohumeral joint, where the head of the humerus articulates with the shallow socket of the scapula, allows for the remarkable range of motion in the shoulder.

Rotator Cuff and Subacromial Bursa – The rotator cuff is a group of four tendons and muscles that stabilize the shoulder joint and facilitate its movement. These four muscles include the supraspinatus, infraspinatus, teres minor, and subscapularis. They work in unison to control arm movements and maintain joint integrity. The subacromial bursa is a fluid-filled sac that reduces friction between the rotator cuff tendons and the acromion, promoting smooth shoulder motion.

Causes of Shoulder Impingement Syndrome

Understanding the underlying causes of shoulder impingement syndrome is crucial for effective rehabilitation. Several factors contribute to the development of this condition.

Anatomical Factors

Shape of the Acromion

The shape of the acromion can vary from person to person. Some individuals have a flat or curved acromion, while others have a hooked or pointed acromion. A hooked acromion is more likely to impinge on the underlying tendons, increasing the risk of impingement syndrome.

Bone Spurs

Over time, the formation of bone spurs (osteophytes) on the acromion or the clavicle can reduce the space within the subacromial space, making impingement more likely.

Overuse and Repetitive Movements

Overhead Activities

Engaging in repetitive overhead activities, such as painting, swimming, or throwing, can lead to overuse of the shoulder joint. This overuse can irritate and inflame the rotator cuff tendons, increasing the risk of impingement.

Poor Posture

Poor posture, especially slouching or forward-leaning positions, can alter the biomechanics of the shoulder joint, narrowing the subacromial space and leading to impingement over time.

Muscle Imbalances

Muscle imbalances in the shoulder girdle can also contribute to impingement syndrome. Weakness or tightness in certain muscles can alter the mechanics of the shoulder joint, leading to impingement.

Trauma and Injuries

Shoulder injuries, such as falls or accidents, can damage the structures within the shoulder joint, leading to inflammation and impingement syndrome. Additionally, dislocated shoulders or fractures can alter the joint’s anatomy, increasing the risk of impingement.

Signs and Symptoms of Shoulder Impingement Syndrome

Recognizing the signs and symptoms of shoulder impingement syndrome is essential for early diagnosis and prompt treatment. Common symptoms include:

Pain

Pain is the hallmark symptom of shoulder impingement syndrome. The pain is typically located at the front or side of the shoulder and may radiate down the arm. It is often aggravated by overhead movements or reaching behind the back.

Weakness

Individuals with impingement syndrome often experience weakness in the affected shoulder. This weakness can affect the ability to lift objects or perform daily activities.

Limited Range of Motion

Impingement syndrome can restrict shoulder mobility. Individuals may find it challenging to raise their arms overhead or reach behind their back.

Night Pain

Many people with shoulder impingement syndrome report pain at night, particularly when lying on the affected shoulder. This can disrupt sleep and lead to chronic fatigue.

Clicking or Popping

Some individuals may hear clicking or popping sounds when moving their shoulder. These noises can indicate underlying structural issues.

Diagnosis of Shoulder Impingement Syndrome

Diagnosing shoulder impingement syndrome involves a combination of clinical evaluation, patient history, and imaging studies. Healthcare providers typically follow these steps:

Medical History

The doctor will ask about the patient’s symptoms, including when the pain started, its location and severity, and any exacerbating factors like specific movements or activities. Oftentimes, impingement syndrome can gradually appear with no obvious cause, but if you look at the long term history of the patient’s work and/or recreational activities, aggressive shoulder movements are typically included (repetitive lifting above the shoulder; contact sports, tennis, baseball pitcher, etc.).

Physical Examination

During a physical examination, the healthcare provider will assess the range of motion in the affected shoulder, strength, and any signs of inflammation or tenderness. The cardinal sign is pain with shoulder abduction (raising the arm from the side causes a deep, sharp pain inside the shoulder joint; patient has difficulty raising his/her arm above shoulder level due to mechanical restriction and acute pain.

Imaging Studies

Imaging studies, such as X-rays, ultrasound, or MRI, may be ordered to visualize the structures within the shoulder joint. X-rays can reveal bone abnormalities, while ultrasound and MRI can provide detailed images of soft tissues like tendons and the subacromial bursa. However, this is usually only done if rest, physical therapy, and home care do not produce desired results after a week.

