LLLT in Physiotherapy
Excellent for optimising soft tissue repair and providing drug-free pain relief, laser therapy is a modality well-used by many physiotherapists. As was discussed at this year's World Confederation for Physical Therapy conference, the number of electrophysical agents studies on PEDro has almost trebled over the past 10 years and they are now associated with high quality trial design, addressing concerns regarding the quality of the evidence base.
Low Level Laser Therapy is prominent amongst these with a large quantity of in vitro and in vivo supporting evidence which grows in volume and quality each year. Applied appropriately it works synergistically with manipulation and activity treatment programmes and is safer than and demonstrated to be just as effective as simple analgesia for managing pain symptoms in some acute and chronic musculoskeletal disorders. The drug-free pain relief it affords, is of particular help in the treatment of arthritic conditions and neuralgic pain being applicable for almost all patients including those who are diabetic or for whom cortisone is contraindicated.
It has fewer contraindications than ultrasound therapy, permitting treatment over plates, pins and patients with pacemakers as well as much greater flexibility including the capacity to effectively (and with Omega equipment, measurably) address trigger points in musculoskeletal treatments.
Recommended Package for Physiotherapists
- Xp (or Xp Clinic) Control Unit
- Infra-red Laser Cluster for pain and soft tissue
(5 x 820nm 200mW)
- Large Multi-wavelength Cluster
- Infra-red Single laser for trigger points
- Point Finder Kit
- On-site training on mainland UK
- 2 Pairs of Protective Glasses
"I have been using lasers in my physiotherapy practice for over three years now. Initially little appreciated and certainly quite left field, I was pleasantly surprised at its potential usage as it steadily gathered a momentum all of its own. Because of its ease and speed of application in a diverse range of musculoskeletal conditions (from fractures & arthritis to tendinopathies and acute injuries), it is quite a unique and dynamic treatment option. Laser has certainly complemented and enhanced the quality and richness of my practice as a clinician in a variety of Occupational Health settings."
Some Relevant Research
The anti-inflammatory mechanism of low level laser therapy and its relevance for clinical use in physiotherapy
Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials
...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.
Photobiomodulation of Pain in Carpal Tunnel Syndrome: Review of Seven Laser Therapy Studies
...Photoradiation is a promising new, conservative treatment for mild/moderate CTS cases (motor latency < 7 msec; needle EMG, normal). It is cost-effective compared to current treatments.
Can intractable discogenic back pain be managed by low-level laser therapy without recourse to operative intervention?
...We conclude that LLLT is a viable option in the conservative treatment of discogenic back pain, with a positive clinical result of more than 90% efficacy, not only in the short-term but also in the long-term, with lasting benefits.
A systematic review of low level laser therapy with location-specific doses for pain from chronic joint disorders
...Low level laser therapy with the suggested dose range significantly reduces pain and improves health status in chronic joint disorders...
The effects of laser treatment in tendinopathy: a systematic review.
...Despite the need for more studies about this theme, the low-level lasertherapy demonstrates consistent results in the treatment of tendinopathy.
The efficacy of low-level laser therapy for shoulder tendinopathy: a systematic review and meta-analysis of randomized controlled trials
...This review shows that optimal LLLT can offer clinically relevant pain relief and initiate a more rapid course of improvement, both alone and in combination with physiotherapy interventions. Our findings challenge the conclusions in previous multimodal shoulder reviews of physiotherapy and their lack of intervention quality assessments.
A randomised, placebo controlled trial of low level laser therapy for activated Achilles tendinitis with microdialysis measurement of peritendinous prostaglandin E2 concentrations
...LLLT at a dose of 5.4 J per point can reduce inflammation and pain in activated Achilles tendinitis. LLLT may therefore have potential in the management of diseases with an inflammatory component.