Low Level Laser
Therapy (LLLT)
AKA
Low Power Laser (LPL), Cold Laser or PhotoMedicine (PM)
Low Level Laser Therapy is nothing more
than shining a high intensity light into the area of interest, it's just that
this "light" is very intense, "monochromatic" (one wavelength), coherent (all
the photons are in phase and synchronized) and is applied with a very specific
dose in mind. It is painless, non-toxic, non-invasive, without drugs and very safe if applied by
a trained practitioner.
In short, LLLTreduces healing duration 30-40%
and the injured tissues are stronger than if they had not been
exposed to LLLT. Listed below
you'll find a brief synopsis of what LLLT is and for those wanting hard data,
you'll find a number of research abstracts from
PubMedline
that document and prove the effectiveness of LLLT.
Cold laser for mucositis - a VERY painful condition that occurs with bone marrow
transplant chemotherapy
Cold laser for non-healing diabetic ulcerations
What is Laser Therapy?
Laser Therapy is the application of red and near infra-red
light over injuries or lesions to improve wound / soft tissue healing and give
relief for both acute and chronic pain. It is now officially referred to as (Low
Level Laser Therapy) LLLT.
Laser Therapy is used to:
Increase the speed, quality and tensile strength
of tissue repair
Give pain relief
Resolve inflammation
An alternative to needles for acupuncture
The red and near infrared light (600nm-1000nm) can be
produced by laser or high intensity LED.
The intensity of LLLT lasers is not high like a
surgical laser*. There is no heating effect.
The effect is photochemical (like photosynthesis in
plants)
Red light aids the production of ATP thereby providing the
cell with more energy which in turn means the cell is in optimum condition to
play its part in a natural healing process.
*LLLT devices are typically delivering 5mW -1000mW (0.2 ->
1.0 Watts).
How long are the treatments?
Treatments can vary in time from seconds
to minutes depending on the condition. Research studies show that there may be a
dose dependent response, so it may be more effective to treat at lower doses at
multiple intervals then to treat a single time with a high dose.
Like photosynthesis -
the correct wavelengths and power of light at certain intensities for an
appropriate period of time can increase ATP production and cell membrane
perturbation could lead to permeability changes and second messenger
activity resulting in functional changes such as increased syntheses
increased secretion and motility changes.
Red and near
infrared light seem to be the most ideal wavelengths.
Red light and near infrared light acts on the mitochondria and at the cell membrane. In in-vitro and animal
LLLT wound healing
studies comparing wavelengths, red consistently is more effective. Shorter
wavelengths are not as good and are more expensive to produce and have poor penetration;
overall, they
are a poor choice. Near infrared light, while not quite as good, do penetrate
better than the red wavelengths and are
available in higher powers
and at low prices. According to live in-vivo experiments at Uniformed
Services University Bethesda Maryland (a US military research centre) 810nm is
the best penetrating wavelength. It also happens to work well in
LLLT nerve regeneration
studies they are doing.
Clinical Effects of LLLT
An appropriate dose of light can improve speed and quality
of acute and chronic wound
healing, soft tissue healing, pain relief improve the immune system and
nerve regeneration. Applications with good RCT evidence include Venous Ulcers,
Diabetic Ulcers, Osteoarthritis, tendonitis, Post Herpetic Neuralgia (PHN,
shingles) & postoperative pain.
To
paraphrase NASA research:
“Low-energy photon irradiation by
light in the far-red to
near-IR spectral range with low-energy (LLLT) lasers or LED arrays has been
found to modulate various biological processes in cell culture and animal
models. This phenomenon of photobiomodulation has been applied clinically in the
treatment of soft tissue injuries and the acceleration of wound healing. The
mechanism of photobiomodulation by red to near-IR light at the cellular level
has been ascribed to the activation of mitochondrial respiratory chain
components, resulting in initiation of a signaling cascade that promotes
cellular proliferation and cytoprotection.”
“A growing body of evidence suggests that cytochrome
oxidase is a key photoacceptor of light in the far-red to near-IR spectral
range. Cytochrome oxidase is an integral membrane protein that contains four
redox active metal centers and has a strong absorbance in the far-red to near-IR
spectral range detectable in vivo by near-IR spectroscopy.”
“Moreover, 660–680 nm of irradiation has been shown to
increase electron transfer in purified cytochrome oxidase, increase
mitochondrial respiration and ATP synthesis in isolated mitochondria, and
up-regulate cytochrome oxidase activity in cultured neuronal cells.”
“LED photostimulation induces a cascade of signaling
events initiated by the initial absorption of light by cytochrome oxidase. These
signaling events may include the activation of immediate early genes,
transcription factors, cytochrome oxidase subunit gene expression, and a host of
other enzymes and pathways related to increased oxidative metabolism.”
