Shedding Light on Low-Level Laser Therapy (LLLT)

Laser Therapy, also known as Low-Intensity Laser Therapy (LILT), Photobiomodulation (PBM), Cold Laser, etc. is a light-based technology proven to be highly effective in the treatment of musculoskeletal (MSK) problems, wound healing, dermatological conditions, and an extensive range of neurological conditions. This technology is non-invasive, non-toxic, currently utilized in 52 countries world-wide, and has been heavily researched since 1959.

Laser Technology uses super-luminous and laser diodes (Class 3B) to treat diseased or traumatized tissue with photons. These particles of energy are selectively absorbed by the cell membrane and intracellular molecules, triggering a cascade of complex physiological reactions, leading to the restoration of normal cell structure and function.

Did you know that laser is an acronym? It stands for Light Amplification by Stimulated Emissions of Radiation.

We treat musculoskeletal problems including spinal pathologies, acute and chronic soft tissue and sports injuries, joint conditions, arthritis, etc. The objective of the therapy is to provide cellular healing which results in the resolution of pain and other symptoms. Additionally, long term maintenance of arthritis has shown great success.

LILT is also revolutionary and highly effective treatment of wounds / dermal ulcers including diabetic lesions and those secondary to compression, surgery and other forms of trauma. This approach provides epithelization of the wound, improved arterial function and regeneration of the local and regional tissues.

We can also treat dermatological conditions including eczema / dermatitis, psoriasis, etc. BioFlex Laser Therapy provides effective resolution of these lesions through the revitalization and regeneration of the dermis and underlying connective tissues by stimulating the production of elastin and collagen.

Lastly, more recent research and application of LILT focuses on the treatment of neurological conditions, including cerebral concussion (traumatic brain injury), neuropathy, myelopathy and more. A number of projects in these areas relating to Alzheimer’s disease, autism, etc. are among the current Bioflex research projects.

The History

In 1903, physician Niels Ryberg Finsen won the Nobel Prize in Medicine for his successful treatment of smallpox and lupus with red light therapy, and research into phototherapy. Then, a few years after the first working laser was invented in 1967, Endre Mester at the Semmelweis University in Budapest, Hungary, performed tests on mice to determine whether or not laser exposure caused cancer. In his experiments he shaved the hair off the backs of mice and divided the subjects into two groups. He exposed one group to laser treatment using a low-power laser while the control group received no laser therapy. The mice who received laser therapy experienced much faster hair regrowth than the control group. Thus, photobiostimulation (activation of the cell by light) was discovered.

At the time, as Hungary was associated with the Soviet Union, Soviet research of therapeutic lasers exploded. During this time, hundreds of studies and thousands of books were published on the topic. Lasers were used in fields of oncology, surgery, dermatology and dentistry, and since 1974 low level laser therapy (LLLT) has been included as a standard of state medical care.

Once more research was readily available, it continued to grow in popularity until eventually it was cleared by FDA and Health Canada. Low power lasers became accessible for the treatment of injury in the late 1970’s and have been widely utilized around the globe by health practitioners in a variety of settings.

In 1986, Canadian Dr. Fred Kahn, a vascular surgeon, injured his shoulder in a skiing accident. Aware of the shortcomings and challenges of surgical repair for this condition, he experimented with Low Intensity Laser Therapy utilizing a primitive European device. Almost instantly, he obtained pain relief and with continuing treatment, restoration of a normal range of motion of the shoulder was achieved. This introduced Dr. Kahn to explore the possibility of developing more sophisticated, accurate and reliable laser devices for a wider range of clinical applications. In 1989 he founded Meditech to research and develop low-level lasers for healing, then in 1992 The BioFlex Laser Therapy System was developed at Ryerson Polytechnic University and the Centre of Advanced Technology (CATE) in Toronto, Canada under the direction of Dr. Kahn and a team of consultants. At IHC, Dr. Nik has been using cold laser therapy for over 15 years.

LLLT has also been deemed safe for animals for decades, and is used in many veterinarian clinics and at many stables/race tracks for varying injuries.

The Process

Laser therapy is a three-step process, all of which must be applied directly to the skin. The first part of the treatment is the Red Light therapy, which has been used for over a century to treat multiple conditions, ranging from Lupus to dermatological conditions like psoriasis. The second is Infrared Light, which is nearly invisible, but because of its long wavelength, it can penetrate through the skin to the deeper tissues of the body, giving it the potential to help patients who suffer from ailments caused by inflammation such as chronic pain and those with poor circulation. With both SLDs, the light is less coherent, thus not able to penetrate as far into tissue compare to lasers. That's why we top off the treatment with a laser probe; depending on the condition being treated, we will use either a Red light laser probe (for superficial conditions like arthritis or open wounds) or the Infrared light laser probe (for deeper issues like a muscle tear or disk herniation).

