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Therapeutic Effects of Laser Therapy

Reported effects of laser on the tissues involve a photochemical reaction in the cells causing:

  •  Increase in cell metabolism. Laser increases the level of ATP (adenosine triphosphate), which is a chemical within the cells known as the “energy transporter”. It is postulated that energy from the low intensity laser is collected in the mitochondria of the cell, which then increases the amount of ATP. Higher levels of ATP activity can increase cell activity, thereby promoting healing.
  •  Increase in macrophage activity. Macrophages re white blood cells whose role is to engulf and then digest cellular debris to stimulate lymphocytes and other immune cells.
  •  Stimulation of fibroblast activity. A fibroblast is a type of cell that builds collagen and the extracellular matrix, which is the structure for tissues and also plays a critical role in tissue healing.

Low Intensity Laser Therapy (LILT) is an emerging therapeutic modality that is used to help with tissue and injury healing.  Albert Einstein first speculated on the effects of laser light but it was not until the 1960’s when Theodore Maiman developed the instruments for therapeutic application.

LASER by definition is Light Amplification by Stimulated Emission of Radiation. Laser light is monochromatic light generated by a low intensity laser diode and is considered to be coherent and directional. This means that the light does not disperse as normal light does (flashlight compared to laser pen) and maintains one direction (it does not bend).

Specific frequencies of light in the red and near infra-red levels were found to change different properties of cells, tissues and chemicals in the body. High intensity lasers known as "hot" lasers are effective in heating and destroying tissue. These lasers are used clinically to make incisions and cauterize during surgeries. They are also used to cut out tissues in place of other cutting tools. Low intensity lasers are known as "cold" lasers and do not cause damage to tissues. Instead they are considered to be healing or rehabilitative in use. Intensity ranges between 0.05 and 1.0 Joules/cm2 have been found to be effective in acute injuries. Higher doses up to 40 Joules/ cm2 are more effective in chronic conditions.

LILT treatment is done via an applicator directly on the skin. The light penetrates the skin and is absorbed by the tissues. The depth of the light application is determined by the amount of time the light is used.

LILT is considered to be non-invasive, nontoxic, easily applied and highly effective. The main safety precaution is to wear protective goggles during treatment as the laser beam can cause retinal damage. When reviewing the research on the benefits of laser, there are mixed results and conflicting findings.  Some studies do show improvements and others show no improvement or an increase in symptoms. More studies are needed and are continuing to be done in this area to know the true effects and effectiveness of laser.

Despite the controversy, there have been some positive studies on the effectiveness of LILT on pain, rheumatoid arthritis, post traumatic joint injuries, myofascial pain conditions, TMJ, and osteoarthritis.

Clinical Observation:

I have been using a laser device for treatment in my clinic since January 2009 and from a clinical perspective I have found it to be very effective in many but not all clients. Most people report an immediate improvement in pain, range of motion and muscle tension.

What you might feel or see may include:

  • Decreased pain
  • Decreased swellingIncreased circulation
  • Decreased inflammation Improved speed of recovery
  • Decreased use of prescription medication

 

Personal Observation:

From a personal perspective, I have had chronic neck pain for many years with ongoing pain and stiffness.  When the laser was applied to my neck, I noticed an immediate and significant change in pain and movement. It does work for me.

 

Professional comment:

All modalities used by physiotherapists including heat, ice, ultrasound, electricity and laser, are considered to be some of the tools we use to help clients to promote healing and recovery. But as with all treatment modalities,not everyone will have the same benefit as others may. There are many  variables to injuries and recovery rates.

Modalities are considered to be passive techniques and because of that there are limitations in lasting benefits. I believe that any modality used alone would not be very effective unless the client also uses an active approach including education, stretching exercises, strengthening exercises, posture correction and functional activities.

Our goal as physiotherapists is to promote healing and to return clients to function. We have many tools that can be used and LILT is just one of the many.

Robynne Smith is a physiotherapist at Off Broadway Physiotherapy and Dizziness Clinic. Phone 933-2619 or email saskbalance@sasktel.net

Article by Robynne Smith

From: www.theneighbourhoodexpress.com        Saskatoon        September 23, 2009        Section

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