Engineering Strategies Applied to Relieving Chronic Pain and Impaired Functioning
Keywords: allostasis, allostatic loading, homeostasis, nostos, nostostasis, nostostatic, R2N, Huntington's Disease, C5/C6 quadriplegia
The task is not so much to see what no one has yet seen; but to think what nobody has yet thought, about that which everybody sees. – Erwin Schrödinger
Allangardiner.com is under construction, slightly repetitive, and formatted for computer screen
This site shares a few insights from an engineer's perspective. My life story centers on the mantra: "if you cannot measure it, you cannot improve it."
My first startup, Kensington Laboratories (1972), created tools at the heart of quality improvement systems in industries that gave you hard disc drives and kept the computer revolution moving along Moore's Law. Objective measures were in nanometers and nanoseconds. I successfully exited in 1998. Later, my ex-partners exited for $320M.
My friends were right when telling me that my early "retirement" and flying charters as a commercial pilot would not be satisfying for very long.
Free to look for a next chapter, I was appalled by the hopelessness of my friends and neighbors from experiencing unrelenting chronic pain and residual impairments from strokes and spinal cord injuries despite the "best" care available.
Estimates suggest that 20 million Americans endure high-impact chronic pain. Could engineering strategies from other industries solve these challenging medical problem?
Allan Gardiner
University of California - BS Mech. Eng. 1970
Professional Engineer, California M15780
U.S. Commercial Pilot, Type Rating CE-500
In 1999, a light came on. Literally. I was exposed to photobiomodulation therapy (PBM) and its ability to relieve chronic pain. I asked the clinician, Constance Haber, how she chose the wavelength to use. She replied, it's the only one I've got. That brief conversation inspired our invention of variable-wavelength therapy. Our invention addresses fundamental limitations to fixed wavelength therapies: A. The wavelength or multiple wavelengths needed by the body are unknown. B. The needed wavelengths likely change as healing resumes or accelerates. In 2000, I formed a team that became my second startup, PhotoMed Technologies, to develop the variable-wavelength therapy. The aim was to find solutions to unrelenting treatment-resistant chronic pain. Outcomes from the therapy were beyond everyone's imaginations. Real-time recordings using thermal imaging and surface electromyography (SEMG) connected the settings and timing of the therapy with responses and outcomes. However, I was skeptical when our medical advisors were puzzled and had found no studies to cite for the observed phenomena. How might years of high-impact chronic pain and coldness from complex regional pain syndrome (CRPS or RSD) simply vanish? The varying wavelengths appeared more complex to study than for a discrete wavelengths. However, the varying wavelengths are like how visible rays of sunlight filtering through a forest in a breeze pleasantly dance on your skin. DOCUMENTING UNPREDICTED EVENTS The team applied engineering strategies as they created sophisticated recording systems to document the unpredicted events in real time. Like how nature videos show ordinary events from new perspectives, the real-time recordings show healing as it switches back on. The responses and outcomes turn out to be ordinary. It is the years of delay and low expectations that make resumed functioning feel special. It's the same for when sensations turn on again, the feeling coldness thaws, and for when one's range of motion returns back to normal. Of course, the body heals itself rather than being forced to do something that it would not have done on its own. Millions of anecdotes from myriad non-invasive therapies tell that story. PhotoMed's real-time recordings let everyone watch like with the man's hands warming after 30 years of dysregulation. Could his experience of coldness have gotten stuck and the temperatures were a result? In 2024, the answer appears to be that the homeostatic set point had changed over time such that homeostasis active maintained his abnormal experience of coldness. I have been honored to work with hundreds of volunteers having no path forward. They often shared detailed stories about their lives left behind. About the grip of pain that narrowed their focus until nothing else seemed to exist. And added details of the torment of losing jobs, friends, and family. But it was their outcomes and gratitude that inspired me to invest 25 years of my life and $20M to solve challenging life limiting problems. The trek helped to develop the variable-wavelength therapy. The insights apply to many non-invasive therapies. They are not specific to any intervention or therapy. For example, I would not have invented variable-wavelength therapy if I had not seen cold limbs warm in response to then called infrared therapy. ​Six U.S. Patents have been issued for the variable-wavelength therapy methods.
I want to thank the volunteers who helped the team develop PhotoMed's variable-wavelength therapy and methods. Most volunteers arrived with chronic pain and impairments having no path forward. I also want to thank the many people who contributed to and challenged ideas: especially Constance Haber, Catherine Willner MD, William Conard MD, and Robert E. Florin MD.
Improving the quality of life
By Allan Gardiner
The team investigated how the therapy might be used to improve lives for maladies other than treatment-resistant chronic pain. The basic therapy aims to help the body recognize errors and return to normal functioning.
