– Clinical Practice and Scientific Background
Introducing the latest and most comprehensive compendium on Laser Phototherapy by Jan Tunér and Lars Hode!
Laser Phototherapy is a guide to the current literature and a wealth of laser therapy knowledge. The book contains 960 pages and 2500 references, and is a thorough update of their 2010 book, The New Laser Therapy Handbook.
From the back cover:
Huge increase of antibiotic resistance, pandemic diabetes, high mortality due to pharmaceuticals side effects - certainly, new ways of tackling the medical challenges of the imminent future are needed. This book presents one such way – the use of low dosages of laser light to stimulate the natural cell healing processes so no side effects are possible. Indeed, therapeutic laser light is one of the most promising medical therapies available. Although it has been successfully used for 50 years, the awareness of its potential has been low in traditional medical circles. This book and sharing the scientific background, will make the reader see things differently.
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WHAT IS LASER PHOTOTHERAPY?
Laser Phototherapy (LPT), also commonly known as Low Level Laser Therapy (LLLT), cold or soft laser, or laser photobiomodulation (LPBM), is a form of phototherapy
which involves the application of monochromatic
and coherent light to injuries and lesions to stimulate
Unlike non-coherent light emitting devices, such as common LEDs and so-called SLDs (just a marketing name for infrared LEDs), the coherent, monochromatic and polarised radiation emitted by LASER has unique, specific, and scientifically-proven effects that persist deep into the tissue.
Laser therapy is used to increase
the speed, quality and tensile strength of tissue
repair, resolve inflammation, and give pain relief.
Clinical Uses of LPT
There are a number of potential
clinical uses for laser therapy, such as those in medical,
dental, acupuncture, podiatric, chiropractic, osteopathic,
and cosmetic applications. The most popular applications
for low-level lasers are in veterinary, physiotherapy, and acupuncture
Click here for an interesting article by the Dr Roberta Chow, in which she discusses the clinical uses of laser therapy in more detail. Link opens a new window.
LPT has been
shown to be effective in, but not limited to, the
treatment of the following indications:
780-830nm Infra-Red Wavelengths - Deep Tissue Penetration:
- Sprains & strains
- Wounds and abrasions
- Ligament & tendon
injuries, bowed tendon
- Joint injuries
- Myofascial trigger
points, pain points and deep-tissue acupuncture
- Chronic & acute pain
- Non-union & small-bone fractures
630-700nm Visible Red Wavelengths - Shallow Tissue Penetration:
- Wounds & abrasions
- Superficial acupuncture points
- Mucous membranes
- Post-surgical wounds
How Does It Work?
The effects of laser therapy are
photochemical and photomechanical, not thermal - at least, not on a macro-scale.
There are two primary forms of effects generated by laser irradiation of biological tissues: photon-absorption (the basis of photobiological action, and generated by all forms of light), and speckle formation, which is unique to laser therapy.
Photon-absorption effects occur when photons enter the tissue
and are absorbed by photoreceptive molecules, called chromophores, in the mitochondria and at the
cell membrane. Photonic energy is then converted
to chemical energy within the cell, and is utilised in the form
A number of the
effects of laser irradiation, however, are unique, and are due to the speckle field that is created
when coherent laser radiation is reflected, refracted and scattered. The speckle field is not simply a phenomenon created at and limited to the tissue surface, but is generated within a volume of tissue, persisting to the total extent of the depth of penetration of the laser beam.
Laser speckles formed deep in the tissue create temperature
and pressure gradients across cell membranes, increasing the rate of diffusion across those membranes. Further, photons within each speckle are highly polarised, leading to an increased probability of photon absorption (one possible reason for why laser therapy has been shown to consistently out-perform other non-coherent light sources, especially for deeper tissue treatments).
Advantages Over Other Modes of Therapy
Laser therapy has been found to offer
superior healing and pain relieving effects compared
to other electrotherapeutic modalities, especially
in the early stages of acute injuries, and for chronic
problems. Low-level lasers can also be used for Acupuncture
Laser therapy is a universal method
of treating muscle, tendon, ligament, connective
tissue, bone and skin tissue with one simple piece
of equipment, however, excellent results are also achieved
when it is used to complement other treatment modalities, such as ice for acute injuries, or shockwave for more chronic conditions.
The portability and diversity
of battery and mains-powered diode laser systems
allows treatment to be carried out in clinical,
hospital, and field locations. This opens up possibilities
for the immediate and therefore more effective treatment
of sporting and athletic injuries, such as muscle
tears, haematomas, and tendinopathies.
This applies equally to
the veterinary use of LPT, which has applications
in both large and small animal physiotherapy for both performance and companion animals. It is especially
popular in the treatment of competition horses,
racing greyhounds and agility dogs.
It is an attractive form
of treatment for both human and animal athletes,
especially those involved in professional sports,
due to the prospect of shorter recovery and lay-off
times. Importantly for athletes,
laser therapy is a non-invasive, drug-free modality that
can be applied on competition day without risking
disqualification by drug-vetting tests.