“In addition to increased oxidative metabolism, red to
near-IR light stimulation of mitochondrial electron transfer is known to
increase the generation of reactive oxygen species. These mitochondrially
generated reactive oxygen species may function as signaling molecules to provide
communication between mitochondria and the cytosol and nucleus.”
Therapeutic photobiomodulation for methanol-induced
retinal toxicity.
Proc Natl Acad Sci U S A. 2003 Mar18; 100(6): 3439-44.
Epub 2003 Mar 07.
MEDIA
WATCH - listing of current articles and research projects
RESEARCH ABSTRACTS
Neurol Res. 2002
Jun;24(4):355-60.
Transplantation
of embryonal spinal cord nerve cells cultured on biodegradable
microcarriers followed by low power laser irradiation for the
treatment of traumatic paraplegia in rats.
Rochkind S, Shahar A, Amon M,
Nevo Z.
Department of Neurosurgery, Tel Aviv Sourasky Medical Center,
Israel. rochkind@zahav.net.il
This pilot study examined the effects of composite implants of
cultured embryonal nerve cells and laser irradiation on the
regeneration and repair of the completely transected spinal cord.
Embryonal spinal cord nerve cells dissociated from rat fetuses and
cultured on biodegradable microcarriers and embedded in hyaluronic
acid were implanted in the completely transected spinal cords of 24
adult rats. For 14 consecutive post-operative days, 15 rats
underwent low power laser irradiation (780 nm, 250 mW), 30 min
daily. Eleven of the 15 (73%) showed different degrees of active leg
movements and gait performance, compared to 4 (44%) of the 9 rats
with implantation alone. In a controlgroup of seven rats with spinal
cord transection and no transplantation or laser, six (86%) remained
completely paralyzed. Three months after transection, implantation
and laser irradiation, SSEPs were elicited in 69% of rats (p =
0.0237) compared to 37.5% in the nonirradiated group. The control
group had no SSEPs response. Intensive axonal sprouting occurred in
the group with implantation and laser. In the control group, the
transected area contained proliferating fibroblasts and blood
capillaries only. This suggests: 1. These in vitro composite
implants are a regenerative and reparative source for reconstructing
the transected spinal cord. 2.
Post-operative low power laser irradiation enhances axonal sprouting
and spinal cord repair.
PMID: 12069281 [PubMed - indexed for MEDLINE]
Photomed Laser Surg. 2004
Jun;22(3):199-204.
A histologic
assessment of the influence of low-intensity laser therapy on wound
healing in steroid-treated animals.
Pessoa ES, Melhado RM, Theodoro
LH, Garcia VG.
Dental School of Marilia, University of Marilia, Marilia, SP,
Brazil.
OBJECTIVE: The aim of the present study was to evaluate the effect
of low-intensity laser therapy on the wound healing process treated
with steroid. BACKGROUND DATA: Various biological effects have been
associated with low-level laser therapy (LLLT). MATERIALS AND
METHODS: Forty-eight rats were used, and after execution of a wound
on the dorsal region of each animal, they were divided into 4 groups
(n = 12), receiving the following treatments: G1 (control), wounds
and animals received no treatment; G2, wounds were treated with
LLLT; G3, animals received an intraperitoneal injection of steroid
dosage (2 mg/kg of body weight); G4, animals received steroid and
wounds were treated with LLLT. The laser emission device used was a
GaAIAs (904 nm), in a contact mode, with 2.75 mW gated with 2.900 Hz
during 120 sec (33 J/cm(2)). After the period of 3, 7, and 14 days,
the animals were sacrificed and the parts sent to histological
processing and dyed using hematoxylin and eosin (HE) and Masson
trichromium (MT) techniques. RESULTS: The results have shown that
the wounds treated with steroid had a delay in healing, while LLLT
accelerated the wound healing process. Also, wounds treated with
laser in the animals treated with steroid presented a differentiated
healing process with a larger collagen deposition and also a
decrease in both the inflammatory infiltrated and the delay on the
wound healing process. CONCLUSION: LLLT
accelerated healing, caused by the steroid, acting as a
biostimulative coadjutant agent, balancing the undesirable effects
of cortisone on the tissue healing process.
PMID: 15315726 [PubMed - in process]
Lasers Surg Med.
2004;34(3):285-9.
Comparison of
single and multiple applications of GaAlAs laser on rat medial
collateral ligament repair.
Ng GY, Fung DT, Leung MC, Guo X.
