For millions of Americans, pain is a regular part of life. According to a report, an estimated 50 million American adults suffer from chronic pain. Chronic pain may last for weeks or years and feel like an ache, burn or sting. Pain is one of the primary reasons people go to the doctor, and it links with problems such as anxiety, depression, dependence on opioids and overall reduced quality of life.
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Chronic pain can be difficult to treat depending on the cause, and sometimes, there is no known reason for the condition. However, specific treatments, such as laser therapy, can help bring fast relief for common ailments like back pain. Laser therapy is a safe and effective solution to relieving pain and healing the body without invasive surgery or potentially harmful medications. Over 4,000 studies demonstrate the positive effects of laser therapy, and it’s earned approval from the Food and Drug Administration (FDA) to treat a range of conditions. Still, we don’t fully understand the science of laser therapy for pain, and scientists need to conduct more research to outline how it works. In the meantime, we’ll explore what we currently know about laser therapy’s effects and how it might help you enjoy long-lasting relief from acute or chronic pain.
Laser therapy, also called low-level laser therapy (LLLT) or cold laser therapy uses visible light radiation to produce a photochemical reaction within the body’s cells. LLLT does not emit heat and is why you might also hear people call it cold laser therapy. The treatment uses wavelengths within the visible light spectrum that falls between 400 to 760 nanometers (nm). These wavelengths can penetrate the skin and soft or hard tissues and have clinically proven to have a positive benefit on inflammation, pain and healing.
During an LLLT session, a physician will align the laser-emitting device over the painful area. The low-level laser will then penetrate your skin without causing pain or damage. Your cells will absorb the light energy and convert it into cell energy, suppressing pain and reducing the inflammatory pathways. The entire therapy procedure may only take a few minutes, but you might need to return for follow-up treatments a few times a week for a month or so. Published data shows that results have lasted up to a year.
The lasers used in LLLT are not like those used to perform surgeries. Laser surgery devices use around 300 watts and can cut through the skin. Cold laser devices use between five and 500 milliwatts. The FDA considers cold lasers to be non-heating instruments.
Although there is much to learn about how lasers work for pain management, laser devices are nothing new. In , Hungarian surgeon Endre Mester discovered the ability of laser light to stimulate healing in mice. He then used his findings to treat skin ulcers in human patients. Since then, advancements in LLLT have allowed physicians, dentists, physical therapists, chiropractors, occupational therapists and other medical professionals to treat various conditions. Now, patients can purchase laser therapy devices and find relief from pain and inflammation at home.
When you undergo LLLT, you expose your skin to photons, or particles of light that carry electromagnetic radiation. A portion of your cells, called the mitochondrion, absorbs the photons. This phenomenon causes your mitochondria to accelerate adenosine triphosphate production, which helps fuel cellular processes in the body. Some tissues, like muscles, have a lot of mitochondria because they need energy.
In addition to giving your cells an energy boost, LLLT improves circulation and speeds up tissue healing. Only cells and tissues that are normally dormant absorb the light energy emitted by an LLLT device, and it does not affect healthy cells.
For LLLT to work correctly, you need to choose the right device, because specific wavelengths are more suitable for particular treatments. For example, visible wavelengths in the 400 to 760 produce a photochemical reaction, while infrared wavelengths 760+ work through a photothermal effect, producing heat and potentially harmful side-effects. Use our Find a Provider Form to find our laser near you!
Coping with pain can be a frustrating, time-consuming and sometimes risky experience. For example, turning to back surgery to relieve pain carries the risk of complications. Health experts recommend trying non-invasive treatments such as LLLT before agreeing to get an operation.