Thomas is a college baseball pitcher who has used the therapy to keep in top condition by addressing his injuries right away. He has provided input on developing the therapy for sports injuries.
Thomas guides his interactive therapy by telling me where he perceives a limit to his moving fluidly.
Each session addresses the problems that might limit his next game. A year ago, he broke a key finger and thought the his game was over. The variable-wavelength therapy accelerated healing.
Sports and fresh injuries
Figure 1 Thomas is a college pitcher with an ongoing need for therapy to recover quickly and remain in top condition.
The interactive methods are easy to learn and apply. The therapy prompts the body to resume its ordinary healing tasks.
My primary focus has been on helping people who have no path forward.
I have been inspired by the hundreds of people for whom the therapy has improved their quality of life. Most received only a few sessions of therapy to get back on the road. I shared in their moments of elation and amazement as their sensations and coordinated movements came back online.
Their outcomes improved the quality of my life, too. Perhaps consider joining me in restoring lives.
Improving lives of families
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"Beth" and Mark are among the most impactful people who show that ongoing therapy can overcome big challenges. But just getting to the clinic was a family challenge I am inviting you to help solve by lending devices to the family to use at home. More on that later.
Beth's C5/C6 quadriplegia resulted from a tragic auto accident. Beth's mom shares how her life changed as she cared for Beth as they accomplished her tasks of daily living. I learned how challenging just getting to the clinic was each week. Lending devices with individualized training frees up the travel time to use for the therapy at home.
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During a year of the new therapy, Beth returned to physical rehabilitation to rebuild her strength enough to manage her manual wheelchair. She went on to school and to live independently.
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Mark's loss of coordination from Huntington's disease limited his activities of daily life. Nothing that we take for granted was easy for Mark. He lived in a nursing home which made it impossible for Mark to be the father that he wanted to be.
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During his first two years of the new therapy, Mark's Huntington's-disease-eroded coordination improved sufficiently for him to move out of a nursing home to live independently. Mark's speech improved enough to get custody of his kids back. He became the father that he had hoped to be.
Figure 2 Beth arrived having post-plateau C5/C6 quadriplegia from an auto accident. The therapy restarted her improvements which allowed her to get back into rehabilitation. Beth transitioned to manual chair in a year.
Mark had impaired coordination from Huntington's disease that forced him to live in a nursing home. The therapy helped him improve his speech and coordination sufficiently to live independently again and to regain custody of his kids. To become the father he had hoped to be.
Figure 3 Clips from interviews with Beth. (4:09)
Figure 4 Clips from the first anniversary meeting and an interview with Mark telling about getting custody of his kids back. (1:40)
Sadly, the therapy is not widely available. About 40,000 people have C5/C6 spinal cord injuries and about 7,000 people have coordination issues associated with Huntington's disease that might be improved. Their families are waiting, too.
My passion remains high with reports of how the therapy restores quality of lives on a daily basis.
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I am working with the L.C. and Lillie Cox Haven of Hope (a non-profit organization) to implement their project (PhotoMed Project.) We lend therapy devices to families having members who might benefit from the therapy. We are starting with people having challenges like Beth and Mark. https://www.allangardiner.com/lending-project
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Please share my contact information with families in the San Francisco Bay Area who might wish to try the therapy. Of course, funding must come from gifts, donations, and grants.
Want to get involved?
Contact me.​​
You can learn more about the therapy and device at https://www.photomedtech.com/
Real-time recordings change how medical science is done
From the beginning of PhotoMed Technologies's feasibility studies 25 years ago, the responses and outcomes to the therapy appear to be, and remain, "unimaginable" from conventional perspectives.
Today, we have a wellness perspective that includes the return to normal functioning that is delayed rather than being unimaginable.
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Do not most practitioners of non-invasive therapies aim (or hope) to hear their patients report "I feel normal again"?
But, I felt isolated until I recognized that likely millions of "I feel normal again" anecdotes from hundreds of seeming unrelated non-invasive therapies have been dismissed.
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My team and I tested ideas using real-time recorded data. We were astonished to recognize that the responses and outcomes are indistinguishable from the same events during the "acute" phase. That is, the cognitive dissonance arises from knowing "before" story, delay, and failed interventions.
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Curiously, the "evidence" is the strongest on the planet (but ignored) when the person no longer needs therapy for their previously unresponsive malady.
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Real-time recordings increase in value by helping answer new questions. Without the recordings, my team and I could not have named a fundamental principle of biology. The principle lies in plain sight every time someone recovers functioning after a period of a not-healing state. See the Schrödinger quote above.
Start by documenting the conclusion of autonomic dysregulation
The team created sophisticated real-time recording systems to document events that appeared to have no precedent.
