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Acute Conditions

 

Laser therapy has been shown to be effective to help treat acute conditions. Bringing pain under control quickly helps the healing process and usually helps promote better outcomes.

Chronic Conditions

 

With chronic conditions, research has shown that therapy lasers can be used to help combat persistent pain and promote circulation to damaged tissues. It can be a powerful, non-pharmaceutical solution to help reduce pain without the side effects of medication1,2.

Post-Activity Recovery

 

LightForce® Therapy Lasers can be found on the sidelines of many pro, college, and Olympic sports teams across the United States and many parts of Europe and Asia. Laser therapy has been shown to be effective at improving post-activity recovery times and reducing delayed onset muscle soreness (DOMS)3.

  • TMJ6,7
  • Neck Pain8
  • Shoulder Pain9,10,11
  • Elbow & Joint Pain12
  • Fibromyalgia13
  • Low Back Pain14,15
  • Sciatica16,17
  • Arthritis18
  • Sports Injuries19,20
  • Soft Tissue Damage21
  • Plantar Fasciitis22,23

 

 

 

SAFETY

LightForce® therapy lasers are cleared by the FDA and adhere to strict ISO standards in order to provide you with a safe, non-invasive treatment option and effective alternative to drugs and surgery4.

 

 

Class IIIb Laser

LightForce® Class IV Laser

Photobiomodulation

LightForce® therapy lasers work by flooding the tissue with photons, which energizes cells resulting in increased circulation to the injured area and ultimately pain reduction, in a process called photobiomodulation (PBM).

Low Level Laser Therapy (Including PBM) Research Articles

LLLT or Low Level Laser Therapy: 7,364
Photobiomodulation (PBM): 1,151

Laser Therapy (Including PBM) Research Articles By Year

*Data According to PubMed

“Clinicians should consider the use of low-level laser therapy to decrease pain and stiffness inpatients with Achilles tendinopathy.” – APTA

“Laser therapy is beneficial in treatment of neck pain.” – WHO

“Laser therapy shows strong evidence of effectiveness for pain relief.” – IASP

What is the purpose of laser therapy?

Laser therapy, or photobiomodulation, is the process of photons entering the tissue and interacting with the cytochrome c complex within the cell mitochondria. The result of this interaction, and the point of conducting laser therapy treatments, is the biological cascade of events that leads to an increase in cellular metabolism (promoting tissue healing) and a decrease in pain. Laser therapy is used to treat acute and chronic conditions as well as post-activity recovery. It is also used as another option to prescription drugs, a tool to prolong the need for some surgeries, as well as pre and post-surgery treatment to help control pain.

 

 

Is laser therapy painful? What does laser therapy feel like?

Laser therapy treatments must be administered directly to skin, as laser light cannot penetrate through layers of clothing. You will feel a soothing warmth as the therapy is administered. Many patients receiving LightForce® Therapy Laser treatments report enjoying the experience, especially when a massage-ball treatment head is used to deliver what is often referred to as a “laser massage.”

Patients receiving treatments with higher-power lasers also frequently report a rapid decrease in pain. For someone suffering from chronic pain, this effect can be particularly pronounced. Laser therapy for pain can be a viable treatment.

 

 

Is laser therapy safe?

Class IV laser therapy (now called photobiomodulation) devices were cleared in 2004 by the FDA for the safe and efficacious reduction of pain and increasing micro-circulation. Therapy lasers are safe and effective treatment options to reduce musculoskeletal pain due to injury. The biggest risk to injury during laser therapy treatments is to the eye, which is why certified, protective eyewear is always required during LightForce® treatments.

 

 

How long does a therapy session last?

With LightForce® lasers, treatments are quick usually 3-10 minutes depending on the size, depth, and acuteness of the condition being treated. High-power lasers are able to deliver a lot of energy in a small amount of time, allowing therapeutic dosages to be achieved quickly. For patients and clinicians with packed schedules, fast and effective treatments are a must.

 

 

How often will I need to get treated with laser therapy?

