Embed Size (px)
Citation preview
Phototherapy with low level energy LASER
Basic science• Laser is a source of light• Using of light for treatment is called phototherapy• Interaction of light with chemical substances is studied by
photochemistry• Interaction of light with living organisms is studied by
photobiology• For photochemical or photo biological effects to occur, ENERGY
CARRIED BY LIGHT MUST BE ABSORBED by a system• Amount of ENERGY (J) absorbed by the system depends mainly
on INTENSITY (W/cm2) and TIME (s) of exposure to the incoming light
• The magnitude and type of the biological effect depends also on WAVELENGTH of the light and physiological state of the cell at the moment of irradiation
Technical characteristics of LLLT• The source of energy are Low-level energy lasers also
known as “cold or soft lasers” with output of 5 – 500 milliwatts. When applied to the skin, these lasers produce no thermal sensation. (Lasers used in surgery typically use 300 watts).
• Wavelength spectrum is between 600 and 1000 nm red or near-infrared beam
• In general the wavelength is non ionizing and intensity is non thermal on physiological level
• Why LASER? Because it is well defined source of light that is almost monochromatic, polarized, coherent, can be precisely dosed in intensity and studied regarding its biological effects
Why red or near infrared
Therapeutic objective• To help the natural healing process by photo
stimulation.
How is it supposed to work?• The exact mechanism is still being explored and debated but it is
agreed that the mechanism is photochemical rather than heat-related.
• Observed biological and physiological effects include changes in cell membrane permeability, up-regulation and down-regulation of ATP and NO.
• Visible and near-infrared radiation is absorbed in the respiratory chain molecules in the mitochondria (e.g., cytochrome c oxidase), which results in increased metabolism, which leads to signal transduction to other parts of the cell, including cell membranes, and ultimately to the photoresponse (e.g., stimulation of growth).
• Certain wavelengths of light at certain intensities, applied in certain clinical situations may aid tissue regeneration, resolve inflammation, relieve pain and boost the immune system.
• Clinical applications that show some potential of effectiveness include treating of soft tissue injury, chronic pain, wound healing, effects on tinnitus, nerve regeneration and hair growth.
Does it really work?• In 1967 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. From this time on several hundreds of studies had been published.
• The topic of Low Level Light Therapy (LLLT) is still very controversial. Some researchers claim to have achieved positive clinical and pre-clinical results, while others remain skeptical.
• This type of therapy has not yet been accepted into the mainstream of science and medicine, because many of the studies have been conducted without a proper understanding of the properties and biological effects of light. In addition, many studies have not been conducted with proper scientific methodology.
• http://www.lni.wa.gov/ClaimsIns/Files/OMD/LLLTTechAssessMay032004.pdf
US Food and Drugs Administration Status
• Between 2002 and 2004, the Food and Drug Administration granted approval to several companies to market lasers that provide LLLT. The LLLT lasers are classified under “Lamp, Non-heating, for Adjunctive Use in Pain Therapy”.
It means the procedure is safe but not necessarily
effective.
US Insurers opinion• Aetna's September 2003 policy states that cold laser
therapy is experimental and investigational. There is inadequate evidence of the effectiveness of low-energy lasers in wound healing, pain relief, or for other musculoskeletal dysfunction, arthritis, and neurological dysfunction.
• Blue Cross of California and BlueCross BlueShield of Georgia determined in March 2004 that low-level laser for carpal tunnel is investigational.
• The Regence Group determined in January 2004 that LLLT for neuromuscular pain was investigational.
• General Motors offers LLLT to injured workers in its in-plant medical clinics.
Speaker opinion…
As is a brush for the painter, the chisel for the sculptor or an instrument for the musician – In the hands of a sensible physician – the laser may be a useful tool for the art of healing…
Not forgetting the ultimate healer
Surah 24. Light 35. Allah is the Light of the heavens
and the earth. The Parable of His Light is as if there were a Niche and within it a Lamp: the Lamp enclosed in Glass: the glass as it were a brilliant star: Lit from a blessed Tree, an Olive, neither of the east nor of the west, whose oil is well-nigh luminous, though fire scarce touched it: Light upon Light! Allah doth guide whom He will to His Light: Allah doth set forth Parables for men: and Allah doth know all things.