Cortisone injection

In some cases, an injection of a local anesthetic into the subacromial space may be performed. If the pain is alleviated shortly after the injection, it can confirm the diagnosis of impingement syndrome. This is because with impingement syndrome, there is swelling and inflammation, and cortisone is a quick-acting anti-inflammatory medication. So, if the pain is alleviated following a cortisone shot, it confirms there is localized swelling, which is likely coming from either the bursae or a tendon.

Non-Surgical Rehabilitation for Shoulder Impingement Syndrome

The treatment of shoulder impingement syndrome typically begins with non-surgical interventions, such as physical therapy and lifestyle modifications. The goals of rehabilitation are to alleviate pain, improve shoulder function, and prevent recurrence.

Rest and Activity Modification

Resting the affected shoulder and avoiding activities that worsen symptoms are essential in the early stages of rehabilitation. This may include temporarily ceasing activities that involve repetitive overhead motions.

Physical Therapy

Physical therapy is a cornerstone of non-surgical treatment for shoulder impingement syndrome. A qualified physical therapist will design a personalized exercise program to address muscle imbalances, improve strength, and enhance shoulder mobility. Common physical therapy techniques include:

Stretching Exercises

Stretching exercises target tight muscles in the shoulder girdle and surrounding areas. This can help improve flexibility and reduce tension that contributes to impingement (see video below).

Modalities

You can use a red light therapy wrap to reduce pain and swelling of your impingement syndrome. Red light therapy wraps use light in the therapeutic wavelengths of red and infrared to accelerate tissue healing and deep heat tissues to increase blood flow and oxygen. See below for an example:

SUMMARY:

Shoulder impingement syndrome occurs when a swollen tendon and/or bursa inside the glenohumeral joint, where your humerus articulates with your scapula, impedes movement of the joint by rubbing against hard structures, particularly the acromion. The goal is to shrink the swollen tendon so that proper movement is restored, and then correct any biomechanical deficiencies in the shoulder complex, such as weak or tight muscles, and subluxated joints affecting the shoulder movements, using exercise rehabilitation, joint mobilization and red light therapy.

Can Air Compression Boots Really Help Lymph Circulation?

by Pain Doc | May 18, 2023 | Lymphatic System

Do your legs, arms, feet and hands often feel stiff? Do they appear puffy/ swollen? If so, it may be that you have impaired lymph flow, or lymphedema. In this article, we’ll discuss the function of the lymphatic system, and what you can do if you have impaired lymph flow.

What are the parts of the lymphatic system?

The lymphatic system is a vital part of the body’s immune system and plays a crucial role in maintaining fluid balance, removing waste products, and fighting infections. It consists of a network of lymphatic vessels that run alongside veins and arteries and form connections at the arteriole/ venule level; lymph nodes, lymphoid organs (spleen, tonsils, thymus, appendix), and lymphatic fluid called lymph. Unlike the circulatory system that has the heart to move blood through it, the lymph has no such organ. Lymph fluid circulates slower than blood and is driven primarily via skeletal muscle contraction, the movements of breathing, and slight contraction of smooth muscle in vessel walls.

Here’s a simplified overview of how the lymphatic system works:

Lymphatic vessels: Lymphatic vessels are thin-walled, one-way channels (made possible by specialized valves that allow flow only in one direction) that carry lymph throughout the body. They are similar to blood vessels but have larger gaps between their cells, allowing fluids, waste products, and immune cells to enter (see diagram below):

Lymphatic vessels connect with arteries and veins to filter out excess fluids and waste

Interstitial fluid collection: Interstitial fluid is a clear fluid that surrounds the cells in body tissues. It is derived from blood plasma that leaks out of capillaries. The lymphatic vessels collect this excess fluid, along with proteins, cellular waste, and pathogens, preventing its accumulation and maintaining tissue fluid balance. It’s important to note that heavy exercise, such as long distance running, increases the pressure in the circulatory system and also increases heart rate and vessel contraction/dilation movement, which can cause more fluids to build up in the interstitial space along with metabolic products of muscle cell metabolism; i.e. lactic acid and carbon dioxide. So, the lymphatic system is very active during and following intense exercise.