Most clinicians will encourage their patients to receive 2-3 treatments per week as the therapy is initiated. There is a well-documented support that the benefits of laser therapy are cumulative, suggesting that plans for incorporating laser as part of a patient’s plan of care should involve early, frequent treatments that may be administered less frequently as the symptoms resolve.

 

 

How many treatment sessions will I need?

The nature of the condition and the patient’s response to the treatments will play a key role in determining how many treatments will be needed. Most laser therapy plans of care will involve 6-12 treatments, with more treatment needed for longer standing, chronic conditions. Your doctor will develop a treatment plan that is optimal for your condition.

 

 

How long will it take until I notice a difference?

Patients often report improved sensation, including a therapeutic warmth and some analgesia immediately after the treatment. For noticeable changes in symptoms and condition, patients should undergo a series of treatments as the benefits of laser therapy from one treatment to the next are cumulative.

 

 

Does insurance cover treatments?

Generally insurances do not reimburse for laser treatments despite there being codes that can be used to submit for the service.  Laser treatments are usually handled as a cash transaction between the clinic and the patient.  Average cost of a treatment varies across the country.   Many clinics offer discounts when purchasing visits in packages.   We recommend checking with your provider to get specific pricing.

 

 

Do I have to limit my activities?

Laser therapy will not limit a patient’s activities.  The nature of a specific pathology and the current stage within the healing process will dictate appropriate activity levels.  Laser will often reduce pain which will make it easier to perform different activities and will often help restore more normal joint mechanics.  That being said, reduced pain should not overshadow the advice of a medical professional that understands how the laser will fit into a rehabilitation protocol when deciding how aggressively to push functional limits.

 

With LightForce® lasers, treatments are quick usually 3-10 minutes depending on the size, depth, and acuteness of the condition being treated. High-power lasers are able to deliver a lot of energy in a small amount of time, allowing therapeutic dosages to be achieved quickly. For patients and clinicians with packed schedules, fast and effective treatments are a must.

The nature of the condition and the patient’s response to the treatments will play a key role in determining how many treatments will be needed. Most laser therapy plans of care will involve 6-12 treatments, with more treatment needed for longer standing, chronic conditions. Your doctor will develop a treatment plan that is optimal for your condition.

CLINICAL FAQS

 

 

Is there a certification to administer low level laser therapy?

Every clinician using a LightForce® therapy laser is encouraged to complete certification training through the American Institute of Medical Laser Applications (AIMLA). LightForce® provides access to this training to every clinical office or athletic training team that becomes a customer. In addition, LightForce® provides onsite installation training from our clinically trained representatives. This secondary training certification accredits clinicians in the operation of the laser device.

 

 

What does power or wattage have to do with LLLT (laser therapy treatments)?

The biggest challenge in photobiomodulation therapy is getting light energy in sufficient quantity to injured tissues. Skin does an excellent job scattering and reflecting most of the light that it is introduced to it. Additionally, melanin absorbs most of the remainder of light into the skin, leaving very little to get transmitted below skin level. When normal white light or sunshine hits the skin, very few photons get past this impressive gate keeper.

As if the natural barriers to light weren’t enough, most injuries involve dozens to hundreds of square centimeters of tissue damage. When larger areas need to be treated, even more power is needed at the surface to maintain the same therapeutic dose at depth over the entire treatment area. Therefore, even if you are using a laser that has the appropriate wavelengths to penetrate tissue ideally, but has a very low level of overall power, you will only be able to effectively treat very small areas. Additionally, treatments may take 30 minutes or longer.

The higher wattage Class 4 lasers (anything above 0.5W) allow for sufficient laser energy to be passed onto nerve, muscle, ligament, tendon, and/or capsular tissue in a reasonable amount of time. Normal treatment sessions range from 3-10 minutes, which is quite acceptable in a clinical setting. Higher powered lasers will also allow clinicians to have the versatility to treat injured tissue in multiple areas in a given session, which greatly improves the overall effectiveness of the laser when adding it to a plan of care.

 

 

What’s the difference between a super pulsed laser, gated pulsing laser or continuous wave laser?

Photobiomodulation therapy can be delivered in either a continuous wave or pulsed mode. Typically, there are two types of pulsing used in therapy lasers—super pulsed or gated.

