Low Intensity Laser Therapy

What is Laser Therapy?

Laser therapy is the use of monochromatic light emission from a low intensity laser diode (250 milliwatts or less) or an array of high intensity Super Luminous Diodes (providing total optical power in the 1000-2000 milliwatt range) to treat musculoskeletal injuries, chronic and degenerative conditions and to heal wounds. The light source is placed in contact with the skin allowing the photon energy to penetrate tissue, where it interacts with various intracellular biomolecules resulting in the restoration of normal cell function and enhancement of the body’s healing processes. This brochure outlines the specific effects of Low Intensity Laser Therapy.

Physiological Effects of Low Intensity Laser Therapy

CLINICIAN info

Short Term Effects

• Production and release of beta-endorphins (these are morphine like substances produced by various cells in the body that inhibit the sensation of pain)
• Cortisol production is increased (cortisol is the precursor of cortisone). This enables the body to combat the stress associated with trauma or the disease process
• The short-term effect is significant in 5-10% of cases during or after the conclusion of the initial treatment, but is not as important as the long term or cumulative effect

Long Term or Cumulative Effect

• ATP (adenosine triphosphate) production is increased resulting in improved cellular metabolism
• DNA (desoxyribosenucleicacid) production, the protein building block of tissue is substantially increased
• Neurotransmission is facilitated due to elevated levels of serotonin and aceytylecholine
• Mitochondrial activity is stimulated resulting in cell replication etc.
• Modulation of macrophages, fibroblasts and other cells
• Angiogenesis (formation of new blood vessels)
• Regulates cell membrane potential, essential in NA, CL and K ion transfer (electrolyte balance)
• Cytokines and other chemicals enhancing cellular communications are released
• Other Effects
• The immune response is stimulated
• Lymphatic drainage is improved
• The histamine response is positively altered
• Production of growth hormone is increased
• Stimulation of the healing processes is accompanied by relief of symptoms
• It should be noted that many other positive physiological activities are modulated and extensive research is currently in progress to fully explore these changes.
• Medical Application of Low Intensity Laser Therapy

 

The medical application of low intensity lasers exists in a great number of medical fields. The musculo-skeletal problems most effectively treated are:

 

(i) General

• ·   repetitive stress injury
• ·  fibromyalgia
• · carpal tunnel syndrome
• ·  reflex sympathetic dystrophy
• ·  rotator cuff tear
• ·  tempero-mandibular joint problems
• (ii) Injuries
• ·  ligament and tendon tears
• ·  contusions
• ·  fractures with associated soft tissue injuries
• ·  facet syndrome
• ·  subluxations
• (iii) Inflammatory
• · tendonitis
• · bursitis
• · myositis
• · fascitis
• · synovitis
• · rheumatoid arthritis

(iv) Degenerative

• · osteoarthritis
• · discogenic and vertebrogenic 
• · radiculopathy
• · chondromalacia patella
• · calcifications (e.g. bone spurs)
• (v) Other Applications
• ·  wound healing
• ·  dermal ulcers:       1. venous stasis
• 2. atherosclerotic
• 3. Compression
• 4. Diabetic

PATIENT INFORMATION
 

• 1. In the rare instance that you experience an increase in pain subsequent to any treatment, utilize ice on the area of involvement and pain medications as required.
• 2. Notify clinic staff on your next visit that this has occurred. The existence of this phenomenon is due to a high sensitivity tissue response and protocols will be adjusted accordingly on your next visit.
• 3. Usually treatments are scheduled two/ three times per week or more frequently in acute cases, at least initially. Subsequent treatments are scheduled in accordance with the patient’s status.
• 4. The majority of patients will not notice any changes with regard to their symptoms until treatment sessions three or four. There are however exceptions to this rule. If any time you have questions regarding your progress, bring these to the attention of one of the doctors or the clinic staff.
• 5. With regard to the number of treatment sessions, these may vary from 1 to 30. Acute injuries generally respond more rapidly than chronic problems and each individual’s tissue response varies. It is important to be aware before treatment is initiated that the exact number of treatments cannot be predicted. In most cases we expect to see some change in symptomatology after 3-5 visits, however in a small percentage, a more prolonged period of treatment may be required. This is particularly true in longstanding back problems, frequently accompanied by spinal or foraminal stenosis.

• In these situations there is encroachment on the spinal cord or the nerve roots, as they exit the spinal canal. Almost without exception we are able to relieve those symptoms, however patience and time are often required. Do not forget that our objective is to minimize the length of treatment and the number of visits, however on occasion even our best efforts required multiple treatments, patience and time.
• 6. We recommend massage therapy, ETPS/acupuncture and chiropractic as a complementary therapy. In most instances when performed in the early phase of treatment, this process breaks down adhesions, increases muscle mobility and lymphatic and arterial circulation.
  It is considered a complimentary process to laser therapy and can speed up the healing process.
• References:

1. The Therapy for the 21st Centure- Available Now., F. Kahn, MD; Dynamic Chiropractic, March 10, 1997.

2. Lasers Heal: Chiropractors could benefit from this technology. D. Fitz-Ritson, F. Kahn, Dynamic Chiropractic, Nov. 8,1999.

3. The Biomedical effects of laser application.; Mester, E. Mester, A.F. Mester, A., Lasers Surg Med., 1985, 5: 31-39

Summary

Absorption as a result of photon bombardment of various bio-molecules in the cell results in the transformation of light into biochemical energy. This is a cumulative effect and requires sufficient stimulation in order to initiate response. Typically 5-20 treatments varying from 15-30 minutes in duration are required. The end result of low intensity laser irradiation is the restoration of normal function of the cell unit. Conversely, worldwide research to date has failed to record any negative effects from this process. It should be noted that normally functioning cells are not adversely affected by the irradiation. In contrast to other therapies, Low Intensity Laser Therapy is curative rather than simply modulating symptomatology. Continued research in the Meditech and other laboratories should further enhance the effectiveness of this existing technology. After treatment the patient may have an exacerbation of pain for a varying period of time. If this occurs, utilize pain medication, and/or ice and let the therapist know prior to the next treatment.