On most weekends, you’ll find Steven Shapiro paddling whitewater on a river somewhere in the United States. Nothing would keep the Arlington Heights resident away from his passion, not even the near-constant pain from tendinitis that used to plague his right elbow. He tried ultrasound, cortisone shots and even had a device made so he could keep paddling. Nothing worked.
“I was finally at a point where I could barely lift my arm,” Shapiro says. “It felt like I had a hot poker in there.”
Just as the condition became unbearable, Shapiro found what he calls the “magic” that took away the pain. The magician was Lloyd Fielder, a Schaumburg chiropractor who wielded a wand called the Microlight 830, a portable, low-energy laser that is said to augment natural healing in the body’s soft tissues.
The treatment Shapiro underwent is part of a clinical research study to determine the effectiveness of low-level infrared laser energy in the treatment of pain, muscle/joint injuries and soft-tissue injuries. Fielder is one of a handful of medical professionals in the Chicago area participating in the study administered by Texas-based Lasermedics Inc., according to Joyce Heinrich, director of regulatory affairs for the company.
Prior to opening his own practice in May 1996, Fielder gained experience with the laser while working with George Michalopoulos, a chiropractor from Addison who was one of the first medical professionals to sign on with the research study.
“I knew I wanted to use the laser in my own practice when I saw a patient come into Dr. Michalopoulos’ office, have the treatments, then cancel the surgery (for carpal tunnel syndrome) four days before it was scheduled,” says Fielder, a Schaumburg resident.
Research data he had read on the success of the cold laser, in particular one study involving treatment of assembly-line workers at General Motors who were afflicted with carpal tunnel syndrome, convinced Fielder that the device was a viable, non-invasive alternative to treatments such as surgery, which he notes carries a less than 50 percent success rate.
The device, called a cold laser because it does not use heat like typical lasers, looks like a thin, fancy flashlight and also is used to treat other conditions such as tendinitis, joint pain and rheumatoid arthritis.
A typical course of treatment is three times a week over a five- to six-week period. Sessions take approximately 10 minutes as the laser is trained on the affected area.
“Sometimes patients will get a slight tingling during treatment,” he says. “But all it is is light that penetrates the skin.”
Fielder says the laser works because the light is absorbed by the treated cells’ photoreceptors. The absorbed light, in turn, augments the body’s own natural healing process.
“In a repetitive injury, you have a breakdown process and a healing process,” he says. “The laser puts the healing process a notch ahead of the breakdown process.”
Since it is a relatively new procedure, the cold laser is little known in the medical world.
Even though the laser has been approved in Europe and Canada, it is still considered experimental in the United States by the Food and Drug Administration. To be part of the clinical investigation, Fielder had to submit an application to Lasermedics, which owns the device’s American rights.
“(Lasermedics) needed a review of clinical practices that would show us that (medical professionals) have some experience dealing with soft-tissue trauma or repetitive stress injury. We knew that few people would have actual experience with low-level therapeutic lasers,” Heinrich says. “We wanted to make sure they know how to deal with that type of patient.”
Each medical professional is limited to treating 250 patients with the laser. Heinrich says the study began during the third quarter of 1995 and is expected to be finished within a year. The actual end, however, is dependent on when investigators finish treating their allotted number of patients.
Once this information is collected, Lasermedics will turn it over to an independent review board for analysis, with the results going to the FDA for clearance to market.
Michalopoulos, was the first chiropractor in Illinois to use the laser beginning in June 1995. “It (the laser) seems like a great adjunct to other therapies for our patients,” he says.
Michalopoulos says that he believes the laser is not as effective on post-surgical patients. “The great thing about the laser is that if (the patient) is not seeing at least 50 percent improvement in the first 14 to 21 days, they’ve really lost nothing, except for a few weeks of therapy,” he says.
Patients who undergo the cold-laser therapy must sign a consent agreement that advises them not to change current medications and says they can expect a course of 5 to 15 treatments. Fielder also administers a chiropractic exam to potential patients as well as a battery of diagnostic tests. The tests determine whether he can help patients through cold-laser therapy or whether they need to be referred to other medical professionals such as neurologists.
To determine whether a patient’s pain is caused by carpal tunnel syndrome, which is a compression of the median nerve in the wrist caused by swelling of tendons surrounding it, Fielder runs approximately six tests, including grip strength.
“A lot of times there are other things that can mimic carpal tunnel syndrome, and it’s not just a musculoskeletal problem but a system problem like diabetes,” he says. “It could be a hypothyroidism, it could even be pregnancy.”
Fielder says patients usually start seeing results after about five treatments. At that point, Fielder runs additional tests, an important step because initial diagnoses sometimes may not be correct. He points to the case of a woman who came to him for treatment of carpal tunnel syndrome but ultimately received a much more serious diagnosis.
“She was getting better (after treatments had begun) but not in the right kind of way,” he says. “I referred her to a neurologist who took an MRI. It turned out to be multiple sclerosis.”
The seesawing between breakdown and healing often fools people into believing their pain will go away. It’s also one reason some wait several years before seeking treatment. Such was the case with Carol Stream resident Frank Monachino. He was afflicted with numbness and shooting pains for three to four years, caused by years of working on a computer keyboard. The deciding factor came when he bought a motorcycle.
“My hands were going numb when I gripped the handlebars, and that’s not a good thing when you’re going 50 miles per hour,” Monachino says.
After a half-dozen treatments with Fielder, Monachino noticed improvement. Now he says his pain is “almost nonexistent,” although he sometimes endures a tingling sensation if he places his hands in an odd position.
Monachino’s wife, Joan, also suffered from carpal tunnel syndrome. After seeing her husband’s condition improve, she took the treatments too.
“(The pain) kind of went in cycles,” she says. “At night I would wake up. It got to be like a really bad toothache feeling.”
Joan Monachino also has arthritis in her hands, so the combined condition was particularly disabling. Not only would her fingers swell, but she had difficulty picking up objects. She says the laser eased her arthritis as well as her carpal tunnel syndrome. The only symptom she now experiences is occasional tingling in her hands while gardening.
As for canoeist Shapiro, he no longer lives on what he used to call “Vitamin I,” or ibuprofen. “I’m about 98 percent cured,” he says.
Yet he remains realistic about the occasional twinges he feels in his elbow. “After all, you don’t live your life in a vacuum,” Shapiro says. “I still have to use my arm every day.”
