What is low-level laser therapy?
Also known as soft laser, low-level laser therapy is a form of photo-therapy used to stimulate tissue repair and provide pain management. The laser uses focused red and infrared light to stimulate tissue at and below the surface of your pet’s skin. The biochemical effect of the low-level light increases the production of cellular energy and thus promotes cellular regeneration, production of collagen for tissue repair, and vascular dilation and synthesis for better circulation. Light from the low-level laser also encourages production of the body’s natural pain-relievers.
What is the history of low-level laser therapy in veterinary medicine?
The first low-level laser was developed in 1960 and early testing showed an increase in the speed and overall success of the healing process when it was used. Originally used for wound repair, clinical trials done throughout the 1970’s showed the applicability of the low-level laser in therapy to be more widespread than previously thought. The 1990’s came with the invention of more powerful and effective versions of the cold laser, eventually increasing its popularity in the field of rehabilitation.
How can my pet benefit from low-level laser therapy?
If your pet has sustained an injury, undergone orthopedic surgery, or suffers from arthritis or other painful conditions, they may be a candidate for low-level laser therapy. The low-level laser not only speeds the healing process but affects the overall quality of the repaired tissue. Muscle, tendon and ligament injuries require increased collagen production for successful healing and the low-level laser stimulates this function. The light also increases vascular growth and dilation for improved circulation in pets that may have limited movement. Pets experiencing pain from their condition may find relief from cold laser treatments. The biochemical effect of the low-level laser boosts the body’s production of endorphins. Low-level laser therapy is another great way to treat the source of the pain, thereby making it less likely that your pet will need additional pain reducing medication
What conditions are most often treated with low-level laser therapy?
Low-level laser can be used to treat a myriad of conditions but within the realm of rehabilitation is used mainly on musculoskeletal injuries, soft tissue injuries (sprains and strains) and arthritis. It also helps to release tight muscles, stimulate nerve regeneration, reduce inflammation and aid in pain management. Arthritic Pain Hip Pain Musculoskeletal Pain Myofascial Pain Stress Pain Bruising Edema Hematomas Lesions Tendon, ligament injury and soreness Shoulder Pain Traumatic and oversue injuries Scar Tissue Ulcers and other persistent non-healing wounds Splints Strains Sore back Ankle, hock injuries Stifle injuries Bone chips Hoof conditions: abscesses, bone spurs, inflammation, navicular, ringbone and laminitis Inflammatory conditions: acute or chronic otitis (ear problems), anal gland inflammation, periondontitis (gingivitis, hot spots, lick granulomas, idiopathic cycstitis (bladder inflammation), sinusitis, rhinitis (nasal problems)
Who practices low-level laser therapy?
Your pet will receive their cold laser treatment from a trained animal rehabilitation therapist (ART) . He/She may incorporate the low-level laser into other forms of therapy such as therapeutic massage or therapeutic exercise, or it may be done independently.
On which types of animals is low-level laser therapy practiced?
Animals involved in sports or other physically demanding activities have been the most common candidates for low-level laser therapy. Horses and sled dogs are among those most frequently benefiting from this form of therapy, as their lifestyles make them more prone to injury. However, as the field of canine and feline rehabilitation expands, use of the low-level laser is becoming more popular as it has some tremendous benefits.
How successful is low-level laser therapy?
Because low-level laser therapy has a cumulative effect, for best results treatments should be done at the frequency recommended by your veterinarian. Low-level laser therapy is often recommended in conjunction with other modalities to provide the best outcome and may be used as either a primary or complimentary therapy.
How safe is low-level laser therapy?
Low-level laser therapy is very safe when done properly. To ensure that laser therapy is done only in cases where it is appropriate, an exam is first done by a veterinarian. The veterinarian will then provide the specifics for the application of the cold laser. Although the term “laser” may conjure up images of the high-powered version sometimes used in surgical settings, the low-level laser causes no temperature change to the patient during or after the treatment and there is no risk of burning. Laser therapy should not be used in certain patients that are pregnant or that have cancer, as it stimulates cell growth and does not differentiate between healthy and cancerous cells.