There are also issues with taking pain medications to find relief. Doctors typically suggest medicine such as acetaminophen or non-steroidal anti-inflammatory drugs for pain, but these often come with undesirable side effects or do little to help. For more severe pain, a doctor might prescribe an opioid, which carries a high risk of misuse. Patients who do not feel comfortable taking medications and who want an effective way to treat pain or inflammation might look toward LLLT. Here are some of the benefits:
The Erchonia Laser is the only LLLT to receive FDA Clearance to treat overall nociceptive Muscle skeletal pain which includes a vast range of conditions, such as:
There is nothing to fear about LLLT, but there is potential to explore. If you’ve been living with chronic pain or are seeking an alternative way to heal from an injury, you might consider LLLT. If you’re curious about cold laser therapy for purposes other than pain relief, you’ll find it has limitless uses. For example, we can also use LLLT in body contouring applications and acne treatments to help you look and feel better. If you still have questions about lasers and how they work for pain management, we are here to help at Erchonia.
At Erchonia, we are proud to be leaders and innovators in the field of medical equipment manufacturing. We specialize in delivering high-quality low-level laser products to medical professionals and clients. We care about our clients, and we want to help you or your patients find relief from pain quickly, easily and effectively. To learn more about our products or how LLLT works, please reach out to us today.
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Low-level laser therapy (LLLT), cold laser therapy or photobiomodulation (PBM)[1][2][3][4][5] is a medical treatment that applies low-level (low-power) lasers or light-emitting diodes (LEDs) to the surface of the body without damaging tissue. Proponents claim that this treatment stimulates healing, relieves pain, and enhances cell function. Sometimes termed as low-level red-light therapy (LLRL), its effects appear to be limited to a specific range of wavelengths. Its effectiveness is under investigation. Several such devices are cleared by the United States Food and Drug Administration (FDA) The therapy may be effective for conditions such as juvenile myopia,[6][7] rheumatoid arthritis,[8] and oral mucositis.[9]
LLLT makes use of Grotthuss-Draper law, the first law in photochemistry: light must be absorbed by a chemical substance in order for a photochemical reaction to take place. In LLLT that chemical substance is represented by the respiratory enzyme cytochrome c oxidase which is involved in the electron transport chain in mitochondria,[10][11] which is the generally accepted theory. Administering LLLT below the dose range does not appear to be effective.[12]
Photochemical reactions are well known in biological research.
LLLT has been promoted for use in treatment of musculoskeletal conditions, including:
LLLT appears to be effective for preventing:
Transcranial photobiomodulation or transcranial low level light therapy is limited in neuromodulation due to several reasons:
Insufficient information from clinical trials compares the effectiveness of different types of devices or device parameters (wavelengths, power output, session time, area of actuation).[29]
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Veterinary clinics use cold laser devices to treat a wide variety of ailments, from arthritis to wounds, on dogs and cats.[30][31] Little research has been done on the effects of such treatments on animals. Brennen McKenzie, president of the Evidence-Based Veterinary Medicine Association, stated, "research into cold laser in dogs and cats is sparse and generally low quality. Most studies are small and have minimal or uncertain controls for bias and error".[32][33] He allowed that some studies show promising results, while concluding that evidence is not sufficient to support routine clinical.
