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Low-level laser therapy

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For more general use of light in therapy, see Light therapy.

Low-level laser therapy (LLLT, also known as photobiomodulation, low intensity laser therapy (LILT), cold laser therapy and laser biostimulation) is a medical and veterinary treatment that uses low-level lasers or light-emitting diodes to stimulate or inhibit cellular function.[1] Low level laser therapy has been demonstrated effective in the treatment of short-term pain for rheumatoid arthritis, [2] osteoarthritis, acute & chronic neck pain,[3] tendinopathy,[4][5] wound care and possibly chronic joint disorders.[6]

The effects of LLLT appear to be limited to a specified set of wavelengths of laser,[5] and though more research is required to determine the ideal wavelengths, durations of treatment, dose and location of treatment (specifically whether LLLT is more appropriately used over nerves versus joints.[2] Administering LLLT below the dose range does not appear to be effective.[6]

History

In 1967 a few years after the first working laser was invented, Endre Mester in Semmelweis University experimented with the effects of lasers on skin cancer. While applying lasers to the backs of shaven mice, he noticed that the shaved hair grew back more quickly on the treated group than the untreated group.[7]

Clinical applications

LLLT has primarily been shown useful in the short-term treatment of acute pain caused by rheumatoid arthritis,[2] , osteoarthritis, tendinopathy,[4][5] and possibly chronic joint disorders.[6] LLLT has also been useful in the treatment of both acute and chronic neck pain.[3] Whoever is deleting the double blind evidence for LLLT's efficacy in wound care and replacing it with the flawed Cochrane review data....can stop it any time...double blind studies are valid info to be posted here. You delete my entry and I will delete yours.

Mechanism

It is unclear how LLLT works. LLLT may reduce pain related to inflammation by lowering, in a dose-dependent manner, levels of prostaglandin E2, prostaglandin-endoperoxide synthase 2, interleukin 1-beta, tumor necrosis factor-alpha, the cellular influx of neutrophil granulocytes, oxidative stress, edema, and bleeding. The appropriate dose appears to be between 0.3 and 19 joules per square centimetre.[8] Another mechanism may be related to stimulation of mitochondrion to increase the production of adenosine triphosphate resulting in an increase in reactive oxygen species, which influences redox signalling, affecting intracellular homeostasis or the proliferation of cells.[9] The final enzyme in the production of ATP by the mitochondria, cytochrome c oxidase, does appear to accept energy from laser-level lights, making it a possible candidate for mediating the properties of laser therapy.[10]

The effects of LLLT appear to be limited to a specified set of wavelengths of laser,[5] and though more research is required to determine the ideal wavelengths, durations of treatment, dose and location of treatment (specifically whether LLLT is more appropriately used over nerves versus joints.[2] Administering LLLT below the dose range does not appear to be effective.[6] The factors of wavelength, effective dose, dose-rate effects, beam penetration, the role of coherence, and pulses (peak power and repetition rates) are still poorly understood in the clinical setting. The typical laser average power is in the range of 1-500 mW; some high-peak-power, short-pulse-width devices are in the range of 1-100 W with typical pulse-widths of 200 ns. The typical average beam irradiance then is 10 mW/cm2 - 5 W/cm2. The typical wavelength is in the range 600-1000 nm (red to near infrared), but some research has been done and products are available outside this range.[11]

See also

References

  1. ^ Attention: This template ({{cite pmid}}) is deprecated. To cite the publication identified by PMID 20011653 , please use {{cite journal}} with |pmid= 20011653 instead.
  2. ^ a b c d Attention: This template ({{cite pmid}}) is deprecated. To cite the publication identified by PMID 16235295 , please use {{cite journal}} with |pmid= 16235295 instead.
  3. ^ a b Attention: This template ({{cite pmid}}) is deprecated. To cite the publication identified by PMID 19913903 , please use {{cite journal}} with |pmid= 19913903 instead.
  4. ^ a b Attention: This template ({{cite pmid}}) is deprecated. To cite the publication identified by PMID 19708800 , please use {{cite journal}} with |pmid= 19708800 instead.
  5. ^ a b c d Attention: This template ({{cite pmid}}) is deprecated. To cite the publication identified by PMID 18510742 , please use {{cite journal}} with |pmid= 18510742 instead.
  6. ^ a b c d Attention: This template ({{cite pmid}}) is deprecated. To cite the publication identified by PMID 12775206 , please use {{cite journal}} with |pmid= 12775206 instead.
  7. ^ Mester, E. (1967). "Effect of laser on hair growth of mice". Kiserl Orvostud. 19: 628–631. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
  8. ^ Attention: This template ({{cite pmid}}) is deprecated. To cite the publication identified by PMID 16706694 , please use {{cite journal}} with |pmid= 16706694 instead.
  9. ^ Attention: This template ({{cite pmid}}) is deprecated. To cite the publication identified by PMID 18665762 , please use {{cite journal}} with |pmid= 18665762 instead.
  10. ^ Attention: This template ({{cite pmid}}) is deprecated. To cite the publication identified by PMID 18651871 , please use {{cite journal}} with |pmid= 18651871 instead.
  11. ^ Attention: This template ({{cite pmid}}) is deprecated. To cite the publication identified by PMID 20011653 , please use {{cite journal}} with |pmid= 20011653 instead.
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