What about Visual Safety? Are my eyes/my animal's eyes safe when using the laser?
Protective eye wear is NOT required during application of the low-level laser. One should never look directly at a laser emitter or any similar light source for more than 30 seconds. Multi Radiance Medical laser devices are designed to low power specifications with maximum attention to eye safety. Whether or not you decide to use the safety goggles is largely the matter of personal preference and comfort.
Does low level laser technology cause heat damage or cancer in the tissue?
Absolutely not. The average power and the type of light source (non-ionizing) laser devices use do not permit heat-damage or carcinogenic (cancer-causing) effects. Due to increased blood circulation there is sometimes a very minimal sensation of warmth locally.
What is the current recommended wait time to do laser therapy after the patient has taken ibuprofen or pain meds? Is it unsafe to use it while on those meds, less effective or ineffective?
There is no necessary "wash out" time needed when laser therapy is performed during NSAID use. It has been shown that the use of NSAIDs may reduce the laser effect, but the effect has not been clinically significant.
Can low-level laser therapy be combined with other types of veterinary medicine?
Low-level laser therapy can be, and often is, combined with other types of veterinary medicine. Because low-level laser decreases pain and enhances circulation, your veterinarian may choose to use the cold laser in conjunction with other forms of therapy to enhance the benefits of those therapies. In general, low-level laser therapy integrates well into a treatment plan that utilizes either traditional or alternative forms of veterinary medicine. If your companion animal is receiving low-level laser therapy from a practitioner other than your regular veterinarian, it is imperative that both individuals are kept updated about the ongoing treatment in order to provide coordinated care of your pet, to allow proper evaluation of treatment and to minimize any avoidable interactions or interferences. Our veterinarians, who are well-trained and versed in a variety of rehab modalities including low-level laser therapy, collaborate with the pet’s primary care veterinarian to appropriately coordinate care.
How deep into the tissue can laser light penetrate?
The level of tissue penetration by the laser beam depends on the beam’s optical characteristics, as well as on the concentration and depth of the chromophores, which are absorbed at different percentages according to the laser light’s wavelength. For instance, water absorbs almost 100 percent of the laser irradiation at 10,600 nanometers, the wavelength of a CO2 gas laser. That is the reason why this type of laser wavelength is used in surgical applications. Other factors affecting the depth of penetration are the technical design of the laser device and the particular treatment technique used. There is no exact limit with respect to the depth penetrated by the light. The laser light gets weaker the further from the surface it penetrates where eventually the light intensity is so low that no biological effect from it can be measured. In addition to the factors mentioned, the depth of penetration is also contingent on tissue type, pigmentation and foreign substances on the skin surface such as creams or applied oils. Bone, muscles and other soft tissues are transparent to certain laser lights, which means that light can safely penetrate these tissues. The radiation in the visible spectrum, between 400 and 600 nanometers, is absorbed by the melanin, while the whole extension of the visible which goes from 420 to 750 nanometers is absorbed by composite tetrapyrrolics. In the infrared, which covers about 10,000 nanometers of light spectrum, water is the main chromophore. Fortunately, there exists a narrow band in the light spectrum where water is not a highly efficient chromophore, thereby allowing light energy to penetrate tissue that is rich in water content. This narrow band, which extends approximately from 600 to 1,200 nanometers, is the so-called “therapeutic window”. That is the reason why the lasers in the market today have wavelengths within the 600-1,200 nanometer limit. The penetration index is not at the same level throughout the therapeutic window. In fact, lasers in the 600 to 730 nanometer range have less penetration and are more suitable for superficial applications such as in acupuncture methodologies.
What is pulsed electromagnetic therapy?