Department of Rehabilitation Sciences, The Hong Kong Polytechnic
University, Hung Hom, Kowloon, Hong Kong. rsgng@polyu.edu.hk
BACKGROUND AND OBJECTIVES: To examine single versus multiple
applications of the gallium aluminum arsenide (GaAlAs) laser on the
healing of surgically injured medial collateral ligaments (MCLs) in
rats. STUDY DESIGN/MATERIALS AND METHODS: Sixteen rats were studied,
with 12 receiving surgical transection to their right MCL and 4
receiving a sham injury. Group 1 (n = 4) received a single dose of
GaAlAs laser therapy (wavelength 660 nm, average power 8.8 mW, pulse
10 kHz, dosage 31.6 J/cm(2)) directly to their MCL during surgery.
Group 2 (n = 4) received 9 doses of GaAlAs laser therapy applied
transcutaneously on alternate days (wavelength 660 nm, average power
8.8 mW, pulse 10 kHz, dosage 3.5 J/cm(2)). The controls (Group 3, n
= 4) received one session of placebo laser at the time of surgery,
with the laser equipment shut down, while the sham injured Group 4
(n = 4) received no treatment. Biomechanical tests for structural
stiffness, ultimate tensile strength (UTS), and load-relaxation were
done at 3 weeks after injury. The stiffness and UTS data were
normalized by expressing as a percentage of the left side of each
animal before statistical analysis. RESULTS: The load-relaxation
data did not show any differences between the groups (P = 0.18). The
normalized stiffness levels of Groups 2 (81.08+/-11.28%) and 4
(92.66+/-13.19%) were significantly higher (P = 0.025) than that of
the control Group 3 (58.99+/-15.91%). The normalized UTS of Groups 2
(81.38+/-5.68%) and 4 (90.18+/-8.82%) were also significantly higher
(P = 0.012) than that of the control (64.49+/-9.26%). Although,
Group 1 had higher mean stiffness and UTS values than the control,
no statistically significant difference was found between these two
groups. CONCLUSIONS: Multiple laser therapy
improves the normalized strength and stiffness of repairing rat MCLs
at 3 weeks after injury. The multiple treatments seem to be superior
to a single treatment when the cumulative dosages are comparable
between the two modes of application. Copyright 2004
Wiley-Liss, Inc.
Low-level laser
irradiation attenuates production of reactive oxygen species by
human neutrophils.
Fujimaki Y, Shimoyama T, Liu Q,
Umeda T, Nakaji S, Sugawara K.
Department of Hygiene, Hirosaki University School of Medicine,
Japan.
OBJECTIVE: The aim of this study was to examine the effects of
low-level laser therapy (LLLT) on production of reactive oxygen (ROS)
species by human neutrophils. BACKGROUND DATA: LLLT is an effective
therapeutic modality for inflammatory conditions. MATERIALS AND
METHODS: The laser device used was the infrared diode laser (GaAlAs),
830-nm continuous wave (150 mW/cm(2)). After irradiation, ROS
production by neutrophils was measured using luminol-dependent
chemiluminescence (LmCL) and expression of CD11b and CD16 on
neutrophil surface was measured by flow cytometry. RESULTS: The LmCL
response of neutrophils was reduced by laser irradiation at 60 min
prior to the stimulation with opsonized zymosan and calcium
ionophore. The attenuating effect of LLLT was larger in neutrophils
of smokers than non-smokers, while the amount of produced ROS was
larger in neutrophils of smokers. Expression of CD11b and CD16 on
neutrophil surface was not affected by LLLT. CONCLUSION:
Attenuation of ROS production by
neutrophils may play a role in the effects of LLLT in the treatment
of inflammatory tissues. There is a possible usage of LLLT to
improve wound healing in smokers.
PMID: 12828853 [PubMed - indexed for MEDLINE]
J Clin Laser Med Surg. 2000
Apr;18(2):67-73.
Wound healing of
animal and human body sport and traffic accident injuries using
low-level laser therapy treatment: a randomized clinical study of
seventy-four patients with control group.
Simunovic Z, Ivankovich AD,
Depolo A.
Department of Anesthesiology, La Carita Medical Center, Laser
Center, Locarno, Switzerland. info@lasermedico.ch
BACKGROUND AND OBJECTIVE: The main objective of current animal and
clinical studies was to assess the efficacy of low level laser
therapy (LLLT) on wound healing in rabbits and humans. STUDY
DESIGN/MATERIALS AND METHODS: In the initial part of our research we
conducted a randomized controlled animal study, where we evaluated
the effects of laser irradiation on the healing of surgical wounds
on rabbits. The manner of the application of LLLT on the human body
are analogous to those of similar physiologic structure in animal
tissue, therefore, this study was continued on humans. Clinical
study was performed on 74 patients with injuries to the following
anatomic locations: ankle and knee, bilaterally, Achilles tendon;
epicondylus; shoulder; wrist; interphalangeal joints of hands,
unilaterally. All patients had had surgical procedure prior to LLLT.