Lymph transport: The lymphatic vessels carry the collected fluid, now called lymph, through a network of progressively larger vessels. Smooth muscle contractions in the vessel walls and one-way valves help propel lymph toward the chest where the filtered lymph fluid re-enters the circulatory system at the thoracic ducts.

Lymph nodes: Along the lymphatic vessels, there are small, bean-shaped structures called lymph nodes. Lymph nodes are highly concentrated with immune cells, such as lymphocytes and macrophages, which help filter and cleanse the lymph of pathogens, foreign substances, and damaged cells. Lymph nodes play a crucial role in immune response and can become swollen and tender when fighting infections. They are more concentrated in the neck, axilla (armpit region), and inguinal (groin area) regions, although they are present throughout all parts of the body. Lymph nodes are easily palpated through the skin as the lymph vessels are mostly just under the skin.

Lymph node cross section

Lymphoid organs: In addition to lymph nodes, other lymphoid organs, such as the spleen, thymus, appendix and tonsils, are part of the lymphatic system. These organs house immune cells and contribute to the production and maturation of lymphocytes, which are key players in the immune response.

Lymphatic fluid return: Ultimately, the lymphatic vessels return the filtered lymph back into the bloodstream, near the heart, through the thoracic duct (left side of the body) and the right lymphatic duct (right side of the body). The lymph rejoins the blood circulation, and any remaining waste products are eliminated through the kidneys and other excretory organs.

The lymphatic system acts as a drainage and defense system, collecting excess fluid and waste, filtering it, and helping to mount immune responses against infections. By doing so, it helps maintain tissue health, fluid balance, and overall immune function in the body.

What happens if your lymph system is impaired?

Lymphatic insufficiency, also known as lymphedema, occurs when there is a disruption or impairment in the normal functioning of the lymphatic system. This condition can result in a buildup of lymphatic fluid in the affected area, leading to swelling, tissue damage, and increased susceptibility to infections.

Some common causes of lymphedema are:

Surgery: Lymphedema can occur as a complication of surgical procedures that involve the removal or damage to lymph nodes or lymphatic vessels. This is often seen in cancer surgeries, such as breast cancer or melanoma surgeries, where lymph nodes are removed or radiation therapy is administered to the lymphatic area. Some destruction of adjacent lymph vessels occurs, and flow is impaired.

Radiation therapy: Radiation treatment for cancer can damage lymph nodes and lymphatic vessels, leading to lymphedema. The risk is higher when radiation is directed towards the lymphatic drainage pathways.

Infection: Certain infections can cause inflammation and damage to the lymphatic vessels, resulting in lymphedema. Examples include filariasis (a parasitic infection transmitted by mosquitoes), cellulitis (bacterial skin infection), and lymphangitis (inflammation of the lymphatic vessels).

Primary lymphedema: In some cases, lymphedema can be present at birth or develop later in life due to congenital abnormalities or genetic factors that affect the development or function of the lymphatic system. This is known as primary lymphedema.

Secondary lymphedema: Secondary lymphedema occurs as a result of an acquired condition or event that damages the lymphatic system. Common causes include trauma, burns, severe obesity, chronic venous insufficiency, or surgical procedures unrelated to cancer.

Cancer: Lymphedema can also occur as a result of cancer itself. Tumors can obstruct or invade the lymphatic vessels, impairing lymphatic flow and causing fluid buildup.

It’s important to note that lymphedema can develop immediately after an event (e.g., surgery or radiation) or may manifest months or years later. The severity and progression of lymphedema can vary from person to person.

Here’s what happens in the body during lymphatic insufficiency:

