Cold Laser Therapy Pain Management Treatment
Cold Laser Therapy or Low Level Laser Therapy (LLLT) is a treatment that utilizes specific wavelengths of light to interact with tissue and is thought to help accelerate the healing process. It can be used on patients who suffer from a variety of acute and chronic conditions in order to help eliminate pain, swelling, reduce spasms and increase functionality.
How Cold Lasers Work
Cold lasers are handheld devices used by the clinician and are often the size of a flashlight. The laser is placed directly over the injured area for 30 seconds to several minutes, depending on the size of the area being treated and the dose provided by the cold laser unit.
During this time, the non-thermal photons of light that are emitted from the laser pass through the skins layers (the dermis, epidermis, and the subcutaneous tissue or tissue fat under the skin). This light has the ability to penetrate 2 to 5 centimeters below the skin at 90mw and 830 nm. Once the light energy passes through the layers of skin and reaches the target area, it is absorbed and interacts with the light sensitive elements in the cell. This process can be compared to photosynthesis in plants - sunlight is absorbed by plants, which is then converted to usable energy so that the plant can grow. When cells absorb this light energy, it initiates a series of events in the cell that is theorized to eventually result in normalizing damaged or injured tissue, a reduction in pain, inflammation, edema and an overall reduction in healing time by increasing intracellular metabolism.1,2
Cold laser therapy can stimulate all cell types including muscle, ligament, cartilage, nerves, etc., so a number of conditions can be treated by cold laser therapy. Some of conditions that may typically be treated by cold laser therapy include:
• Arthritis pain
• Back pain
• Carpal tunnel syndrome
• Fibromyalgia pain
• Knee pain
• Neck pain
Effectiveness of Cold Laser Therapy
For years, physicians have been using cold laser therapy on patients who are seeking effective, alternative methods for pain relief. Since 1967 there have been over 2,500 clinical studies published worldwide. Many of these studies are double-blinded, placebo-controlled and have demonstrated cold laser therapy to be a proven method for pain relief.
However, many of these studies were done with small groups, so further larger studies need to be completed. For example, one issue that needs to be studied further is that there does not appear to be a uniform standard regarding the dose and number of treatments.
The effectiveness of cold laser therapy for neck pain was recently reviewed by The Bone and Joint Decade 2000-2010 Task Force on Neck Pain, an initiative conducted by a multidisciplinary team of researchers and clinicians.
The task force concluded that low-level laser therapy can be a beneficial treatment for certain types of neck pain, including types of pain that cause little or no interference with daily activities and pain the does limit daily activities, as compared to pain that includes radiculopathy (arm pain) or serious pathology.3
Cold Laser Therapy has been used in clinical practice all around the world for over four decades. In 1916, Albert Einstein conceived the theory of Light Amplification through Stimulated Emission of Radiation or LASER. In 1967, Professor Andre Mester began using low power lasers in medicine. Dr. Mester is recognized by many as the grandfather of laser therapy.
F.D.A Recognition of Cold Laser Therapy
The F.D.A classifies medical lasers into three categories:
• Class 4 Surgical Lasers
• Class 3B Non-surgical Lasers
• Class 3A Low-Level Lasers
Class 4 Surgical Lasers are used to cut, coagulate, and vaporize tissue. This is different from Class 3B and Class 3A non-surgical lasers, which are painless, non-burning, and non-cutting forms of lasers. Class 3B or Class 3A Low Level Lasers do not have the intensity to damage cells. Class 3A lasers help heal superficial wounds and conditions and will typically not penetrate below the skin’s surface. However, Class 3B low level lasers have the ability to penetrate and assist in the healing process of deep tissue and joint problems.
The first experimental FDA clearance of Class 3B Lasers occurred in February of 2002, after a successful study for carpal tunnel syndrome on workers at General Motors. The laser that was used had a power of 90mw at 830nm.
Certain low level laser devices are also FDA approved for relief of the following conditions3,4:
• Muscle and joint pain
• Stiffness associated with arthritis
• Pain associated with muscle spasms
• Hand pain and wrist pain associated with Carpal Tunnel Syndrome
• Wound healing
Potential Cold Laser Therapy Advantages
Cold laser therapy is a non-invasive procedure, meaning that it does not require a surgical incision. This means that there is no prolonged recovery time.
Laser therapy also does not involve taking any medications, and many patients prefer to avoid taking medications. Studies have so far found that cold laser therapy does not have serious side effects when used properly by a doctor.
Potential Cold Laser Therapy Disadvantages
Cold laser therapy does have some disadvantages. Patients do not typically get full relief or resolution from their pain symptoms after the first treatment. It takes a series of treatments, usually 8 to 30, depending on the severity and duration of the condition.
Patients often have to return to the doctor for treatments at least 2 to 4 times per week. Old injuries may be aggravated for a few days after treatments, but for most patients this sensation is short term, lasting for a couple of days.
Medicare and Medicaid do not cover cold laser therapy expenses. Some major medical insurance carriers do assist with payment and others do not cover any of the treatment.
TAKEN FROM: http://www.spine-health.com/
1 Martin R. Laser-Accelerated Inflammation/Pain Reduction and Healing. Practical Pain Management. Nov/Dec 2003 3(6):20-25. Marovino T. Cold Lasers in Pain Management. Practical Pain Management. Sep/Oct 2004. 4(6):37-42.
2 Hurwitz, EL, Carragee EJ, vander Velde G, et al. Treatment of neck pain: noninvasive interventions: Results of the bone and joint decade 2000-2010 task Force on neck pain and its associated disorders. Spine 2008;33:S123-152.
3 Hurwitz, EL, Carragee EJ, vander Velde G, et al. Treatment of neck pain: noninvasive interventions: Results of the bone and joint decade 2000-2010 task Force on neck pain and its associated disorders. Spine 2008;33:S123-152.
4 Hopkins, JT, McLoda TA, Seegmiller JG, Baxter GD. Low-level laser therapy facilitates superficial wound healing in humans: A triple-blind, sham-controlled study. J Athl Train. 2004 Jul–Sep; 39(3): 223–229.