However, co-inventor Constance Haber had been prompting the return to normal functioning using infrared lasers and LEDs that took her hours of clinic time to prompt the desired event.
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Haber and my inventions were about efficiency and effectiveness rather than our needing to overcome impossibilities.
The efficiency opened the practicality of making uninterrupted recordings of events during a session, typically during the first or second session.
Figure 5 Thermal imaging of hands warming that marks the conclusion of the person's complex regional pain syndrome (CRPS or RSD). The person's hands released an unrelenting sensation like the burning of "holding ice." The warming trend marks the release of all four "Budapest Criteria" for CRPS.
However, it is the unrelenting sensations that appear to be "stuck" because normal temperature sensations are transient and fade within a few minutes. Other examples show that an unrelenting painful sensation of coldness is not related to the actual skin temperature.
The real-time recordings like this one helped to make the therapy more efficient and effective by linking therapy settings (#1, #2, and #3 in Figure 5) with the thermal imaging data. Watch as warming resumes shortly after #3.
Later, thermal imaging showed the team that the warming can begin within a few heartbeats of the first application of the therapy.
The aim is to vary the settings until noticing a monitored physiological response that usually marks the return of normal functioning or ordinary healing such as with wounds.
I was skeptical that a few photons could prompt the body to restore normal responsive skin temperature regulation so quickly. However, I recalled my experiences at a ski lift where my face received a few seconds of infrared from a heater as we approached the chair. Seemingly within seconds, my whole body felt a sense of warming.
Figure 6 Real-time recording of thermal imaging of hands warming that marks the conclusion of the person's complex regional pain syndrome (CRPS or RSD). The time is accelerated.
Documenting the return of ordinary sensations, movement, and resolution of pain
The real-time recording systems evolved as volunteers arrived with their individual collections of maladies. The recordings show how independently the responses can be related or disconnected.
Skin temperature regulation
For example, multiple signs of complex regional pain syndrome (CRPS or RSD) and Raynaud's syndrome appear to vanish at the instant warming begins end the experience like the burning of holding ice. Catherine Willner M.D., a neurologist, observed a pupillary response to know when she could end the therapy. The response typically occurred within 30 to 55 seconds of starting the therapy. See Figures 5 and 6.
Skin's touch sensations
An instructive example shows the return of sensations in feet after 8 years but his touch-maps were misaligned with his anatomy. Watch as the man gasps at the instant his touch-maps realign upon observing where he was being touched. Figure 7 and 8.
Figure 7 "George" arrived without sensations in his feet after 40 years of diabetes. His sensations resumed during his second session but were misaligned (left panel). He felt a touch at his right arch in his left outer heel.) His sensations realigned when he observed where he was being touched (right panel).
The real-time recordings let the team investigate different possible mechanisms for the resumed awareness of touch and its misalignment. The misalignment appears in many recordings of reawakened sensations of touch but in most cases a cross-sensory observation prompted realignment before we could perform testing.
Thank you, George, for complying with my request to not move or look at your feet until requested by me.
Figure 8 Watch as George experiences sensations that had been unimaginable by him only a few minutes before. I am the voice behind the camera.
Real-time recordings of events such as experienced by George often show two components. The first (awakening) is prompted by the therapy in a nostostatic event and the second (map realignment) via an ordinary cross-sensory observation.
The team and I mused over many recordings to tease out a common factor: we found that it is the delay that is special rather than the recovery.
The set of real-time recordings is likely the world's only collection showing that the return to normal functioning and "I feel normal again" are not distinguishable from the same events during the acute phase. That is, knowing the delay, "before" state, and failed interventions makes the responses and outcomes feel like magic.
We wondered, why a delayed return to normal functioning should cause the apparent cognitive dissonance by the person, their family, and doctors?
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Could the dismissal of millions of anecdotes reflect that there isn't a medical term for an abrupt return to normal functioning event or outcome?
Naming a fundamental principle of biology
I spent $18 million and 25 years to create a single word.
My problem came from asking, what is common among all the crazy-fast return to normal events?
Not having this word has blinded the world to the possibility of ending “chronic” pain with the important new technologies that my team and I invented. Thinking about a full return to normal has been prevented by the word, “chronic” because we can’t think about, comprehend, or be open to anything for which we don’t have a word.
My advisor Parker Lapp and I solved the missing term problem by inventing the term nostostasis from the Greek root nostos that refers to a homecoming after an epic journey.
Nostostasis names a fundamental principle in biology: a change-of-state from a not-healing state back to normal healing.
