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†Nonprofit Organizadon, Sho-Yu-Kai Shiroto Icho-Gekka Hospital and ‡Shiroto Clinic, Goshogowara City, Aomori, Japan. ABSTRACT: Since 1984 my institutes have been studying the efficacy of low reactive-level laser therapy (LLLT) in pain attenuation using the 830 nm GaAlAs diode laser, and I have presented regular updates at various national and international congresses. We use the `Luketfon' system, researched and developed by the Japan Medical Laser Laboratory and Matsushita Electric Company, and currently marketed by Mochida Pharmaceutical Company. Laser energy at 60 mW, 830 nm in continuous or switched wave is easily delivered by a hand-held probe used in contact with the target tissue. Our average effective rates are always over 85%. Having studied LLLT data from other clinics and hospitals, however, we have found that the results from these clinics vary with some pain entities resistant to LLLT. 3 years ago we opened an annex to our main clinic about 30 minutes away by car, where we applied the same LLLT techniques for pain attenuation, but the overall efficacy rate a year ago was surprisingly poor, 75%. However, we reviewed and improved the therapists' attitude and level of enthusiasm, since we believed the problem lay there, and after a further year the overall efficacy rose to 89.7%. In the main hospital, due to the removal of a hospital ward, we have been able to construct a new laser therapy facility of some 32 tsubo (approximately 64 m2) . We have designed an open, spacious and warm environment, with a decor relying on natural wood and greenery, in which 6 laser therapists can work to a selection of appropriate BGM. In addition to laser therapy, another 3 types of pain attenuation system are employed, thus using patients' waiting time to the maximum efficiency. Preliminary findings indicate even better results in pain attenuation, showing that a good environment combined with the use of appropriate conventional methodologies can enhance the efficacy of LLLT.

AUTHOR'S EXTENDED EXPERIENCE IN GaAlAs DIODE LASER THERAPY (LLLT) FOR PAIN ATTENUATION