Super Pulsed. Various claims suggest there are ideal pulsing frequencies; however, there are no published reports that show Super Pulsing is more effective than constant wave forms of light therapy.

Gated. When the laser is used in gated mode, it is cycling its continuous wave power on and off and consequently delivering a lower average output power. In general, the use of pulsing decreases light delivered to the target due to photos being emitted in short bursts with slack periods between.

Continuous Wave. Continuous wave lasers deliver photobiomodulation therapy by having the laser “on” all the time. There is no period where the laser is “off” during the treatment. It is analogous to turning on a light to brighten a room. In most cases, LightForce® recommends the use of its equipment in this fashion to maximize energy delivery to the treatment area. This helps promote consistent outcomes by making it easier to correctly dose tissue in less time.

 

 

What are the contraindications for laser therapy?

The following are contraindications with laser therapy.

  • Do not treat over growth plates in children.
  • Do not treat pregnant patients over the abdominal area or the low back/ pelvic area.
  • Avoid treating around glandular tissue (such as thyroid, testes, ovaries).
  • Do not treat over pacemakers or internal pain pumps.
  • Do not treat patients taking photosensitive medications (such as steroids or antibiotics)

 

 

What are the side effects of laser therapy?

Based on peer-reviewed literature, there are no known significant side effects from laser therapy for most conditions. Increased blood flow is a positive benefit associated with laser therapy that can cause the skin to get flush and the feeling of warmth. These changes are short-lived, typically lasting for up to a few hours. Improper dosing can lead to increased swelling for acute injuries where there is a lot of inflammation present as well as increased nerve-related pain for certain conditions when irritable nerve tissue is over stimulated.  This is usually correctable by adjusting the treatment settings.  On these rare occasions, the setbacks usually reverse themselves within 24-36 hours.  Understanding proper dosing parameters minimizes this phenomena.

 

 

Is Class 4 laser a cold laser?

The term “Cold Laser” is a dated term.  It was created to help describe lower power Class 2 and 3 lasers that don’t have power densities (irradiance) sufficiently high enough to create surface heat when applied.  Therefore, Class 4 lasers, or Class IV lasers, are not technically “Cold Lasers” since they do create a warming sensation on the skin when applied in most cases.

Since 2015 , the correct term that encompasses all therapy lasers and LEDs is photobiomodulation (PBM).  This term describes all light sources that are designed to promote circulation, improve tissue repair, and reduce pain.

 

 

Can low level laser therapy be used with other modalities/treatments?

Yes, it generally works well with other modalities that are designed to promote tissue repair.  Examples might include blood flow restriction and shockwave devices.  The mechanisms that are associated with these modalities work well with laser therapy.  Generally using modalities that are designed to provide cryotherapy which generally reduce blood flow and promote vasoconstriction are not recommended as adjunctive therapies with laser.

 

 

Can laser be effective as a post-surgical treatment for pain?

Absolutely! Some of the most consistently reported benefits of laser therapy are related to reduced pain after treatment. Research has shown that PBM can speed up the healing process of certain tissues through increased cellular metabolism. For post-surgical patients, appropriate doses of light energy can be delivered to effectively reduce pain, without negatively impacting the body’s natural healing process5.

 

 

Can laser be used over metal/implants?

Yes, laser can be used over metal implants/ hardware.  At the irradiance levels used with LightForce equipment, light will simply bounce off of metal.  There will be no heating that takes place at depth when using LightForce® lasers within recommended parameters.

 

 

Is laser effective for treating arthritis?

The suffix, –itis comes from the Greek that denotes inflammation. Several studies have shown that laser is an excellent therapy to help address the symptoms related to both osteo and rheumatoid arthritis. While it will not restore damaged cartilage, it can help improve ROM of the affected joints and help reduce pain so that functional levels can be maintained, NSAIDS can be reduced, and in some cases, more invasive procedures can be delayed or prevented.

 

 

Is there any literature supporting the use of low level laser therapy (LLLT) in rehabilitation?