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Like with gravity, fundamental principles are easy to spot once you know to look for it.​
There are medical and research terms for "getting worse." Nostostasis provides a logical step for "getting better" from a not-healing state. Terms such as "new normal," unrelenting, and treatment-resistant do not imply a logical endpoint. We replaced "chronic" with "delayed healing" to introduce an anticipated logical endpoint.
Figure 9 "Chronic" has no logical endpoint. "Delayed healing" provides a logical path an endpoint that marks a change-of-state from a not-healing state back to a normal healing state.
The ability to return to normal functioning after an upset is the essence of life.
The team and I investigated our real-time recordings to find that the not-healing state ends with a nostostatic event. Of course, the normal-healing state does not imply an instant recovery to fully normal functioning. Many nostostatic events can sequentially improve functioning despite continuing erosion via a progressive disorder such as Huntington's disease.
Building models about nostostasis and nostostatic events
Engineers are comfortable with change-of-state phenomena such as THIS/THAT and IF/THEN.
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You may be familiar with "states" from adjusting your air conditioning set point temperature. The set point is an instruction to the system to adjust the room temperature and stop when the temperature matches the set point.
Then automation, like homeostasis, maintains the set point temperature if possible.
In an air conditions example, a "new normal" set point could be uncomfortably cool such as 63 degrees in Figure 10.
A "new normal" or "not-healing" state persists and actively resists changes by heating or cooling when air impinges from outside the environment.
A nostostatic event is like someone adjusting the set point back to its "normal" setting. Then the air condition system returns the room environment back to normal.
Figure 10 An air conditioning thermostat models homeostasis about a set point. A change in set point is like a nostostatic event with the system adjusting temperatures to acquire and maintain the new set point.
A very brief history of homeostasis, allostasis, and nostostasis
In 1849, Claude Bernard introduced the concept of stabilizing the internal environment as crucial for life.
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In 1926, Walter Cannon expanded Bernard's ideas and coined homeostasis to describe the body's ability to maintain the status quo.
In the 1970s, Peter Sterling and Joseph Eyer began studying the effects of chronic stress on human physiology that could not be explained by homeostasis alone.
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In 1988, Sterling and Eyer introduced the concept of allostasis that accounts for how stress can prompt maladaptive homeostatic states that maintain pain and impaired functioning.
The concepts of allostasis shifting homeostatic set points support common notions of a "new normal" homeostatic set point and associated status quo.
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The "new normal" accounts for the stability of the status quo that maintains pain, impaired functioning, and associated experiences such as PTSD. The stability is achieved by resisting interventions and therapies.
In 2019, the stability of the "new normal" state led to the International Association for the Study of Pain (IASP) defining some types of chronic pain as a disease itself in the ICD-11.​
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In 2025, we introduce nostostasis to fill a language void to open new fields of thinking, research, and clinical care.
What are some characteristics of fundamental principles?
As a fundamental principle, nostostasis provides a name for thinking about and researching ordinary phenomena that result in an abrupt release of maladies.
A nostostatic event occurs as a change-of-state from a "not-healing" state to the "normal-healing" state. The principle describes the same event at scales from sub-cellular to whole humans.
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​Fundamental principles can be tested and demonstrated, like with gravity, without understanding details about how the principle works.
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Nostostasis and the nostostatic event are not specific to any intervention, therapy, or malady. The cycle may need to be repeated to advance a healing process.
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We hope that future researchers can begin investigating properties of living things from this fundamental perspective.
Figure 11 A comparison of the effects of gravity and delayed healing at the instant when nostostasis occurs to restart healing.
Summarizing thoughts
I recognize that introducing nostostasis may cause a bit of cognitive dissonance.
I suggest replacing notions about chronic meaning forever with "delayed healing" to remove the blockage of expectations about possible healing.
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​Note that nostostasis names a change in state rather than being a tangible "thing" that can be quantified.
Figure 12 I talk about the introduction of "nostostasis" as a fundamental principle of biology. At the time of the recording in January 2025, I was testing the term "baseline healing" that I now call a "normal-healing" state. (3:16)
​In 2000, the team and I saw our first nostostatic events. The outcomes were deemed to be unbelievable by the conventional medical community. I was sufficiently skeptical that the team created the first real-time recording systems that would allow us to ask new questions of the crazy-fast responses and return to normal outcomes.
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A term coined by engineer's for a fundamental principle of biology might ruffle a few feathers, but the bird is now out of its cage.
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I welcome questions, comments, challenges, and suggestions.
Allan Gardiner
March 12, 2025
Disclaimer: The information and insights on this website are not to be considered as recommendations or medical advice. PhotoMed's variable-wavelength therapy and other non-invasive therapies are presented to support a broader understanding of wellness therapies. PhotoMed's Varichrome Pro is not intended to diagnose or treat any disease or disorder.