Fluid buildup and swelling: The impaired drainage causes a buildup of lymphatic fluid in the affected area. Initially, this may lead to mild swelling, which tends to worsen over time if left untreated. The swelling is often persistent and may involve the limbs, most commonly the arms or legs. In some cases, lymphedema can affect other areas of the body, such as the face, neck, or genitals.
Tissue changes: Prolonged accumulation of lymphatic fluid results in changes to the affected tissues. The tissues become fibrotic and less elastic, causing them to harden and thicken. Why this happens isn’t clear, but if interstitial fluid that needs to be moved out lingers around instead of being picked up by the lymph system, the waste products in it accumulate and the body responds by laying down fibrous tissue to consolidate it. Over time, this can lead to skin changes, such as thickening, hardening, or a “woody” appearance. The skin may become more prone to infections, ulcers, and other complications.
Increased risk of infections: The stagnant lymphatic fluid creates an environment favorable for bacterial or fungal growth. The compromised lymphatic system also means that the body’s immune response is weakened in the affected area. As a result, individuals with lymphatic insufficiency are at a higher risk of developing recurrent infections, such as cellulitis, lymphangitis, or fungal infections.
Reduced transport of nutrients and waste removal: The impaired lymphatic flow hinders the transport of nutrients, oxygen, and waste products between the tissues and the bloodstream. This can lead to further tissue damage, impaired wound healing, and an increased risk of secondary complications.
Functional limitations: Lymphedema can cause functional limitations and affect the quality of life. The swelling and tissue changes can lead to discomfort, pain, heaviness, and difficulty moving the affected limb(s). The condition may impact daily activities, mobility, and emotional well-being.

How can leg compression boots help lymphedema?

Treatment for lymphatic insufficiency focuses on managing the symptoms, reducing swelling, preventing infections, and improving overall function. This may involve a combination of techniques, including compression therapy, manual lymphatic drainage massage, exercise, skin care, and sometimes surgery. Take note; it is not a good idea to wear tight-fitting clothes as it may worsen the problem, so if you have lymphedema, make sure to wear loose clothing.

The legs are especially affected by lymphedema since they are furthest away from the heart and the fluids there have to work against gravity. Many people with lymphedema are finding success using compression boots. This popular therapy device contains individual air bladder sections, from the foot to the upper thigh, which are filled using a programmable air pump unit. When maximally filled with air, the air bladder compresses that section of your leg. You can control the sequence of filling of these bladders, and the pressure level. The higher end models are capable of generating a strong compression while the cheaper versions do much lighter compression.

For example, the standard program compresses the feet first, then the lower calf, upper calf, and thigh, in that order. It holds the pressure for a couple of seconds, then all the air is released, and the process is repeated. This repeated pattern of compression, from leg to thigh, pushes the lymph upwards towards the heart.

Compression boots for lymphatic insufficiency

You don’t have to suffer from lymphedema to benefit from compression boots. They are great for post-exercise treatment, especially after a marathon or a long hike. The compression waves not only help blood and lymph in your leg vessels to move towards the heart and thoracic ducts, they massage the leg muscles as well. This may even reduce the onset of delayed onset muscle soreness (DOMS), the soreness that often comes a few hours after rigorous exercise involving the legs.

Bottom Line: Compression boots are helpful in alleviating the symptoms of lymphatic insufficiency, and assisting circulation in your legs, post exercise. They offer a relatively inexpensive form of palliative care, and are worth the investment. Lymphatic insufficiency can cause long-term problems such as fibrosis, skin hardening and even toxicity if left unchecked, so it’s best to be active in managing the condition.

Can Shockwave Therapy Help Plantar Fasciitis?

by Pain Doc | May 16, 2023 | Foot and Ankle Pain, Sprains and Strains

Extracorporeal shockwave therapy (ESWT) is a non-invasive treatment option that is used for various musculoskeletal conditions, including:

plantar fasciitis
iliotibial (IT) band syndrome
shin splints
patellar tendonitis
frozen shoulder (adhesive capsulitis)
tennis elbow (epicondylitis)
post-surgical fibrosis (fibrous tissue growth)

ESWT involves the application of high-energy sound waves to the affected area to stimulate healing and reduce pain. The two main types of shockwave devices are piezoelectric and radial.

Piezoelectric machines have an applicator that contains an array of crystals made of ceramic material that are embedded in a concave bowl. A voltage is applied, which causes the crystals to deform very quickly. This generates a mechanical wave. The waves from the crystal array are focused by the concave bowl and directed into the patient’s body, through which it travels. Piezoelectric machines generate a high pitched, short “tick” sound with each pulse. The pulse frequency is varied by varying the power to the applicator. It is important to note that since the energy waves generated by piezoelectric machines are focused into a small area, treating large areas takes a lot of time/ treatment sessions.

