Laser Therapy: Pain Management in Physiotherapy

Laser therapy in physiotherapy, also known as low-level laser therapy (LLLT) or cold laser therapy, involves the use of low-intensity lasers to stimulate healing at the cellular level. Laser therapy follows the phenomena of photochemical effect that is light is absorbed into the deeper tissue causing a chemical change. It prevents increased thermal effect on superficial layer of skin.

Classification

Low-Level Laser Therapy (LLLT): 

Also known as cold laser therapy, LLLT uses low-power lasers or light-emitting diodes (LEDs) to target tissues without generating heat. It's used to promote tissue repair, reduce inflammation, and alleviate pain.

High-Power Laser Therapy (HPLT): 

This type of laser therapy uses higher power levels than LLLT and can generate more heat. It's often used for deeper tissue penetration and to treat conditions that may require more intense stimulation for healing.

Effects Of Laser Therapy

• reduce pain
• decrease inflammation
• reduce edema
• promote wound healing
• prevent tissue damage

Types of Laser

• Ruby laser(694 nm)
• He-Ne laser(632.8 nm)
• Ga-Al-As laser(805 or 650 nm)
• Ga-As laser(904 nm)

 

Indications

• Osteoarthritis of the knee, hip and ankle
• Rheumatoid arthritis
• TMD
• Shoulder impingement syndromes
• Hip or shoulder bursitis
• Low back disc degeneration
• Disc herniation
• Sciatica
• Neuropathic pain
• Tendonitis
• Tennis elbow
• Plantar fasciitis
• Reduction of volume and pain in lymphedema

Research Based Evidence

• Red and near infrared LLLT administration is thought to reduces inflammation significantly, and is equally effective as NSAIDs
• gallium-arsenide low-power laser therapy treatment is combined with physiotherapy exercises to reduce pain and increase range of motion in shoulder related conditions
• HILT is effective on the stiffness that results in knee osteoarthritis
• Low Level laser therapy (LLLT) is used in temporomandibular disorders (TMDs) because it have analgesic, anti-inflammatory and biostimulating effects
• LLLT is also effective in treating diseases such as stroke, myocardial infarction, and degenerative or traumatic brain disorders. It involves mechanism that involve mitochondria (produce ATP), reactive oxygen species, intracellular calcium, and release of nitric oxide are the initial events.

 

Contraindication

• Pregnancy - over the abdomen and lower back during pregnancy, especially in the first trimester, as a precaution
• Cancer
• Photosensitivity
• Active Hemorrhage
• Over Thyroid or Endocrine Glands
• Active Infections
• Prolonged use of corticosteroids
• History of Seizures