Yes, there is a growing body of peer-reviewed clinical research supporting the use of Class 4, deep tissue lasers as a safe and effective treatment option for a myriad of conditions in rehabilitation. This body of literature includes numerous randomized control trials.

As of 2020, a search on Pubmed.com yielded over 7500 publications on “Low Level Laser Therapy” and over 1200 articles on the more recently coined term “Photobiomodulation”.

 

1. Holanda VM, Chavantes MC, Silva DF, de Holanda CV, de Oliveira JO Jr, Wu X, Anders JJ. Photobiomodulation of the dorsal root ganglion for the treatment of low back pain: A pilot study. Lasers Surg Med. 2016 Sep

2. Holanda VM, Chavantes MC, Wu X, Anders JJ. The mechanistic basis for photobiomodulation therapy of neuropathic pain by near infrared laser light. Lasers Surg Med. 2017 Jul

3. De Marchi T, Schmitt VM, Machado GP, de Sene JS, de Col CD, Tairova O, Salvador M, Leal-Junior EC. Does photobiomodulation therapy is better than cryotherapy in muscle recovery after a high-intensity exercise? A randomized, double-blind, placebo-controlled clinical trial. Lasers Med Sci. 2017 Feb

4. Dima R, Tieppo Francio V, Towery C, Davani S. Review of Literature on Low-level Laser Therapy Benefits for Nonpharmacological Pain Control in Chronic Pain and Osteoarthritis. Altern Ther Health Med. 2018 Sep

5. Langella LG, Casalechi HL, Tomazoni SS, Johnson DS, Albertini R, Pallotta RC, Marcos RL, de Carvalho PTC, Leal-Junior ECP. Photobiomodulation therapy (PBMT) on acute pain and inflammation in patients who underwent total hip arthroplasty-a randomized, triple-blind, placebo-controlled clinical trial. Lasers Med Sci. 2018 Dec

6. Abbasgholizadeh ZS, Evren B, Ozkan Y. Evaluation of the efficacy of different treatment modalities for painful temporomandibular disorders. Int J Oral Maxillofac Surg. 2020 May;49(5):628-635. doi: 10.1016/j.ijom.2019.08.010. Epub 2019 Sep 21. PMID: 31547949.

7. Khairnar S, Bhate K, S N SK, Kshirsagar K, Jagtap B, Kakodkar P. Comparative evaluation of low-level laser therapy and ultrasound heat therapy in reducing temporomandibular joint disorder pain. J Dent Anesth Pain Med. 2019 Oct;19(5):289-294. doi: 10.17245/jdapm.2019.19.5.289. Epub 2019 Oct 30. PMID: 31723669; PMCID: PMC6834715.

8. Chow RT, Johnson MI, Lopes-Martins RA, Bjordal JM. Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials. Lancet. 2009 Dec 5;374(9705):1897-908. doi: 10.1016/S0140-6736(09)61522-1. Epub 2009 Nov 13. Erratum in: Lancet. 2010 Mar 13;375(9718):894. PMID: 19913903.

9. Santamato A, Solfrizzi V, Panza F, Tondi G, Frisardi V, Leggin BG, Ranieri M, Fiore P. Short-term effects of high-intensity laser therapy versus ultrasound therapy in the treatment of people with subacromial impingement syndrome: a randomized clinical trial. Phys Ther. 2009 Jul;89(7):643-52.

10. Kim SH, Kim YH, Lee HR, Choi YE. Short-term effects of high-intensity laser therapy on frozen shoulder: A prospective randomized control study. Man Ther. 2015 Dec;20(6):751-7. doi: 10.1016/j.math.2015.02.009. Epub 2015 Mar 2. PMID: 25770420.

11. Awotidebe AW, Inglis-Jassiem G, Young T. Low-level laser therapy and exercise for patients with shoulder disorders in physiotherapy practice (a systematic review protocol). Syst Rev. 2015 Apr 30;4:60. doi: 10.1186/s13643-015-0050-2. PMID: 25925768; PMCID: PMC4423144.