Radial shockwave machines generate an energy wave using kinetic energy. An electromagnet inside the applicator accelerates a metal rod, called a “bullet,” against a strike plate. The strike plates are attachments to the applicator, and come in different sizes. Small attachments will concentrate the wave energy into a smaller area, but again, will require multiple treatments to cover large areas such as for shin splints or IT band treatment. Larger attachments will cover more area, but the energy is attenuated more because of this. Radial shockwave machines generate energy waves that cover more area than a piezoelectric generated wave, but are not as focused.

ESWT for plantar fasciitis:

Procedure: During ESWT, a handheld device delivers shockwaves to the plantar fascia, which is the tissue causing the pain and inflammation. The shockwaves help to break up scar tissue, promote blood flow, and stimulate the healing process.

Treatment sessions: ESWT is typically administered in a series of sessions, usually spaced about one week apart. The number of sessions required can vary, but it typically ranges from three to six sessions.

Effectiveness: ESWT has been shown to be effective in relieving pain and improving function in many patients with plantar fasciitis. Research studies have demonstrated positive outcomes, with reductions in pain and improvements in foot function.

Side effects: ESWT is generally considered safe, and serious complications are rare. However, some individuals may experience mild side effects such as temporary pain, redness, bruising, swelling, or numbness in the treated area.

Post-treatment: Following ESWT, it’s important to follow your healthcare provider’s instructions for post-treatment care. This may include rest, ice application, stretching exercises, and avoiding activities that may aggravate the condition. Physical therapy and orthotics may also be recommended to aid in the recovery process.

Suitability: ESWT is typically considered when conservative treatments, such as rest, stretching, orthotics, and medications, have failed to provide sufficient relief. Your healthcare provider will assess your individual case and determine if ESWT is a suitable option for you.

It’s worth noting that while ESWT can be effective for many people, individual results may vary.

Since it is a relatively save procedure with rare serious side effects, extracorporeal shockwave therapy is safe to do at home. There are personal devices available such as this one that allow consumers to apply the treatment to themselves. While it isn’t cheap, it is a fraction of the cost of the professional models and is just as effective.

The benefits of owning your own extracorporeal shockwave machine is that, if you have a chronic problem, such as in your shoulder, that surfaces a couple times a year, you can save a lot of money by doing the treatment yourself. A typical ESWT treatment at a physical therapist or chiropractor office runs anywhere from $50-$200/treatment, and they require you to get at least six; often more.

Bottom Line: whether you seek Extracorporeal Shockwave treatment from a therapist, or invest in your own machine, it can help your body heal from slow-healing soft tissue injuries by breaking down abnormal scar tissue and stimulating regeneration of newer tissue.

Is Blue Light Good for Your Skin, like Reducing Acne and Wrinkles?

by Pain Doc | May 6, 2023 | Aesthetics, Blue Light therapy

Blue light is a type of electromagnetic radiation with a wavelength of approximately 400-490 nanometers (nm, one billionth of a meter) on the visible light spectrum. It is used in various applications, including medical treatments and disinfection procedures. Recent studies have shown that blue light in the 460-470nm range can be an effective tool in killing bacteria.

Light is he visible portion of the electromagnetic spectrum.

There are about 30,000 known species of bacteria. Some are pathogenic (cause disease) while some are “friendly” and play an important role in microbiomes such as in the gut and on the skin. For example, Lactobacillus and Bifidobacteria and Bacteroides thetaiotaomicron help you digest food in the gut, and on the skin S. epidermidis helps protect the skin from water loss and damage. The presence of these friendly bacterial strains helps guard against colonization of harmful bacteria like E. coli in the gut and Staph aureus on the skin.

As we know, bacteria are abundant everywhere, especially where there are high concentrations of humans: hospitals, clinics, schools, offices and homes. And obviously, anything that is meant to be touched (handles, doorknobs, keyboards, childrens toys, etc.) has a much higher bacterial count.

The spread of bacteria can be controlled by using antibiotics and disinfectants. However, the overuse of antibiotics has led to the development of antibiotic-resistant strains of bacteria, making it more challenging to treat infections. In addition, some disinfectants are harmful to humans and the environment. Fortunately, there are other means to fight harmful bacteria.

Blue light therapy has emerged as an alternative to traditional methods of bacterial control. Research has shown that blue light in the 470nm range can effectively kill bacteria, including some antibiotic-resistant strains, without causing harm to human cells or the environment.

How does blue light kill bacteria?

