by David Longstaff D.O. Registered Osteopath

I have used Laser treatment for since 1988 with no side-effects

and considerable success, but it does vary like all treatments.

The Supraspinous Ligament origin is at the External Occipital Protuberance on the Occiput. From there it is part of the Ligamentum Nuchae, attached to the Tubercle of the Atlas and all the spinous processes of the Cervical Spine,the Dorsal Spine,the Lumbar Spine and from the L5 spinous process to the S1 spinous process of the Sacrum (Ligament of Widarol) and then onto the spinous processes (sacral crest) of the Sacrum. 

The superficial fibres travel 3-4 segments,the deepest to adjacent spinous processes.It is attached deep to the interspinous ligament.

Nerve supply is the Medial Branch of the Dorsal Ramus of the spinal nerve.

The Ligament of Widarol is put on full stretch on flexion (so it is used to prevent hyper flexion of the spine),but it can also be “nipped”on extension between the spinous process of L5 and the spinal process of S1 as they approximate.

When you palpate the interspinous space,where the Ligament of Widarol is, it feels like a bruise from the patient’s perspective if it is symptomatic.If the problem is localised then the segment above and below feels normal.

Although the L5-S1 segment is the most commonly affected ,sometimes it can be tender above and/or below,and occasionally most of the whole length of the Supraspinous ligament can be affected.

The Laser I use is an ASAH LASER 201.

Use protective glasses that these wavelengths cannot penetrate.

This is very safe equipment.There is no heat and the patient cannot feel anything, the only thing they can feel is afterwards when it is nearly always less tender or not tender at all.

The laser has a: 

1: Visible 1mw red light at 670nm wavelength, this is a tracker ,so you can see it.

2: Invisible 30mw (0.03 W )infra-red at 830nm wavelength laser, this is the one that is therapeutic and we use in the calculation.

I would normally use 4 bursts of 15 seconds, so not long, to the Ligament of Widarol , and that is enough.The longer you do it after this, the less effect you have, the so called Arndt-Schultz law, small doses stimulate , larger doses inhibit in some biological chemical reactions.

The tip of the probe needs to be firmly in touch with the skin at 90 degrees to the surface.

1.In approximately 5% of the patients the tenderness is removed completely and the patient on standing can flex/extend symptom free.

2. 90%of patients, are 20% less tender.

3. In 5% of patients ,there is no change, predominantly smokers ,diabetics and very long standing problems.

I have had a number of problems resolve in just a few seconds(extremely rewarding),so I know it can be therapeutic.

I found the 830nm wavelength seemed to be the most therapeutic and continuous wave the best.

There is a cascade of chemical changes in the tissue believed to include vasodilation ,so increasing blood flow and decreasing inflammation.It also provides energy to the mitochondrion (the cell power house) and improves cell membrane transfer.Sometimes the change is so quick (4 seconds the fastest ! ) that maybe some other mechanism is involved.

I have used the ligament of Widarol as an example, because it is the most common spot of tenderness along the whole length of the supraspinous ligament.

I believe that this ligament of Widarol is vastly under-rated as a cause of low back pain ,acute and chronic.

Laser is very safe and very easy to use,I believe it fits in well with the Osteopathic ethos.

Give it a go! 

David Longstaff

P.S Just some technical stuff.I always use a laser probe with the same diameter,so I am always applying the same amount of energy to the same size spot, 5 mm diameter.

Energy(Joules) 0.45J = Power(Watts) 0.03W xTime(Seconds)15s

So 2 bursts are 2 x 0.45J = 0.9 (Approx 1J )