The Effect of Low-Level Laser in Knee Osteoarthritis: A Double-Blind, Randomized, Placebo-Controlled Trial
BÃ©la HegedÅ±s, LÃ¡szlÃ³ Viharos, MihÃ¡ly Gervain, MÃ¡rta GÃ¡lfi. Photomedicine and Laser Surgery. August 2009, 27(4): 577-584. doi:10.1089/pho.2008.2297.
Published in Volume: 27 Issue 4: August 20, 2009 Online Ahead of Print: June 16, 2009
Introduction: Low-level laser therapy (LLLT) is thought to have an analgesic effect as well as a biomodulatory effect on microcirculation. This study was designed to examine the pain-relieving effect of LLLT and possible microcirculatory changes measured by thermography in patients with knee osteoarthritis (KOA).
Materials and Methods: Patients with mild or moderate KOA were randomized to receive either LLLT or placebo LLLT. Treatments were delivered twice a week over a period of 4wk with a diode laser (wavelength 830nm, continuous wave, power 50mW) in skin contact at a dose of 6J/point. The placebo control group was treated with an ineffective probe (power 0.5mW) of the same appearance. Before examinations and immediately, 2wk, and 2 mo after completing the therapy, thermography was performed (bilateral comparative thermograph by AGA infrared camera); joint flexion, circumference, and pressure sensitivity were measured; and the visual analogue scale was recorded.
Results: In the group treated with active LLLT, a significant improvement was found in pain (before treatment [BT]: 5.75; 2 mo after treatment : 1.18); circumference (BT: 40.45; AT: 39.86); pressure sensitivity (BT: 2.33; AT: 0.77); and flexion (BT: 105.83; AT: 122.94). In the placebo group, changes in joint flexion and pain were not significant. Thermographic measurements showed at least a 0.5Â°C increase in temperatureâ€”and thus an improvement in circulation compared to the initial values. In the placebo group, these changes did not occur.
Conclusion: Our results show that LLLT reduces pain in KOA and improves microcirculation in the irradiated area.
FDA Cleared for Osteoarthritis of the Hand. The Effects of Low Level Laser Therapy on Osteoarthritis (OA) of the Hand. A Clinical Study
Dr Larry Lytle, DDS, Ph.D. and Dr. Serafettin Ozdogan, MD
Conclusions: Laser can provide temporary relief of pain and stiffness arising from osteoarthritis of the hand.
Treatment of a sprained ankle can be separated into immediate first aid and longer term rehabilitation and strengthening.
• Immediate First Aid for a sprained ankle:
• Aim to reduce the swelling by RICE (Rest, Ice, Compression, Elevation) as soon as possible. Come into the office for an evaluation as soon as possible. The sooner I can start to treat the injury with the Laser the better it will feel.
• R is for rest. It is important to rest the injury to reduce pain and prevent further damage. Use crutches if necessary. I advocate partial weight bearing as soon as pain will allow. Getting you back to your activities of daily living will accelerate the rehabilitation process.
• I is for ICE or cold therapy. Applying ice and compression can ease the pain, reduce swelling, reduce bleeding (initially) and encourage blood flow (when used later). Apply an ice pack immediately following the injury for 15 minutes. Repeat this every hour.
• C is for compression – This reduces bleeding and helps reduce swelling. A wrap or bandaging technique is excellent for providing support and compression to a recently injured ankle.
• E is for Elevation – Uses gravity to reduce bleeding and swelling by allowing fluids to flow away from the site of injury. So put your feet up and get someone else to wait on you!
• Following the initial painful stage, there are other treatments that can help the ankle return to normal as soon as possible. Range of motion exercises such as ankle circles can help to get the ankle moving again, as well as reducing swelling if performed with the leg elevated. The calf muscles often tighten up to protect the joint following a sprained ankle, and so gently stretching the calf muscles can also help to maintain movement at the joint.
Dr. Tucker says “One of the major goals of my treatment is to increase the blood flow and oxygen content to the tissues and that helps to reduce pain”. Cells and tissues that have a poor blood supply and low oxygen content as a result of inflammation, swelling/edema, and injury have been shown to have a significantly higher response to warm laser therapy than normal healthy structures.
Applicable conditions of laser therapy
1. Low back pain
2. Wound healing
3. Dermatological conditions
4. Temporo-mandibular Joint Dysfunction
5. Frontal and maxillary sinus inflammation
6. Rotator Cuff injuries
7. Epicondylitis (elbow pain)
8. Small joints of the hands
9. Trigeminal Neuralgia
10. Bell’s Palsy
11. Neck pain
Laser is used for sports injury, back problems, neurological conditions, wound/post surgical healing, fracture healing, Carpal Tunnel Syndrome, soft tissue therapy, wounds, burns, arthritis, strains, tendonitis, temporary increase in local blood circulation, relief of minor muscle & joint aches, pain & stiffness, relaxation of muscles, & muscle spasms.
Laser therapy has been shown to: stimulate cell growth; increase cell metabolism; improve cell regeneration; produce an anti-inflammatory response; produce an edema (swelling) reduction; reduce fibrous (scar) tissue formation; stimulate nerve function; reduce the production of substance P (a pain producing chemical); stimulate long-term production of nitric oxide; decrease the formation of bradikynin, histamine and acetylcholine (painful chemicals); and stimulate the production of endorphins. Dr. Tucker finds “These responses are responsible for the pain-relieving effects often observed in patients treated with laser therapy”.
Tucker says, “Laser therapy influence the cells at the molecular level to improve healing”. The result is rapid regeneration, normalization and healing of damaged cellular tissue. This painless warm light therapy is a trigger for improving metabolism.