Two types of laser devices were used: infrared diode laser (GaAlAs)
830 nm continuous wave for treatment of trigger points (TPs) and
HeNe 632.8 nm combined with diode laser 904-nm pulsed wave for
scanning procedure. Both were applied as monotherapy during current
clinical study. The results were observed and measured according to
the following clinical parameters: redness, heat, pain, swelling and
loss of function, and finally postponed to statistical analysis via
chi2 test. RESULTS: After comparing the healing process between two
groups of patients, we obtained the following results: wound healing
was significantly accelerated (25%-35%) in the group of patients
treated with LLLT. Pain relief and functional recovery of patients
treated with LLLT were significantly improved comparing to untreated
patients. CONCLUSION: In addition to
accelerated wound healing, the main advantages of LLLT for
postoperative sport- and traffic-related injuries include prevention
of side effects of drugs, significantly accelerated functional
recovery, earlier return to work, training and sport competition
compared to the control group of patients, and cost benefit.
Successful
treatment of oral lesions of chronic lichenoid graft-vs.-host
disease by the addition of low-level laser therapy to systemic
immunosuppression.
Chor A, de Azevedo AM, Maiolino
A, Nucci M.
University Hospital, Universidade Federal do Rio de Janeiro, Rio de
Janeiro, Brazil.
We report a case of severe oral stomatitis caused by lichenoid
chronic graft-vs.-host disease in which low-level laser therapy
applied to the oral mucosa, in addition to standard systemic
immunosuppressive treatment, resulted in
quick healing and symptomatic relief.
Publication Types:
Case Reports
PMID: 14962242 [PubMed - indexed for MEDLINE]
Clin Oral Implants Res. 2004
Jun;15(3):325-32.
Low-level laser
therapy stimulates bone-implant interaction: an experimental study in
rabbits.
Khadra M, Ronold HJ, Lyngstadaas SP,
Ellingsen JE, Haanaes HR.
Department of Oral Surgery and Oral Medicine, Faculty of Dentistry,
University of Oslo, Oslo, Norway. maawan@odont.uio.no
The aim of the present study was to investigate the effect of low-level
laser therapy (LLLT) with a gallium-aluminium-arsenide (GaAlAs) diode
laser device on titanium implant healing and attachment in bone. This
study was performed as an animal trial of 8 weeks duration with a
blinded, placebo-controlled design. Two coin-shaped titanium implants
with a diameter of 6.25 mm and a height of 1.95 mm were implanted into
cortical bone in each proximal tibia of twelve New Zealand white female
rabbits (n=48). The animals were randomly divided into irradiated and
control groups. The LLLT was used immediately after surgery and carried
out daily for 10 consecutive days. The animals were killed after 8 weeks
of healing. The mechanical strength of the attachment between the bone
and 44 titanium implants was evaluated using a tensile pullout test.
Histomorphometrical analysis of the four implants left in place from
four rabbits was then performed. Energy-dispersive X-ray microanalysis
was applied for analyses of calcium and phosphorus on the implant test
surface after the tensile test. The mean tensile forces, measured in
Newton, of the irradiated implants and controls were 14.35 (SD+/-4.98)
and 10.27 (SD+/-4.38), respectively, suggesting a gain in functional
attachment at 8 weeks following LLLT (P=0.013). The histomorphometrical
evaluation suggested that the irradiated group had more bone-to-implant
contact than the controls. The weight percentages of calcium and
phosphorus were significantly higher in the irradiated group when
compared to the controls (P=0.037) and (P=0.034), respectively,
suggesting that bone maturation processed faster in irradiated bone.
These findings suggest that LLLT might have a
favorable effect on healing and attachment of titanium implants.
PMID: 15142095 [PubMed - indexed for MEDLINE]
J Clin Laser Med Surg. 2003
Oct;21(5):291-6.
Effect of the clinical
application of the GaAlAs laser in the treatment of dentine
hypersensitivity.
Marsilio AL, Rodrigues JR, Borges AB.
Restorative Dentistry, UNESP School of Dentistry, Sao Jose dos Campos, SP,
Brazil. analumarsilio@bol.com.br
OBJECTIVE: The aim of this study was to evaluate the effectiveness of the
clinical use of the gallium-aluminum-arsenium (GaAlAs) laser at the maximum
and minimum energies recommended by the manufacturer for the treatment of
dentine hypersensitivity. BACKGROUND DATA: Dentine hypersensitivity (DH) is
a response to a stimulus that would not usually cause pain in a healthy
tooth. It is characterized by sharp pain of short duration from the denuded
dentin. Its etiology is unknown. The dentin only begins to show sensitivity
when exposed to the buccal environment. This exposure can result after
removal of the enamel and/or dental cement, or after root denudation.
