|Cold Laser Therapy or Low
Level Laser Therapy
Low Level Laser Therapy (LLLT) AKA Low Power Laser (LPL), Cold Laser or
Low Level Laser Therapy is a high intensity
light directed 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
In short, LLLT reduces 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.
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
An alternative to needles for acupuncture
The red and near infrared light (600nm-1000nm) can be produced by laser or high
The intensity of LLLT lasers is not high like a surgical laser*. There is no heating
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 it's part in a natural
*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.
Laser Therapy is Popularly Used For:
* Pain Relief (muscles, joints, nerves)
* Plantar fascitis
* Wound Healing
* Migraine headaches
* Lower back pain
* Repetitive Stress Injuries (RSI)
* Carpal Tunnel Syndrome (CTS)
* Fibromyalgia / Myofascial Pain
* Sprains and strains
* Post-operative pain
* Post-operative wounds
* Knee, foot, ankle pain
* Tennis Elbow
* Golfer's Elbow
* Soft tissue injuries
* Pressure sores
* Herpes simplex
* Rotator Cuff Injury
How does LLLT work?
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
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) &
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
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.
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. firstname.lastname@example.org
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
PMID: 15022259 [PubMed - indexed for MEDLINE]
J Clin Laser Med Surg. 2003 Jun;21(3):165-70.
· J Clin Laser Med Surg. 2003 Aug;21(4):183.
Low-level laser irradiation attenuates production of reactive oxygen species by
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
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,
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.
Randomized Controlled Trial
PMID: 11800105 [PubMed - indexed for MEDLINE]
Eur J Haematol. 2004 Mar;72(3):222-4.
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
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
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. email@example.com
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
Marsilio AL, Rodrigues JR, Borges AB.
Restorative Dentistry, UNESP School of Dentistry, Sao Jose dos Campos, SP, Brazil.
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.
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.
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.
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
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.
Randomized Controlled Trial
PMID: 11434469 [PubMed - indexed for MEDLINE]
J Clin Laser Med Surg. 1997;15(5):217-20.
Laser therapy for fibromyositic rheumatisms.
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.
PMID: 9612173 [PubMed - indexed for MEDLINE]
Acupunct Electrother Res. 1994 Jun-Sep;19(2-3):141-51.
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
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
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.
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.
PMID: 15369190 [PubMed - in process]
Vopr Kurortol Fizioter Lech Fiz Kult. 2002 Jul-Aug;(4):25-7.
[Laser therapy and electric stimulation in rehabilitation treatment of peripheral
[Article in Russian]
Miriutova NF, Abdulkina NG, Luksha LV, Levitskii EF.
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.
PMID: 12380528 [PubMed - indexed for MEDLINE]
Arch Phys Med Rehabil. 2002 Jul;83(7):978-88.
Arch Phys Med Rehabil. 2002 Dec;83(12):1806; author reply 1806-7.
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. firstname.lastname@example.org
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
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.
PMID: 10100028 [PubMed - indexed for MEDLINE]
Vopr Kurortol Fizioter Lech Fiz Kult. 1995 Sep-Oct;(5):10-3.
[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.
PMID: 8597209 [PubMed - indexed for MEDLINE]
Conditions that are treated very effectively with Cold Laser
(also known as Low Level Laser Therapy)
Carpal Tunnel Syndrome
Thoracic Outlet Syndrome
Herniated or Bulging Discs
Sacroilliac Joint Pain
Tennis or Golfer's Elbow
Improving Fracture Healing
Shoulder Pain or Bursitis
Cold Laser Therapy,
Back Pain, Neck