Laser treatment protocols

by Dava Stewart

The effectiveness of low level laser therapy (LLLT) as a treatment option to support pain relief is widely accepted and has been demonstrated in a number of scientific studies. Cold lasers have also received approval from the FDA. However, administering the treatment is not as simple as flipping a switch and directing a cold laser at the area of the patient’s pain. Determining the most appropriate parameters for the treatment is of paramount importance for the patient to see the best outcome.

There are multiple parameters for administering LLLT, including power density, output, duration, pulsation, and frequency of treatment. Each of these elements can be adjusted in order to provide optimal treatment for patients. Unfortunately, the reverse is true as well: when the parameters are not improperly defined, the treatment results will be sub-optimal.

For example, power density and duration of the laser may be correctly identified, but the pulsation set too slow. Even when only one parameter is incorrect, the patient may not see the greatest possible benefit from the treatment.

How do DCs determine the appropriate LLLT parameters? The first step is through thorough training in how to use each device. Many manufacturers provide advanced training through seminars, software, and online classes. Taking advantage of such training provides the benefit of making sure you understand the exact equipment you own and use, rather than similar equipment.

The results of many of the scientific studies regarding LLLT have shown that the effectiveness of the treatment hinges on getting the parameters properly set. Manufacturers have responded by investing more into researching technologies that help DCs correctly define the specific parameters for each patient receiving LLLT. Graphic readouts, software, pre-determined settings, manual options, and more are increasingly sophisticated.

An important consideration for chiropractors who plan to add new LLLT equipment should be the quality of on-going training and support options from the manufacturer. Cost is always a factor, but knowing that the option to continue to learn as the technology evolves is also pertinent. When choosing a laser, it is recommended that DCs request in-office demonstrations. The ability of the representative to answer questions about training and on-going support will provide an early indication of what to expect.