Different treatments are proposed for this disorder. MATERIALS AND METHODS:
In this study, 25 patients, with a total number of 106 cases of DH, were
treated with GaAlAs low-level laser therapy (LLLT). 65% of the teeth were
premolars; 14% were incisors and molars; 6.6% were canines. The teeth were
irradiated with 3 and 5 J/cm2 for up to six sessions, with an interval of 72
h between each application, and they were evaluated initially, after each
application, and at 15 and 60 days follow-up post-treatment. RESULTS: The
treatment was effective in 86.53% and 88.88% of the irradiated teeth,
respectively, with the minimum and maximum energy recommended by the
manufacturer. There was a statistically significant difference between DH
and after a follow-up of 60 days for both groups. The difference among the
energy maximum and minimum was not significant. CONCLUSION:
The GaAlAs low-level laser was effective in
reducing initial DH. A significant difference was found between initial
values of hypersensitivity and after 60 days follow-up post-treatment.
No significant difference was found between minimum (3 J/cm2) and maximum (5
J/cm2) applied energy.
PMID: 14651797 [PubMed - indexed for MEDLINE]
J Clin Laser Med Surg. 1999
Dec;17(6):241-3.
In vivo caries-like
lesion prevention with argon laser: pilot study.
Blankenau RJ, Powell G, Ellis RW,
Westerman GH.
Creighton University, Omaha, Nebraska, USA.
OBJECTIVE: This clinical pilot study was conducted to investigate the
effectiveness of argon laser irradiation to reduce demineralization or loss
of tooth structure in vivo. SUMMARY BACKGROUND DATA: In vitro research
previously demonstrated the ability of argon laser irradiation to reduce
demineralization or loss of tooth structure. METHODS: Using the Ogaard model
of producing demineralization, the experimental teeth were irradiated with
argon laser of 250 mW (producing approximately 12 J/cm2) prior to banding.
Polarized light evaluation of the sectioned, extracted teeth was used to
determine the amount of demineralization. RESULTS: Results showed a 29.1%
reduction in demineralization in the experimental teeth as compared to the
bilateral control teeth. CONCLUSION: Low-power
argon laser irradiation significantly reduced demineralization clinically.
Publication Types:
Clinical Trial
PMID: 11800094 [PubMed - indexed for MEDLINE]
Clin Ter. 1990 May 31;133(4):219-22.
[Application of
"cold" laser (I.R. with semiconductors) as antalgic and
anti-inflammatory therapy in osteo-articular and musculotendinous
pathologies]
[Article in Italian]
Petrachi F, Matzuzzi G.
Dipartimento di Medicina Interna, II Universita degli Studi di Roma Tor
Vergata.
The therapeutic efficacy of an I.R. laser appliance with semiconductors
(GaAs) and a cooling device (cold laser) has been tried for
osteo-articular ad muscle-tendinous painful pathologies. The
result in almost all types of disorder has been satisfactory with
diminution or disappearance of painful symptomatology and functional
recovery.
PMID: 2142908 [PubMed - indexed for MEDLINE]
J Clin Laser Med Surg. 1999
Feb;17(1):29-33.
Low power laser therapy
and analgesic action.
Tam G.
tam.g@agemont.it
OBJECTIVE: The semiconductor or laser diode (GaAs, 904 nm) is the most
appropriate choice in pain reduction therapy. SUMMARY BACKGROUND DATA:
Low-power density laser acts on the prostaglandin (PG) synthesis, increasing
the change of PGG2 and PGH2 into PG12 (also called prostacyclin, or
epoprostenol). The last is the main product of the arachidonic acid into the
endothelial cells and into the smooth muscular cells of vessel walls, that
have a vasodilating and anti-inflammatory action. METHODS: Treatment was
performed on 372 patients (206 women and 166 men) during the period between
May 1987 and January 1997. The patients, whose ages ranged from 25 to 70
years, with a mean age of 45 years, suffered from rheumatic, degenerative,
and traumatic pathologies as well as cutaneous ulcers. The majority of
patients had been seen by orthopedists and rheumatologists and had undergone
x-ray examination. All patients had received drug-based treatment and/or
physiotherapy with poor results; 5 patients had also been irradiated with
He:Ne and CO2 lasers. Two-thirds were experiencing acute symptomatic pain,
while the others suffered long-term pathology with recurrent crises. We used
a pulsed diode laser, GaAs 904 nm wavelength once per day for 5 consecutive
days, followed by a 2-day interval. The average number of applications was
12. We irradiated the trigger points, access points to the joint, and
striated muscles adjacent to relevant nerve roots. RESULTS: We achieved very
good results, especially in cases of symptomatic osteoarthritis of the
cervical vertebrae, sport-related injuries, epicondylitis, and cutaneous
ulcers, and with cases of osteoarthritis of the coxa. CONCLUSIONS:
Treatment with 904-nm diode laser has substantially
reduced the symptoms as well as improved the quality of life of these
patient, ultimately postponing the need for surgery.