Magnetic fields play a key role in biological life. A magnetic field is created when a conductor is crossed by an electrical current. Magnetic fields arranged around single conductors are summed in a coil producing a density of magnetic force lines. If current produced in this way flows in pulses, then a pulsed magnetic field is created. In the bioenergetic and chemical terms of an organism, the essential concept of magnetism is not the magnetic load, but the energy-rich dipole which is surrounded by a magnetic field and whose transformation and exploitation for the production of energy in the organism is highly significant. The most important effect from pulsed electromagnetic fields (EMF) therapy is found on the cellular transmembrane potential (TMP). It is known that damaged or diseased cells present an abnormally low TMP, up to 80% lower than healthy cells. This signifies a reduced metabolism, impairment of the electrogenic sodium-potassium (Na-K) pump activity, and therefore, reduced ATP production. In a nutshell, the TMP is proportional to the activity of the Na-K pump and thus to the rate of healing. Healthy cells have TMP voltages of 70 to 100 millivolts. Due to constant stresses of modern life and a toxic environment, cell voltages tend to drop as we age or due to illness. As the voltage drops, the cell is unable to maintain a healthy environment for itself. If the electrical charge of a cell drops to 50, the patient may experience chronic fatigue. Electromagnetic therapy with the Maxi provides one effective way to affect healing rates by increasing cellular TMP.
Pulsed vs. continuous wave lasers
In general, laser diodes are either continuous wave or pulsed. The continuous wave (CW) diodes emit laser energy continuously, hence its name. Pulsed diodes emit a radiation impulse with a high amplitude (intensity) and duration which is typically extremely short: 100-200 nanoseconds. Continuous wave lasers produce a fixed level of power during emission. Although lacking the high peak power of a "true" or "super" pulsed laser, most continuous wave lasers can be made to flash a number of times per second to simulate pulse-like rhythms by interrupting the flow of light rapidly as in turning a light switch “off” and “on”. “True” or “super” pulsed lasers, as the name implies, produce a brief high power level light impulse. It is the high power level achieved during each pulse that drives the light energy to the target tissue. Even though the pulse peaks at a high power level there are no deleterious thermal effects in the tissue because the pulses are of such short duration. Therefore, the peak power of a “true” or “super” pulsed laser is quite high compared to its average pulse power. By using “true” or “super” pulsed lasers, one is able to more effectively drive light energy into tissue. The laser and electronic technologies required to use pulsed diodes are more advanced and the diodes themselves are more expensive than the continuous wave diodes. This is why over 90% of the therapeutic lasers in the North American market are low power continuous wave lasers. Some of these lasers provide power literally at the same level as an inexpensive laser pointer costing around $30.
Lasers vs. LED
Light emitting diodes (LED) are tiny light bulbs that fit easily into an electrical circuit. But unlike ordinary incandescent bulbs, they do not have a filament that will burn out. They are illuminated solely by the movement of electrons in a semiconductor material. LED’s produce incoherent light just like an ordinary light bulb. Light from LED’s have very little tissue penetration compared to laser light. By applying the first law of photochemistry (Grotthus-Draper Law) which states that light must be absorbed by a molecule before photochemistry can occur, one can immediately conclude that light from LED’s will work only on skin level conditions. For conditions deeper than skin layers, one must choose laser.
Is low level laser technology scientifically well documented?
There are more than 120 double-blind positive studies confirming the clinical effects of laser technology. More than 300 research reports have been published. There are over 300 dental studies alone. More than 90% of these studies verify the clinical value of using laser technology. A review of negative results shows that low dosage was the single most significant factor. By dosage is meant the light energy delivered to a given unit area during treatment. The energy is measured in joules and the area in cm2. Assuming that the power of the laser remains constant during the treatment, the energy of the light will be equal to the power in watts multiplied by the time in seconds during which the light is emitted. Therefore, a laser with more power (watts) can deliver the same amount of energy (joules) in less time. A pulsed laser with more average power (watts) can deliver the same amount of energy (joules) in less time and at deeper target tissues than a continuous wave laser.
Trends in laser technology
Therapeutic lasers are getting better every year. New lasers have entered the North American market that provide deeper tissue penetration, higher power densities and reliable electronics to achieve better clinical outcomes. The trend has been to increase power density and dose, since these have been shown to produce better clinical outcomes. In the case of superficial target tissues, clinicians have several laser options to consider. Underpowered lasers currently available in North America do not deliver the needed light energy to treat tissues beyond a few centimeters.
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