Laser Therapy for Chronic and Acute Musculoskeletal Pain

tendlightLow level laser therapy, or LLLT is the application of low-powered lasers or light emitting diodes for the purpose of pain relief and/or injury repair.  The therapy is typically done transdermal; meaning through the skin into the target tissue, such as a sore shoulder joint (no surgical incisions).  While some research studies show that LLLT can result in immediate pain reduction in rheumatoid arthritis, osteoarthritis, tendinopathies, acute and chronic neck pain, temporomandibular joint (TMJ) pain and other joint disorders there is currently a lack of consensus on the best parameters to use; i.e. power, dosage, time, pulsing, and type of laser.  The therapeutic wavelength appears to be between 800-1,000 nm; and dose to be around 6-10 joules/cm2.

LLLT may reduce pain related to inflammation by lowering levels of COX-2 and tumor necrosis factor-alpha (enzymes associated with inflammation);  oxidative stress, edema, and bleeding.  It is also believed to cause cellular mitochondria to produce more ATP– a cell’s basic energy unit, resulting in increased metabolic activity.

Low level laser therapy is offered by some chiropractors, sports physicians, and acupuncturists.   Lasers are classified according to how much damage they can do to the eye, which basically means how powerful they are in terms of wattage.  The wattage rating of a laser determines how long it takes to deliver a dose, and how deep the light penetrates tissue (important if you are treating thick areas of the body such as the hip or knee joint).  At 10 watts max output, the LiteCure and K-Laser are two of the strongest lasers in the market for this purpose.  Lasers with output of 500mW or less will not penetrate as deeply, and will require a longer treatment time to administer a therapeutic dose.

A typical treatment regimen will be 10-15 minutes of laser; six to eight sessions.  Sometimes that is all it takes to take care of an acute or chronic problem.  Many practitioners including myself incorporate soft tissue therapy, joint mobilization and rehab exercises to fully deal with the painful condition.

So if you are experiencing a recent injury such as a sports injury; or have chronic pain such as tendinitis, sciatica,  plantar fascitis, rotator cuff tear, or knee pain, consider trying low level laser therapy.  It is generally safe, and faster-acting than manual therapies alone (chiropractic, PT, occupational therapy).  Be cautious and tell your practitioner if you are taking photosensitive medications, or have light sensitive skin, as the treatment can be uncomfortable and may even cause pigmentation.

UPDATE ON THIS TOPIC: Can Red Light Heal Injuries and Lessen Pain?

 

Dr. Dan

 

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