Dr. Tucker uses class IV laser therapy approved by the FDA with the highest wavelength for deeper penetration. Penetration is paramount in order to stimulate deep musculoskeletal, vascular, lymphatic and neurological structures.
He uses the top healing and pain reduction modalities available today. Dr. Tucker’s unique treatments not only include laser therapy, he also uses the Deep Muscle Stimulator (DMS), exercise therapy and First Line Therapy nutritional recommendations.
“The most common musculoskeletal conditions I treat are neck pain and low-back pain”. The most common generators of pain in the cervical regions are the zygapophyseal joints of the neck in acute (traumatic) and chronic neck pain conditions. Several authors have reported the most common tissue of pain origin in the low back to be the outer layer of the disc. Given that the depth of these painful structures lies below multiple layers of muscle and fascia, Tucker uses a therapeutic laser device that has the ability to penetrate multiple layers of tissue.
Treatment plans include:
• Sports Medicine Laser Therapy.
• Painless laser therapy sessions (You must feel it to see why).
• Specialized plans for chronic pain relief.
• Deep Muscle Stimulator (DMS) massage.
• Exclusive 30-minutes sessions directly with Dr. Tucker.
• No long term commitment treatment plans. You can be done with care.
• Specialized Corrective Exercise Training.
• Myofascial Trigger Point Therapy for misdiagnosed pain.
• Nutritional & weight loss advice.
• Performance Enhancement.
What is High Power Deep Tissue Laser Therapy?
Laser Therapy is a non-invasive, safe, and effective treatment modality where light is used to relieve pain, reduce inflammation, and promote wound healing and soft tissue repair. Most therapy lasers on the market today have a power range from 5mw to 500mw, making them a cold laser. Our laser will emit a power range from 1000mw to 10,000mw, making this a high-power heat deep tissue laser that can put an end to your pain fast!
You get better FAST!
How is the treatment done?
The laser is placed in contact with the skin allowing the healing energy to penetrate tissue, where it interacts with various intracellular bio-molecules resulting in the restoration of normal cell function. This also enhances the body’s natural healing processes. In essence, light energy is converted into biochemical energy.
The result; normal cell functions are restored. The process results in a disappearance of symptoms and increases the speed at which your body heals.
Other Effects; the immune system response is stimulated, lymphatic drainage is improved, production of growth hormone is increased, & the body’s natural healing process are enhanced.
What does laser therapy have over other forms of therapy?
It does not require the use of drugs or surgery, there are less side effects or risks, and it is quick and convenient. Studies have shown that it is equal to or more effective than other forms of physical therapy. Pain relief is often immediate.
Does it hurt? What does the treatment feel like?
There is a warm heat sensation during treatment. Clients work with me to make sure the temperature is not too hot. There is no pain associated with the treatment. Laser treatment is relaxing and you welcome to ‘dose off’ during the session or we can talk during the session. Occasionally it occurs that pain can increase or begin 6-24 hours after a treatment session. This is because the laser light starts the healing process. This type of pain is particularly likely to arise when the health problems are chronic in their nature. It usually subsides after a few days but can, in rare cases, last longer.
How long does the treatment take?
The typical course of treatment is 10-20 minutes, depending on the size of the area being treated. Acute conditions may be treated daily, particularly if they are accompanied by significant pain. More chronic problems respond better when treatments are received 2 to 3 times a week. Treatment plans are determined on an individual basis.
How many treatments does it take?
This depends on the nature of the condition being treated. For some acute conditions, 3 to 6 treatments may be sufficient. More chronic conditions may require 6-12 sessions. Conditions such as severe arthritis may require ongoing periodic care to control pain.
How long before results are felt?
You may feel improvement in your condition (usually pain reduction) after the very first treatment. Each treatment is cumulative and results are often felt after 2 to 4 sessions. If you don’t notice relief with the laser, I will add the Deep Muscle Stimulator (DMS) to your therapy. Depending on your condition I may start with the DMS first.
Are the results long lasting?
Therapeutic Laser Therapy is about healing. It’s not about masking or covering up a condition. When you feel better from this therapy… it’s because you are better. Therefore results have been found to be quite long lasting.
Can it be used in conjunction with other forms of treatment?
Yes, laser therapy is even more effective when combined with other forms of therapy, including physical therapy, chiropractic, massage, soft tissue mobilization, electrotherapy, and following surgery. I combine our warm laser therapy with specialized corrective exercise techniques to relieve your pain fast!
Is it a cold laser treatment?
NO! Our laser is a Class-4 Deep Tissue Laser with much deeper penetrating power. No cold laser on the market today can come close to the fast-acting therapeutic effects of our Class-4 device. Chronic pain relief and hard-to-fix cases are my specialty. I have many patient’s who have tried cold laser therapy with no success and with just ONE Class IV heat laser treatment they start feeling better. All lasers are not the same.
How do I know if laser therapy is right for me?
I will evaluate your condition and perform a complete functional examination to determine if you are a candidate for this procedure. Call us to schedule your evaluation and Q&A session. The only way to know is to try a course of therapy.
Can laser therapy be used over medical implants or over metal?
Yes, laser therapy is a light treatment. No heating is involved with the surgical or metal implants. It can be used safely with no side effects. It is extremely effective for post-operative wound healing. Many hip and knee replacement patients see us for care.
Is it covered by medical insurance?
Some insurance covers the procedure, but not many. Most patients who decide to receive the benefits of laser therapy are sick and tired of being sick and tired, so they choose to seek this effective method of treatment on their own. Price is usually not a consideration when you have been suffering for so long.
The average course of therapy in our facility is just 10 visits. Other facilities with cold lasers can reach 20 or more visits. So you get better faster, which saves you money on additional insurance co-pays and deductibles.