Based on the results of a systematic review, there is no evidence to suggest that people with cancer or people who are at risk of getting cancer should avoid photobiomodulation.[34]
There are some reports of mild pain or skin irritation after red-light therapy.[35] The long-term effects on the skin or the hair are not known.[35] Eye protection is suggested for some devices.[35] For skin applications, different wavelengths of light may result in different biological effects depending on the person's skin type, race, and ethnicity.[36] Clinical guidelines suggest that a dermatologist be consulted before undergoing treatment.[36]
For safety, if a person chooses to use red-light therapy, a device approved for use on humans by the country the person lives in is recommended. For example, in the US, it is suggested that only devices approved by the FDA for dermatologic application should be used.[35]
Faroese physician Niels Finsen is believed to be the father of modern light therapy.[37] He used red light to treat smallpox lesions. He received the Nobel Prize in Physiology or Medicine in .[38] Scientific evidence for some of his treatments is lacking, and later eradication of smallpox and development of antibiotics for tuberculosis rendered light therapy obsolete for these diseases.[39]
Hungarian physician and surgeon Endre Mester (–) is credited with the discovery of the biological effects of low power lasers,[40] which occurred a few years after the invention of the ruby laser and the invention of the helium–neon (HeNe) laser.[10] Mester accidentally discovered that low-level ruby laser light could regrow hair during an attempt to replicate an experiment that showed that such lasers could reduce tumors in mice. The laser he was using was faulty and was not as powerful as he thought. It failed to affect the tumors, but he noticed that in the places where he had shaved the mice in order to do the experiments, the hair grew back more quickly on the treated mice than on those among the control group.[2] He published those results in .[10] He went on to show that low level HeNe light could accelerate wound healing in mice.[10]
By the s, he was applying low level laser light to treat people with skin ulcers.[10] In , he founded the Laser Research Center at the Semmelweis Medical University in Budapest, and continued working there for the remainder of his life.[41] His sons carried on his work and brought it to the United States.[40] By , companies selling lasers were claiming that they could treat pain, accelerate healing of sports injuries, and treat arthritis, but there was little evidence for this at that time.[40] Mester originally called this approach "laser biostimulation'", but it soon became known as “low-level laser therapy" and with the adaptation of light emitting diodes by those studying this approach, it became known as "low-level light therapy", and to resolve confusion around the exact meaning of "low level", the term "photobiomodulation" arose.[2]
The following terms are accepted as alternatives of low level light therapy term: LLLT, laser biostimulation, laser phototherapy, low-level laser therapy, low-power laser irradiation, low-power laser therapy, and photobiomodulation therapy. The term photobiomodulation therapy is considered the preferred term by industry professionals.[3][4] However LLLT has been marketed and researched under a number of other terms, including red light therapy,[42] low-power laser therapy (LPLT), soft laser therapy, low-intensity laser therapy, low-energy laser therapy, cold laser therapy, bio-stimulation laser therapy, photo-biotherapy, therapeutic laser, and monochromatic infrared light energy (MIRE) therapy.[43] More specific applications sometimes have their own terms, for example when administered to acupuncture points, the procedure is called laser acupuncture. When applied to the head, LLLT may be known as transcranial photobiomodulation, transcranial near-infrared laser therapy (NILT),[44] or transcranial low level light therapy.
The FDA filed a complaint for injunction in , alleging that company QLaser PMA were marketing their devices as being able to treat “over 200 different diseases and disorders,” including cancer, cardiac arrest, deafness, diabetes, HIV/AIDS, macular degeneration, and venereal disease. This case resulted in a permanent injunction against the manufacture, marketing, sale, and distribution of those devices in .[45]
In , the owner of QLaser, Robert Lytle, and two of QLaser's distributors were charged with a criminal conspiracy to commit fraud. Lytle pleaded guilty to one count of conspiracy to introduce misbranded medical devices into interstate commerce with the intent to defraud and mislead, and one count of criminal contempt in January . Lytle was sentenced to serve 12 years in prison and made an initial restitution payment of $637,000. Lytle's conspirators were sentenced to 24 months and 15 months, respectively.[46][47]
Blue Cross Blue Shield Association and Aetna provide coverage for the prevention of oral mucositis, but not any other reason.[48][49] The Centers for Medicare and Medicaid Services does not provide coverage for LLLT.[50] Cigna lists LLLT as "experimental, investigational, or unproven for any indication" and provides literature review summaries for a number of conditions.[51]
