Question
Hi Dr. Durnin,

Thanks again for answering my questions before, offline. Your help and advice gives a lot of promise of true recovery from osteoarthritis.

Quick follow-up question...what do you think about using "cold" laser therapy, instead of therapeutic ultrasound, as a catalyst to get blood flowing to avascular tissue like cartilage? I have a choice of either, and I've heard great things about "cold" laser, but if your treatment for OA only works with ultrasound, then I'd like to follow what works.

Tom

Answer
Hi Tom,

Therapeutic US is more established with solid proven efficacy, cold laser is also proven. Reasons to chose cold laser over ultrasound would be metal implants. Ultrasound is contraindicated over metal, cold laser is not. If this isn't an issue, I would go with ultrasound. US also takes no longer than 5 minutes, cold laser is 3x that long. make sure the proper parameters are inputed in the ultrasound unit before treatment. Superficial setting is 3HZ, deep is 1HZ. Power varies from .75 watts/cm2 through 2.0watts/cm2. The more power, the more it will effect blood supply. Obviously you wouldn't want 2 watts over the wrist, but you don't want low power over an inch of tissue either. Become familiar with US before getting it, that way you will ensure proper treatment settings.

Good Luck!

Dr. Timothy Durnin