Publication Types:
Case Reports
PMID: 10204446 [PubMed - indexed for MEDLINE]
Clin Rheumatol. 2001;20(3):181-4.
The clinical efficacy of
low-power laser therapy on pain and function in cervical osteoarthritis.
Ozdemir F, Birtane M, Kokino S.
Department of Physical Therapy and Rehabilitation, Medical Faculty of Trakya
University, Edirne, Turkey.
Pain is a major symptom in cervical osteoarthritis (COA). Low-power laser
(LPL) therapy has been claimed to reduce pain in musculoskeletal
pathologies, but there have been concerns about this point. The aim of this
study was to evaluate the analgesic efficacy of LPL therapy and related
functional changes in COA. Sixty patients between 20 and 65 years of age
with clinically and radiologically diagnosed COA were included in the study.
They were randomised into two equal groups according to the therapies
applied, either with LPL or placebo laser. Patients in each group were
investigated blindly in terms of pain and pain-related physical findings,
such as increased paravertebral muscle spasm, loss of lordosis and range of
neck motion restriction before and after therapy. Functional improvements
were also evaluated. Pain, paravertebral muscle
spasm, lordosis angle, the range of neck motion and function were observed
to improve significantly in the LPL group, but no improvement was found in
the placebo group. LPL seems to be successful in relieving pain and
improving function in osteoarthritic diseases.
Longo L, Simunovic Z, Postiglione M,
Postiglione M.
Institute for Laser Medicine, Florence, Italy.
BACKGROUND AND OBJECTIVES: The objectives of this study is to treat the
cases of fibromyositic rheumatisms untreatable with other therapies. The
authors chose defocalized laser beams because some experimental studies had
showed their analgesic and anti-phlogistic effects on experimental phlogosis.
Since 1980 non-surgical laser effects were often noncomparable because of
the lack of common treatment protocols. This summarizes fifteen years of
clinical observations as to the purpose of identifying some indications on
laser treatment of defined pathologies included in fibromyositic rheumatism.
STUDY DESIGN/MATERIALS AND METHODS: 846 patients with different types of
fibromyositic rheumatisms were submitted to defocalized laser therapy from
1980 to 1995. Criteria for selection included age, sex, and pathological
pictures. Control groups were used to compare results with those of
traditional methods. Diodes and CO2 lasers were employed, to exploit the
photothermic and photochemical effects of the laser radiations to the
fullest extent. RESULTS: On the whole, results were positive in comparison
with other methods both as regards recovery time and persistence of results.
Results were evaluated on the basis of subjective (such as local pain) and
objective (hypomotility, phlogosis) criteria. CONCLUSIONS:
Results obtained (approximately 2/3 of the patients benefited from the
treatment) indicate that there are greater advantages in use of laser over
other presently available methods. Standardalization of treatment
protocols deserves further studies.
Ga-Al-As laser
irradiation inhibits neuronal activity associated with inflammation.
Sato T, Kawatani M, Takeshige C,
Matsumoto I.
Department of Anesthesiology, Saitama Medical College, Saitama, Japan.
A Ga-Al-As diode system that produces low-energy red light (830 nm, 40 mW)
has been used for the treatment of many kinds of pain. The mechanism of
action of this new laser irradiation for analgesia was studied in
anesthetized rats. The effect of laser irradiation of the saphenous nerve
was studied by recording neuronal activity at the L4 dorsal root filaments
after the injection of a chemical irritant, turpentine.
Laser irradiation inhibited both the asynchronous firing by that was induced
by turpentine and increased part of the slow components of the action
potentials. Thus, the laser irradiation selectively inhibited nociceptive
signals at peripheral nerves.
PMID: 7863838 [PubMed - indexed for MEDLINE]
Stomatologiia (Mosk). 1998;77(4):20-2.
[The prevention of
inflammatory complications in mandibular fractures by using infrared laser
and magnetic-laser radiation]
[Article in Russian]
Makarenkov VV, Shargorodskii AG.
A total of 102 patients with mandibular fractures were treated by
multiple-modality treatment including infrared (IR) laser exposure and
magnetic and laser therapy (MT). For monitoring the treatment efficacy and
predicting its results, nonspecific defense factors and intensity of
free-radical oxidation (FRO) in the saliva were assessed.
IR laser and MT by the Ulei-2K device stimulated local defense factors,
decreased the intensity of salivary FRO, and thus promoted the healing of
mandibular fractures.
