Laser healing involves blood flow increases that promote tissue repair and regeneration
If you look back across the last two decades of advances in chiropractic treatment, none has perhaps come as far in as short an amount of time as laser therapy. This is particularly true for the use of low-level lasers for speeding pain reduction and wound healing. It seems like every time you turn around, the US Food and Drug Administration has approved yet another indication for low-level laser therapy (LLLT) or another fancy marketing brochure for the latest high tech device has landed in your mailbox.
But what’s the real story on LLLT? Is it as beneficial as the hype makes it out to be? How do the lasers exactly work?
How do low-level lasers work?
Although the exact mechanism that allows low-level lasers to speed up tissue repair and reduce pain is not quite understood, it is thought that the red, and near-infrared, wavelengths of light that the lasers emit are absorbed by cellular mitochondria.1
As a result, blood flow increases to the targeted area and certain signaling pathways are activated that promote tissue repair and regeneration. Unlike thermal lasers, which are set to a higher level, low-level lasers do not heat, ablate or cut into the skin, so are not considered an invasive treatment. In fact, your patients should not feel any warmth at all from an LLLT.
Musculoskeletal pain
A 2017 meta-analysis review article in the European Journal of Physical and Rehabilitation Medicine compared findings for the effectiveness of LLLT in treating musculoskeletal pain across 18 studies, which accounted for 1,462 patients.2 After combining the results from all the studies, the researchers concluded that “LLLT is an effective treatment modality to reduce pain in adult patients with musculoskeletal disorders.”2
A 2012 article in Lasers in Medicine and Science evaluated the possible additional benefits of adding LLLT to conventional physiotherapy for 50 patients with rotator cuff tendonitis.3
Twenty-five patients received just routine physiotherapy, while the other 25 also received LLLT (4 J/cm2) for five minutes, at no more than 10 affected points on the shoulder. Those patients undergoing laser therapy showed significant improvement in pain control and disability by three weeks after treatment.3
Wound healing
A 2014 meta-analysis in the Portuguese journal, Revista do Colégio Brasileiro de Cirurgiões, examined findings from journal articles published from 2000 to 2011 on the use of LLLT to speed wound healing.4 The researchers found that doses ranging from 3 J/cm2 to 6 J/cm2, with wavelengths ranging from 632.8 nm to 1000 nm, were the most effective for healing wounds.
One of the articles included in the meta-analysis used low-level lasers to heal superficial wounds made on a group of 20 healthy subjects as a means of creating a baseline treatment model.5
Each subject had two abrasions made on the anterior forearm. After the wounds were cleaned, digital photographs were taken for baseline measurement. One of the two randomly chosen wounds then underwent LLLT for 10 days, with photographs taken after each treatment. Study subjects then returned again on day 20 for a final set of photographs. In analyzing the photographs, the researchers concluded: “The LLLT resulted in enhanced healing, as measured by wound contraction. These data indicate that LLLT is an effective modality to facilitate wound contraction of partial-thickness wounds.”5
Technology can change almost in the blink of an eye, and medical technology is no exception to that rule. Given the research, it would seem that the rapid advances in LLLT are worth considering investing in the technology, as a fast, effective means to speed pain relief and wound healing for your patients.
References
1. Avci P, Gupta A, Sadasivam M, et al. Low-level laser (light) therapy (LLLT) in skin: Stimulating, healing, restoring. Seminars in Cutaneous Medicine and Surg 2013;32(1):41-52.
2. Clijsen R, Brunner A, Barbero M, et al. Effects of low-level laser therapy on pain in patients with musculoskeletal disorders: A systematic review and meta-analysis. European Journal of Physical and Rehabilitation Medicine. 2017 Aug;53(4):603-610.
3. Eslamian F1, Shakouri SK, Ghojazadeh M, et al. Effects of low-level laser therapy in combination with physiotherapy in the management of rotator cuff tendinitis. Lasers in Medicine and Science. 2012 Sep;27(5):951-958.
4. Andrade Fdo S, Clark RM, Ferreira ML. Effects of low-level laser therapy on wound healing [Article in English, Portuguese]. Revista do Colégio Brasileiro de Cirurgiões. 2014 Mar-Apr;41(2):129-133.
5. Hopkins JT, McLoda TA, Seegmiller JG, David Baxter G. Low-level laser therapy facilitates superficial wound healing in humans: A triple-blind, sham-controlled study. Journal of Athletic Training. 2004;39(3):223-229.
