Laser acupuncture – to be or not to be?

By Jan Tunér

A comment on: Hu WL, Chang CH, Hung YC, Tseng YJ, Hung IL, Hsu SF. Laser acupuncture therapy in patients with treatment-resistant temporomandibular disorders. PLoS One. 2014 Oct 17;9(10):e110528.

Is acupuncture really working? There is still a controversy around this medical treatment. Some believe that it is just placebo, others believe in it but doubt the traditional explanations of the mechanisms. Then, what about laser acupuncture? Could dry needling (pain) produce the same effects as gentle low level laser light? Seems unlikely? We have previously touched upon this controversy (http://www.laserannals.com/2015/06/02/laser-acupuncture-works-but-how/) and our conclusion is that there is some evidence after all.

Advances have been seen with “laser needles” with different wavelengths and multi-wavelength options. New studies have been published, but the quality is varying. A prerequisite that has to be fulfilled in a laser acupuncture study is that only acu points are irradiated. In traditional acupuncture there are “ashi points” that are treated. These are very similar to what is called trigger points or tender points in Western medicine. All are located by manual palpation. In the study by Hu et al., three acu points and 2-4 ashi points were irradiated, all but one (Hegu, LI4) were in the area of the masticatory muscles. So in fact, laser acupuncture and traditional LLLT for TMD was used. Let us look at the laser parameters:


The laser was a 810 nm 150 mW laser, “chopped” at 50%, so actually 75 mW. Reason for chopping is not presented.

Two acu points were in the TMD area: ST7 = condyle, ST6 = mandibular corner = muscle masseter.

5 s per acu point = 0.375 J. Two points in the TMD area = 0.750 J.

40 s per ashi/tender point = 3 J. For two points 6 J, for four points 12 J. Maximum total 12.750 J.


Several studies on TMD and LLLT have used energy ranges between 3 and 6 J per point, or even less, and targeting tender points. Therefore, this study is a traditional LLLT study and the contribution of the acu points cannot be evaluated. Future studies should not mix local LLLT with laser acupuncture.