Blue light at a wavelength of 470nm has been found to be effective in killing bacteria due to its ability to penetrate the bacterial cell membrane and cause damage to the bacterial DNA. Bacteria contain a molecule called porphyrin, which is sensitive to light. When blue light at a wavelength of 470nm is applied to the bacteria, the porphyrin molecule (the photosensitizer in the image below) absorbs the light energy and produces reactive oxygen species (ROS).

ROS are highly reactive molecules that can cause damage to bacterial DNA, proteins, and cell membranes. ROS can also interfere with bacterial metabolism, leading to the destruction of the bacterial cell. The production of ROS by the porphyrin molecule in response to blue light is known as photodynamic inactivation (PDI).

from Antimicrobial Blue Light versus Pathogenic Bacteria: Mechanism, Application in the Food Industry, Hurdle Technologies and Potential Resistance. Joshua Hadi, Shuyan Wu, and Gale Brightwell. Foods. 2020 Dec; 9(12): 1895.

PDI using blue light at 470nm has been shown to be effective in killing a wide range of bacteria, including Staphylococcus aureus, Escherichia coli (E.coli), and Pseudomonas aeruginosa. In addition, studies have shown that blue light at this wavelength can kill some antibiotic-resistant strains of bacteria, such as methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE).

Applications of blue light therapy for bacterial control

Blue light therapy has a wide range of applications for bacterial control. It can be used in hospitals and clinics to disinfect surfaces, medical equipment, and patient rooms. Blue light therapy can also be used in the food industry to disinfect food products and equipment.

In dentistry, blue light therapy has been used to kill bacteria associated with dental caries and periodontal disease. It has also been shown to be effective in reducing the bacterial load in root canals.

Blue light therapy has also been used in the treatment of acne. Acne is a skin condition that is caused by the overgrowth of Propionibacterium acnes, a type of bacteria that is found on the skin. Blue light therapy at a wavelength of 470nm has been shown to be effective in killing P. acnes bacteria, reducing inflammation, and improving acne symptoms. Cellulitis, impetigo, and folliculitis are other skin conditions involving pathogenic bacteria that can also be treated with blue light.

Blue light therapy has been used to treat infected wounds. Infected wounds can be difficult to treat, and antibiotic-resistant strains of bacteria can make the treatment even more challenging. Blue light therapy has been shown to be effective in reducing the bacterial load in infected wounds, promoting wound healing, and reducing the need for antibiotics. If you have an open wound, it would probably best to use a combination of a topical antiseptic and blue light. Apply the blue light directly over the wound for 10 minutes, 3x/day for four days, as a guideline. If your injury involved contact with something dirty/unsanitary, then a course of antibiotics would be prudent, as well.

Advantages of blue light therapy for bacterial control

One of the main advantages of blue light therapy for bacterial control is that it is a non-invasive and non-toxic method of disinfection. Unlike traditional disinfectants, blue light therapy does not produce harmful by-products or residues. It is also safe for use around humans.

Now that it is becoming known that blue light can potentially improve acne-causing bacteria, we are starting to see it in consumer health products. There are handheld devices that emit blue light, along with therapeutic red and infrared light. These devices are great for small areas, as they focus the light intensely, bathing the pathological bacteria with the blue wavelength and causing those reactive oxygen species to damage them and kill them.

5 LED handheld device using blue light to treat ear infection

Using blue light to treat middle ear infection.

There are also LED wraps that emit blue light that can be used for treating facial acne and other dermatological conditions related to harmful bacteria.

Using a 200 LED wrap for blue light treatment

Using an LED wrap for blue light therapy to treat facial acne

Blue light can improve acne and red blemishes due to staph infection

According to Cedars-Sinai, large, painful bumps that look like acne can sometimes be caused by Staphylococcus aureus, which lives on our skin, in our noses, and on surfaces everywhere. Inflamed/ reddish skin blemishes are a sign of staph infection and should be treated before they have a chance to spread.

The LED wrap shown above emits blue light, which can be used for treating acne and staph-related skin blemishes. It can also emit red light, which happens to have the opposite effect. It stimulates collagen and elastin production and reduces fine wrinkles, and basically increases cell energy and metabolism.

In the video below, I go into more detail on the therapeutic benefits of blue light.