LOW LEVEL LASER THERAPY OR "COLD LASER" IS THE APPLICATION OF RED AND NEAR INFRA-RED LIGHT OVER INJURIES OR LESIONS TO PROMOTE WOUND AND SOFT TISSUE HEALING, REDUCE "BAD" INFLAMMATION AND GIVE RELIEF OF BOTH ACUTE AND CHRONIC PAIN.

First developed in 1967, it is now commonly referred to as Low Level Laser Therapy (LLLT).  LLLT is used to:

- increase the speed, quality and tensile strength of tissue repair

- resolve inflammation and relieve pain (analgesia)

The red and near infrared light (600nm-1000nm) commonly used in LLLT can be produced by laser or high intensity LEDs. The intensity of LLLT lasers and LED's is not high like a surgical laser. There is no heating effect.

The effects of LLLT are photochemical (like photosynthesis in plants). When the correct intensity and treatment times are used, red and near infrared light reduces oxidative stress and increases ATP. This improves cell metabolism and reduce inflammation. These effects can be enhanced with pulses however when analgesia is required there is a second mechanism which works best when a strong continuous beam is applied.

HOW LOW LEVEL LASER THERAPY WORKS

Light can stimulate or inhibit cellular function according to it's intensity and the time applied.  Lasers and LED's produce intense beams of light at specific wavelengths. When the right wavelength at the right intensity is used at the correct anatomical location for the right amount of time you can stimulate repair, resolve inflammation and reduce pain.

 

One of the primary mechanisms is the effect of light on Cytochrome C Oxidase and the subsequent unbinding of nitric oxide and release of ATP leading to improved cellular function. For anti-inflammatory effects we have found a measurable reduction in pro-inflammatory mediators such as Prostaglandin E2, TNF-a and Interluekin-6 in the synovia surrounding damaged tendons.  For pain relief, high intensity lasers over a nerve supply can inhibit fast axonal flow, promoting regenerative pathways of nerves and thus reducing pain.

In addition, high intensity single point lasers can release trigger points and treat acupuncture points instead of needles.

There is substantial clinical evidence published in peer reviewed medical journals that laser therapy (LLLT) can stimulate repair of tissue, reduce inflammation and relieve pain in musculoskeletal disorders.

In the last 8 years, seven systematic reviews have found in favour of Low Level Laser Therapy

  • BMJ LLLT for chronic non-specific low back pain: a systematic review and meta-analysis of randomised controlled trials found "moderate quality of evidence" and "clinically important benefits" in the short term. (2016) Click here

  • BMJ sports medicine journal, systematic review of surgical and conservative interventions for frozen shoulder found "strong evidence" for LLLT. (2010) Click here

  • The International Association for the Study of Pain (Global Task force on musculoskeletal pain) found "strong evidence" for Low Level Laser Therapy on myofascial pain syndrome. (2010) Click here

  • The BMJ clinical evidence recommendations for tennis elbow 2011 now include LLLT Click here

  • American Physical Therapy Association guidelines recommend LLLT for Achilles tendonitis. (2010) Click here

  • Lancet systematic review: "LLLT reduces pain immediately after treatment in acute neck pain and up to 22 weeks after completion of treatment in patients with chronic neck pain". (2009) Click here

  • World Health Organisation (Bone and Joint Task Force) for neck pain Low Level Laser Therapy "more effective than no treatment, sham, or alternative interventions" (2008) Click here

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Platelet-Rich Plasma (PRP) injections, Stem Cell Therapy, Osteoarthritis, Orthobiologics and Non-surgical Orthopaedics

Dr Paul Schiavo