Low Level Laser Therapy (LLLT) / Photobiomodulation Therapy
Laser Therapy improves tissue repair, reduces pain and inflammation by the application of red and near infra-red light over injuries or lesions. First developed in 1967, it is now commonly referred to as LLLT, Laser Therapy or photobiomodulation therapy.
Laser therapy has been used for many years on sports injuries, arthritic joints, neuropathic pain syndromes, back and neck pain. Over 300 randomised clinical trials have been published on LLLT, half of which are on pain.
Treatments with Laser Therapy take up to 10 minutes typically and may be applied two or more times a week in acute situations or weekly in less acute conditions alongside conventional osteopathic treatment in strains, sprains, inflammation and chronic pain. At Amersham Osteopathic Clinic, laser therapy is used to help speed up healing / repair and reduce the need for anti-inflammatories which slow down the tissue repair process.
Other therapists using laser therapy include the British and US military, Premier Division soccer teams, Olympic teams, Formula 1, rugby and cricket team therapists as well as specialist pain clinics, physiotherapists, osteopaths and chiropractors in the UK and USA.
The effects of LLLT are photochemical (like photosynthesis in plants). When the correct intensity and treatment times are used, red and near infrared light reduces oxidative stress and increases ATP. This improves cell metabolism and reduces inflammation. When pain relief / analgesia is required, there is a different type of treatment with a different mechanism of action used. LLLT works predominately on a protein in mitochondria (cytochrome c oxidase) to increase ATP and reduce oxidative stress. A cascade of mitochondrial and intracellular downstream effects lead to improved tissue repair and reduced inflammation
LLLT is popularly used for soft tissue injuries, joint conditions, neuropathic pain, non-healing leg and pressure ulcers. The intensity of LLLT lasers and LED’s is not high, like a surgical laser. There is no direct heating effect.
In the last 8 years, seven systematic reviews have found in favour of LLLT
BMJ LLLT for chronic non-specific low back pain: a systematic review and meta-analysis of randomised controlled trials found “moderate quality of evidence” and “clinically important benefits” in the short term. (2016) Click here
BMJ Sports Medicine Journal, a systematic review of surgical and conservative interventions for frozen shoulder found “strong evidence” for LLLT. (2010) Click here
The International Association for the Study of Pain (Global Task force on musculoskeletal pain) found “strong evidence” for Low Level Laser Therapy on myofascial pain syndrome. (2010) Click here
American Physical Therapy Association guidelines recommend LLLT for Achilles tendonitis. (2010) Click here
Lancet systematic review: “LLLT reduces pain immediately after treatment in acute neck pain and up to 22 weeks after completion of treatment in patients with chronic neck pain”. (2009) Click here
World Health Organisation (Bone and Joint Task Force) for neck pain Low Level Laser Therapy “more effective than no treatment, sham, or alternative interventions” (2008) Click here
In August 2010 The Lancet reported that the systematic review of LLLT for neck pain was in their top 20 most downloaded papers for 2010.
There is also evidence to support the use of Laser Therapy in aiding fracture / bone healing click here, here and here for some research on this. There is also good evidence for LLLT / Photobiomodulation therapy on oral mucositis (an extremely common side effect of cancer therapy) and exciting emerging evidence for its effects on traumatic brain injury (TBI) click here