Evidence does not support a benefit in delayed-onset muscle soreness.[52] It may be useful for muscle pain and injuries.[53] A Cochrane Library review concluded that LLLT has insufficient evidence for treatment of nonspecific low back pain,[54] a finding echoed in a review of chronic low back pain.[55] A review found benefit in nonspecific chronic low-back pain.[14] LLLT may be useful in the treatment of both acute and chronic neck pain.[15] In , however, a systematic review and meta-analysis of LLLT for neck pain indicated that the benefit was not of significant importance and that the evidence had a high risk of bias.[56] In a study testing the efficacy of low-level laser therapy treating plantar fasciitis found that LLLT significantly reduces pain in lower extremity tendinopathy and plantar fasciitis in the short and medium terms. [57] The same study also stated that while comparing the effect of LLLT to that of therapeutic ultrasound in persons with patellar tendinopathy, and they found a statistically significant effect in favour of LLLT, both on pain reduction and function.[57]
There are tentative data that LLLT is useful in the short-term treatment of pain caused by rheumatoid arthritis,[8] and possibly chronic joint disorders.[12] Research that compared the effects of LLLT against other treatments, sham treatments, or no treatment at all, and randomized adult patients with rheumatoid arthritis to receive it were considered. These outcomes included pain, functional capacity, adverse events, inflammation, disease activity, range of motion, stiffness in the morning, muscle strength, and quality of life.[58] The findings indicate that the differences between utilizing a sham and an infrared laser may be negligible or nonexistent in terms of pain, stiffness in the morning, grip strength, functional ability, inflammation, range of motion, disease activity, and side events. It was also discovered that the data about the effects of laser acupuncture against reflexology in terms of functional ability, quality of life, and inflammation is quite hazy, and about the effects of red laser versus sham in terms of pain, morning stiffness, and side events.[58] The usefulness of red laser, laser acupuncture, and reflexology in the treatment of RA patients is not well enough demonstrated. [58] A systematic review and meta-analysis found evidence for pain reduction in osteoarthritis.[13] While it does not appear to improve pain in temporomandibular disorders, it may improve function.[59]
There is tentative evidence of benefit in tendinopathy.[16][17] A review found benefit in shoulder tendinopathy.[60] A Cochrane review found tentative evidence that it may help in frozen shoulders.[61]
Similarly, the use of lasers to treat chronic periodontitis[20] and to speed healing of infections around dental implants[21] is suggested, but there is insufficient evidence to indicate a use superior to traditional practices.[62] There is tentative evidence for dentin hypersensitivity.[63] It does not appear to be useful for orthodontic pain[64][65] LLLT might be useful for wisdom tooth extraction (complications).[66]
LLLT has been studied as a treatment for hair loss; a review in found little evidence to support the use of lasers to treat hair loss.[67] A review found tentative evidence for benefit for lasers,[68] while another review concluded that the results were mixed, had a high risk of bias, and that its effectiveness was unclear.[69] A review found tentative evidence of benefit.[70] Additionally, a review of clinical trials found 10 of 11 trials reviewed "demonstrated significant improvement of androgenic alopecia in comparison to baseline or controls when treated with LLLT."[71]
LLLT is shown to increase hair density and growth in both genders. The types of devices (hat, comb, helmet) and duration did not alter the effectiveness,[72] with more emphasis to be placed on lasers compared to LEDs.[73] Ultraviolet and infrared light are more effective for alopecia areata, while red light and infrared light is more effective for androgenetic alopecia.[74]
Medical reviews suggest that LLLT is as effective or potentially more than other non invasive and traditional therapies such as minoxidil and finasteride but further studies such as RCTs, long term follow up studies, and larger double blinded trials need to be conducted to confirm the initial findings.[75][76][77]
LLLT has been studied for traumatic brain injury (TBI) and stroke among other conditions.[10] When applied to the head it is known as transcranial photobiomodulation or transcranial low level light therapy.
LLLT has been studied as a way to reduce pain and swelling in breast-cancer related lymphedema.[78][18] The systematic review & meta-analysis by Smoot, Chiavola-Larson, et al found “Moderate-strength evidence supports LLLT in the management of [breast cancer related lymphoedema], with […] reductions in volume and pain immediately after conclusion of LLLT treatments. Greater reductions in volume [of lymph nodes or surrounding tissues] were found with the use of LLLT than in treatments without it.”[79]
An ongoing area of research is the application of LLLT for increasing cell proliferation, including stem cells.[80]
Low level laser therapy has been studied as a potential treatment for chronic wounds, and higher-power lasers have sometimes been successfully used to close acute wounds as an alternative to stitching.[81] However, as of and due to inconsistent results and the low quality of extant research, reviews in the scientific literature have not supported its widespread application.[81][82]