In the short term, the body produces and releases beta-endorphins to control the sensation of pain. Cortisol production (a stress hormone) is increased to combat the stress to the body associated with the trauma or the disease process. Over the long term, ATP (adenosine triphosphate) production is increased, boosting cell energy resulting in improved cellular metabolism. DNA (deoxyribonucleic acid) and collagen production – the protein building block of tissue – is substantially increased. Neurotransmission is facilitated secondary to elevated levels of neurotransmitters (serotonin and acetylcholine). Mitochondrial activity is stimulated resulting in cell replication for the replacement, regeneration and repair of abnormal cells. The process results in the elimination of symptoms, including pain, and stimulating the body’s immune system response, facilitating natural healing.

Check out this testimonial from a client who did a course of laser to target his arthritis, and since then has been doing a maintenance plan of one time per three months for near a decade.

Frequently Asked Questions

Does the treatment hurt? What does a treatment feel like?

There is mild or no sensation during treatment. Occasionally one feels a mild, soothing warmth or tingling.

Are there any side effects or associated risks?

During more than twenty years of use by practitioners around the world, very few side effects have ever been reported. If a patient is allergic or ultra sensitive to light they may show signs of skin irritation for a few days. Occasionally some chronic injuries or pain syndromes may feel aggravated post-treatment as the healing response occurs. This normally manifests as a low grade ache and only lasts a few hours after exposure; this can be treated locally with an ice pack for 10-20 minutes at a time.

How long does the treatment take?

The average treatment duration is 15-20 minutes depending on the condition and size of the area being treated.

How frequently should a patient be treated?

Acute conditions can initially be treated daily if required. Chronic conditions respond best when treatments are received 2-3 times per week. As the patient's condition improves, treatments are tapered to once a week, once every two weeks, or monthly.

How many treatments does it take?

This varies with the each condition. Acute conditions may only require 1-6 treatments while more chronic or long standing issues may require 10-15 sessions. Chronic conditions such as moderate to severe arthritis may require periodic ongoing care to alleviate symptoms.

How long until I notice results?

You may feel results after your first treatment, but this is more common is acute injuries. Each treatment is cumulative and most patients feel results after 3-4 sessions.

How can I start laser therapy treatments?

While laser therapy is an effective treatment for many issues, it's not a one-size-fits-all solution; we want to ensure that treatments are administered in the correct circumstances. With this in mind, a patient must be assessed and referred to laser by one of our Chiropractors, our Physiotherapist or Massage Therapist. If you have an issue that has recently been diagnosed and/or treated by a Chiropractor or Physiotherapist, you can have your practitioner send us their diagnosis on your injury (with your consent) and they can refer you for laser therapy at IHC.

If lasers use radiation, can that cause damage/cancer?

Bioflex's Class 3B lasers are non-ionizing (unlike gamma rays, x-rays and far UV light). In turn, there is no DNA damage. The wavelengths were also selected carefully to ensure no tissue damage.

Non-ionizing radiation is the term given to radiation in the part of the electromagnetic spectrum where there is insufficient energy to cause ionization. It includes electric and magnetic fields, radio waves, microwaves, infrared, near ultraviolet, and visible radiation (World Health Organization).

What are the contraindications of laser?

Pregnancy: There is no evidence of harm to an unborn baby, however there are no safety tests either, so for medico-legal reasons it is not recommended to treat directly over the developing foetus. It may be used on the pregnant woman for the treatment of back pain etc.

Thyroid: There is no evidence of harm and there is some evidence of benefit for treating Hashimoto's thyroiditis with LLLT. As with many things in life too much of what is good for us may be harmful and so it is conceivable that a high intensity laser treatment direct to the thyroid might (temporarily) stimulate (or inhibit) some thyroid activity. We suggest not applying lasers directly over the thyroid. The LED treatments are however relatively low intensity and far less likely to trigger any adverse events when treating that region of the neck.

Tattoo: Treatment over a tattoo with a higher irradiance laser (step 3/3) may cause pain as the dye absorbs the laser energy and gets hot. The SLDs/LEDs will not have the same effect.

Please note that it is NOT a contraindication to treat over pins, metal plates, plastic, or pacemakers.