1: J Clin Laser Med Surg. 2001 Dec;19(6):305-14.
Effect of NASA
light-emitting diode irradiation on wound healing.
Whelan HT, Smits RL Jr, Buchman EV,
Whelan NT, Turner SG, Margolis DA, Cevenini V, Stinson H, Ignatius R, Martin
T, Cwiklinski J, Philippi AF, Graf WR, Hodgson B, Gould L, Kane M, Chen G,
Caviness J.
Department of Neurology, Medical College of Wisconsin, Milwaukee 53226, USA.
OBJECTIVE: The purpose of this study was to assess the effects of hyperbaric
oxygen (HBO) and near-infrared light therapy on wound healing. BACKGROUND
DATA: Light-emitting diodes (LED), originally developed for NASA plant
growth experiments in space show promise for delivering light deep into
tissues of the body to promote wound healing and human tissue growth. In
this paper, we review and present our new data of LED treatment on cells
grown in culture, on ischemic and diabetic wounds in rat models, and on
acute and chronic wounds in humans. MATERIALS AND METHODS: In vitro and in
vivo (animal and human) studies utilized a variety of LED wavelength, power
intensity, and energy density parameters to begin to identify conditions for
each biological tissue that are optimal for biostimulation. Results: LED
produced in vitro increases of cell growth of 140-200% in mouse-derived
fibroblasts, rat-derived osteoblasts, and rat-derived skeletal muscle cells,
and increases in growth of 155-171% of normal human epithelial cells. Wound
size decreased up to 36% in conjunction with HBO in ischemic rat models. LED
produced improvement of greater than 40% in musculoskeletal training
injuries in Navy SEAL team members, and decreased wound healing time in crew
members aboard a U.S. Naval submarine. LED produced a 47% reduction in pain
of children suffering from oral mucositis. CONCLUSION:
We believe that the use of NASA LED for light therapy
alone, and in conjunction with hyperbaric oxygen, will greatly enhance the
natural wound healing process, and more quickly return the patient to a
preinjury/illness level of activity. This work is supported and managed
through the NASA Marshall Space Flight Center-SBIR Program.
Publication Types:
Review
Review, Tutorial
PMID: 11776448 [PubMed - indexed for MEDLINE]
In Vivo. 2004 Jul-Aug;18(4):489-95.
Effect of Ga-as laser on
the regeneration of injured sciatic nerves in the rat.
Bae CS, Lim SC, Kim KY, Song CH, Pak S,
Kim SG, Jang CH.
College of Veterinary Medicine, Biotechnology Research Institute, Chonnam
National University, Gwangju, Korea.
Laser irradiation is one of the therapeutic methods for the recovery of
degenerated peripheral nerves. The aim of the present study was to determine
if low-power laser treatment stimulates the regeneration process of damaged
nerves. A standardized crush to the sciatic nerve was applied to cause
extensive axonal degeneration. After this procedure, low-power infrared
laser irradiation was administered transcutaneously to the injured sciatic
nerve, 3 minutes daily to each of four treatment groups for 1, 3, 5 and 7
weeks, respectively. A nerve conduction study was done, and a morphological
assessment was performed using both light and electron microscopy. With
trauma of the nerve, both amplitude of compound motor action potential and
nerve conduction velocity decreased significantly compared to the pre-trauma
state. Morphologically, the numbers of myelinated axons and degenerated
axons were decreased and increased, respectively, compared with the control.
Typical aspects were of onion skin-type lamellation, fragmentation,
edematous swelling and rarefaction in the myelin sheath.
All these parameters recovered almost to the level of
the pre-trauma state with laser irradiation, in direct proportion to the
time spent for treatment. These results suggest that low-power infrared
laser irradiation can relieve the mechanical damage of sciatic nerves and
stimulate the regeneration of peripheral nerves.
73 patients with compression-ischemic myeloradiculopathy received treatment
including infrared laser radiation on the paravertebral fields, motor points
of the affected nerves and biologically active points Y63, Y67, YB34, YB42,
YB43, E34, E42 (1.0-5.0 mW/cm2; 5 and 5000 Hz), electrostimulation of motor
nerve points and innervated by them muscles by double square impulses with a
fixed gap 5 ms. Impulse infrared laser therapy
relieves pain syndrome, stimulates repair processes in the affected nerve
structures. Further modified electric stimulation activates a regenerative
growth of the nerve fibers, reinnervation of the limb muscles.
Carpal tunnel syndrome
pain treated with low-level laser and microamperes transcutaneous electric
nerve stimulation: A controlled study.
Naeser MA, Hahn KA, Lieberman BE, Branco
KF.