12. Panton L, Simonavice E, Williams K, Mojock C, Kim JS, Kingsley JD, McMillan V, Mathis R. Effects of Class IV laser therapy on fibromyalgia impact and function in women with fibromyalgia. J Altern Complement Med. 2013 May;19(5):445-52. doi: 10.1089/acm.2011.0398. Epub 2012 Nov 23. PMID: 23176373.

13. Roberts DB, Kruse RJ, Stoll SF. The effectiveness of therapeutic class IV (10 W) laser treatment for epicondylitis. Lasers Surg Med. 2013 Jul;45(5):311-7. doi: 10.1002/lsm.22140. Epub 2013 Jun 3. PMID: 23733499.

14. Alayat MS, Atya AM, Ali MM, Shosha TM. Long-term effect of high-intensity laser therapy in the treatment of patients with chronic low back pain: a randomized blinded placebo-controlled trial. Lasers Med Sci. 2014 May;29(3):1065-73. doi: 10.1007/s10103-013-1472-5. Epub 2013 Nov 2.

15. Yousefi-Nooraie R, Schonstein E, Heidari K, Rashidian A, Pennick V, Akbari-Kamrani M, Irani S, Shakiba B, Mortaz Hejri SA, Mortaz Hejri SO, Jonaidi A. Low level laser therapy for nonspecific low-back pain. Cochrane Database Syst Rev. 2008 Apr 16;(2):CD005107. doi: 10.1002/14651858.CD005107.pub4. PMID: 18425909.

16. Holanda VM, Chavantes MC, Silva DF, de Holanda CV, de Oliveira JO Jr, Wu X, Anders JJ. Photobiomodulation of the dorsal root ganglion for the treatment of low back pain: A pilot study. Lasers Surg Med. 2016 Sep;48(7):653-9. doi: 10.1002/lsm.22522. Epub 2016 May 2. PMID: 27135465.

17. Jovicić M, Konstantinović L, Lazović M, Jovicić V. Clinical and functional evaluation of patients with acute low back pain and radiculopathy treated with different energy doses of low level laser therapy. Vojnosanit Pregl. 2012 Aug;69(8):656-62. PMID: 22924260.

18. Dima R, Tieppo Francio V, Towery C, Davani S. Review of Literature on Low-level Laser Therapy Benefits for Nonpharmacological Pain Control in Chronic Pain and Osteoarthritis. Altern Ther Health Med. 2018 Sep;24(5):8-10. PMID: 28987080.

19. Alves AN, Fernandes KP, Deana AM, Bussadori SK, Mesquita-Ferrari RA. Effects of low-level laser therapy on skeletal muscle repair: a systematic review. Am J Phys Med Rehabil. 2014 Dec;93(12):1073-85. doi: 10.1097/PHM.0000000000000158. PMID: 25122099.

20. Dornelles MP, Fritsch CG, Sonda FC, Johnson DS, Leal-Junior ECP, Vaz MA, Baroni BM. Photobiomodulation therapy as a tool to prevent hamstring strain injuries by reducing soccer-induced fatigue on hamstring muscles. Lasers Med Sci. 2019 Aug;34(6):1177-1184. doi: 10.1007/s10103-018-02709-w. Epub 2019 Jan 3. PMID: 30607719.

21. Alves AN, Fernandes KP, Deana AM, Bussadori SK, Mesquita-Ferrari RA. Effects of low-level laser therapy on skeletal muscle repair: a systematic review. Am J Phys Med Rehabil. 2014 Dec;93(12):1073-85. doi: 10.1097/PHM.0000000000000158. PMID: 25122099.

22. Ordahan B, Karahan AY, Kaydok E. The effect of high-intensity versus low-level laser therapy in the management of plantar fasciitis: a randomized clinical trial. Lasers Med Sci. 2018 Aug;33(6):1363-1369. doi: 10.1007/s10103-018-2497-6. Epub 2018 Apr 7. PMID: 29627888.

23. Tiwari, Mukesh & Lamba, Dheeraj. (2014). Benefical effects of Low Level Laser Therapy in Musculoskeletal Disorders of Foot-Plantar Fasciitis, a Review. Indian Journal of Physiotherapy and Occupational Therapy – An International Journal. 8. 70. 10.5958/j.0973-5674.8.1.015.