Low Level Laser Therapy

What Is Low Level Laser Therapy?

When laser power is reduced below the level where it produces perceptible heat, lasers can have powerful clinical effects to promote healing and reduce pain without side effects. This Low-Level Laser Therapy (LLLT) is what we use in our clinic.

What Kind of Laser Do You Use?

We use a Weber Laser from Germany. Developed by Dr. Michael Weber, one of the pioneers in this field who trained me in its use in Germany, it is a so-called 3b laser (5-500 milliwatts or mw). Our treatments usually use 100 mw of power. This is far less than class 4 lasers, which, by definition, are powered at more than 500mw. We avoid class 4 lasers because, unlike the 3b laser we use, they can produce burns and there is no evidence that they are more beneficial. There is also a weaker laser called 3a. This laser is powered at less than 5mw. These are less expensive and in more common use and can have beneficial effects but we believe that the more powerful 3b laser we use at 100mw is the best power range to produce maximum clinical benefit without risk.

How is Low Level Laser Treatment Performed?

Treatment is performed by attaching 4 - 7 small adhesive pads with lasers inserted in them onto the skin. The treatment consists of 20 minutes of continuous light. There are no pain, heat, or side effects. During the treatment, patients occasionally describe that they can feel a pleasant sensation as their pain lessens.

What Do You Use Low Level Laser Treatment For?

• Back and Neck Pain: Especially useful here with roughly 80% of patients obtaining relief
• Muscular Pain: Usually effective for chronic muscle pain and tightness
• Joint Pain: Surface pads do not usually affect large joint (e.g. knee, shoulder) arthritis, but a study at our center recently presented at a prestigious national meeting has shown that needle probes into the joint combined with Platelet Rich Plasma are often effective for joint arthritis when other treatments have failed
• Headaches: It relieves headache pain in most patients. We see headaches in conjunction with neck pain and also TMJ pain
• TMJ: We have found low level laser to provide some relief to most of our TMJ patients, probably relieving masseter muscle spasms without the need for injections

When Are Results of Laser Treatment Felt?

Results are usually seen shortly after the treatment is completed while the patient is still in our office; in some cases not until later that evening or the next day.

How Does Low Level Laser Work?

Research from a Harvard study at the Wellman Center for Photo Medicine at the Massachusetts General Hospital, and elsewhere, indicates that laser light can stimulate mitochondrial activity which improves cell respiration and cell energy production. The laser light seems to work directly on the cytochrome oxidase molecule to dissociate it from its Nitric Oxide (NO) side chain. This side chain inhibits cell respiration. The effect of dissociating the NO is to increase cellular respiration. This produces more energy, ATP, and blood flow to improve the healing of damaged tissue.

Laser light can also work like acupuncture without needles to stimulate the acupuncture meridians. There is evidence from Dr. Peter Dorsher at the Mayo Clinic and others to suggest that this stimulates parasympathetic nerves which produce a direct anti-inflammatory effect.

Here are two excellent papers reviewing how it works.

• *MOJ Orthop Rheumatol. 2015; 2(5): 00068. *The Use of Low Level Laser Therapy (LLLT) For Musculoskeletal Pain. *Howard B Cotler, Roberta T Chow, Michael R Hamblin, and James Carroll https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4743666/
• IEEE J Sel Top Quantum Electron. 2016 ; 22(3): 2561201. Proposed Mechanisms of Photobiomodulation or Low-Level Light Therapy. Lucas Freitas de Freitas and Michael R Hamblin https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5215870/pdf/nihms797827.pdf

What Wavelength of Laser Light Do You Use?

Typically, red and infrared wavelengths are used. We are one of the few centers to also have available blue and yellow lasers. Emerging research has shown improved efficacy for some wavelengths in specific problems. Intravenous laser treatment also shows promise in decreasing generalized inflammation and we are beginning work in this area.