Department of Neurology, Boston University School of Medicine, Psychology
Research Service, MA, USA. mnaeser@bu.edu
OBJECTIVE: To investigate whether real or sham low-level laser therapy
(LLLT) plus microamperes transcutaneous electric nerve stimulation (TENS)
applied to acupuncture points significantly reduces pain in carpal tunnel
syndrome (CTS). DESIGN: Randomized, double-blind, placebo-control, crossover
trial. Patients and staff administered outcome measures blinded. SETTING:
Outpatient, university-affiliated Department of Veterans Affairs medical
center. PARTICIPANTS: Eleven mild to moderate CTS cases (nerve conduction
study, clinical examination) who failed standard medical or surgical
treatment for 3 to 30 months. INTERVENTION: Patients received real and sham
treatment series (each for 3-4wk), in a randomized order. Real treatments
used red-beam laser (continuous wave, 15mW, 632.8nm) on shallow acupuncture
points on the affected hand, infrared laser (pulsed, 9.4W, 904nm) on deeper
points on upper extremity and cervical paraspinal areas, and microamps TENS
on the affected wrist. Devices were painless, noninvasive, and produced no
sensation whether they were real or sham. The hand was treated behind a
hanging black curtain without the patient knowing if devices were on (real)
or off (sham). MAIN OUTCOME MEASURES: McGill Pain Questionnaire (MPQ) score,
sensory and motor latencies, and Phalen and Tinel signs. RESULTS:
Significant decreases in MPQ score, median nerve sensory latency, and Phalen
and Tinel signs after the real treatment series but not after the sham
treatment series. Patients could perform their previous work (computer
typist, handyman) and were stable for 1 to 3 years. CONCLUSIONS:
This new, conservative treatment was effective in
treating CTS pain; larger studies are recommended. Copyright 2002
by the American Congress of Rehabilitation Medicine and the American Academy
of Physical Medicine and Rehabilitation
J Altern Complement Med. 1999
Feb;5(1):5-26.
Carpal tunnel syndrome:
clinical outcome after low-level laser acupuncture, microamps transcutaneous
electrical nerve stimulation, and other alternative therapies--an open
protocol study.
Branco K, Naeser MA.
Acupuncture Healthcare Services, Westport, Massachusetts, USA.
OBJECTIVE: Outcome for carpal tunnel syndrome (CTS) patients (who previously
failed standard medical/surgical treatments) treated primarily with a
painless, noninvasive technique utilizing red-beam, low-level laser
acupuncture and microamps transcutaneous electrical nerve stimulation (TENS)
on the affected hand; secondarily, with other alternative therapies. DESIGN:
Open treatment protocol, patients diagnosed with CTS by their physicians.
SETTING: Treatments performed by licensed acupuncturist in a private
practice office. SUBJECTS: Total of 36 hands (from 22 women, 9 men), ages
24-84 years, median pain duration, 24 months. Fourteen hands failed 1-2
surgical release procedures. INTERVENTION/TREATMENT: Primary treatment:
red-beam, 670 nm, continuous wave, 5 mW, diode laser pointer (1-7 J per
point), and microamps TENS (< 900 microA) on affected hands. Secondary
treatment: infrared low-level laser (904 nm, pulsed, 10 W) and/or needle
acupuncture on deeper acupuncture points; Chinese herbal medicine formulas
and supplements, on case-by-case basis. Three treatments per week, 4-5
weeks. OUTCOME MEASURES: Pre- and posttreatment Melzack pain scores;
profession and employment status recorded. RESULTS: Posttreatment, pain
significantly reduced (p < .0001), and 33 of 36 hands (91.6%) no pain, or
pain reduced by more than 50%. The 14 hands that failed surgical release,
successfully treated. Patients remained employed, if not retired. Follow-up
after 1-2 years with cases less than age 60, only 2 of 23 hands (8.3%) pain
returned, but successfully re-treated within a few weeks. CONCLUSIONS:
Possible mechanisms for effectiveness include
increased adenosine triphosphate (ATP) on cellular level, decreased
inflammation, temporary increase in serotonin. There are potential
cost-savings with this treatment (current estimated cost per case, $12,000;
this treatment, $1,000). Safe when applied by licensed acupuncturist trained
in laser acupuncture; supplemental home treatments may be performed by
patient under supervision of acupuncturist.
[The action of
low-intensity infrared laser radiation on skin afferents]
[Article in Russian]
Ponomarenko GN, Enin LD.
Laser radiation modulates functional
characteristics of mechanoreceptors. This inhibits impulse activity of the
nerve endings from pain focus and reduces pain sensitivity of skin
afferents, excitability of conductive nerve fibers. Changes in sensitivity
become more pronounced with increasing duration of the exposure. By means of
reflectory mechanism laser radiation may cause other general reactions of
the body and enhance immune response of the skin.
