Chronic pain is the most common cause of long-term disability in the United States. As a result most conditions that result in a visit to physical therapy involve a degree of inflammation and pain. These symptoms typically result in functional limitations, decreased strength and impaired mobility. Physical therapists create treatment plans with efficiency and maximum benefits in mind using a combination of manual therapy, activity-based procedures, patient education and physical modalities. When considering using a modality, many factors are considered: ease of use, efficiency of time, whether it’s non-invasive, and the speed in which it can benefit. Low-Level Laser Therapy (LLLT) is one of the most popular treatment modalities in physical therapy. Physical therapists use laser light therapy to great Laser Light Therapy for Physical Therapy effect with a multitude of chronic pain diagnoses including arthritis, neuropathy, muscle strains, fractures, pain reduction and TMJ.

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2. Chronic pain is the most common cause of long-term disability in the United
States. As a result most conditions that result in a visit to physical therapy
involve a degree of inflammation and pain. These symptoms typically result in
functional limitations, decreased strength and impaired mobility.
Physical therapists create treatment
plans with efficiency and maximum
benefits in mind using a combination
of manual therapy, activity-based
procedures, patient education and
physical modalities.

3. Physical therapists use laser light therapy to great
Laser Light Therapy for Physical Therapy effect with
a multitude of chronic pain diagnoses including
arthritis, neuropathy, muscle strains, fractures, pain
reduction and TMJ.
When considering using a modality, many
factors are considered: ease of use,
efficiency of time, whether it’s non-invasive,
and the speed in which it can benefit.
Low-Level Laser Therapy (LLLT) is one of the
most popular treatment modalities in
physical therapy.

4. HOW LASER LIGHT THERAPY WORKS
Laser Light therapy uses very short
wavelengths of light (600-1000 nm) to
penetrate human tissue which
facilitates the healing of tissue, reduces
pain and swelling.
Particles called photons assemble in
waveforms to make light. The light
transmits through the skin's layers (the
dermis, epidermis and the subcutaneous
tissue or tissue fat under the skin) at all
wavelengths within the visible range.
However, light waves in the near infrared
ranges penetrate the deepest of all light
waves in the visible spectrum.

5. When low level laser light waves penetrate deeply into the skin, they
optimize the body’s immune responses in the blood. This creates both anti-
inflammatory and immunosuppressive effects.
Research has found that light
transmitted to the blood through light
therapy has positive effective through-
out the whole body because it supplies
vital oxygen and energy to every cell.

6. The type of light utilized in Laser Light Therapy is most commonly red or near
infrared light. These forms of light are found on the electromagnetic spectrum
just above visible light. Numerous studies have found that the photons,
especially those found in the red or near infrared spectrum, have healing
properties at the cellular level, which means the cells are able to absorb the
photons.
The cell then uses these photons to make
additional adenosine triphosphate (ATP),
which creates the body’s energy. Being
able to create this additional energy helps
accelerate the body’s natural healing
processes.

7. Additionally, Laser Light Therapy is a popular treatment modality, aside from its
therapeutic benefits, is treatments usually last 5 minutes or less are non-
invasive and are pain-free. And while light therapy treatments are usually
performed two to three times a week, most people have noticed improvements
with their first or second treatment, making it fast acting too.
LLLT has been shown to hasten the
inflammatory process through
mitochondrial chromosphere
stimulation.
This is important because this
stimulation increases respiratory
chain activity, which in turn
enhances ATP synthesis, cellular
repair and reproduction.

8. LASER LIGHT
THERAPY DEVICES
IN PHYSICAL
THERAPY

9. Chronic pain is the most common cause of long-term disability. According to
the National Center for Health Statistics, approximately 76.2 million suffers
from acute pain lasting longer than 24 hours. Chronic pain is comprised of pain
associated with muscle spasms, tension, inflammation, stiffness, etc.
 GENERAL CHRONIC PAIN:
LLLT is effective for treating chronic
pain and its side effects on many
levels. LLLT helps relieve muscle
tension, spasms, inflammation, fluid
retention, aches, stiffness, and pain.

10. Other benefits include improved
circulation (blood and lymph), general
flexibility, range of motion, and increased
tissue elasticity (ex: scar tissue).
The laser is placed directly over the
injured area for 30 seconds to several
minutes, depending on the size of the
area being treated and the dose provided
by the cold laser unit.
When cells absorb this light energy, it initiates a
series of events in the cell that is theorized to
eventually result in normalizing damaged or
injured tissue, a reduction in pain, inflammation,
edema and an overall reduction in healing time by
increasing intracellular metabolism.

11. Pelvic floor dysfunction refers to a wide range of problems that occur when the
muscles of the pelvic floor are weak, tight, or there is an impairment of the
sacroiliac joint, low back, coccyx and/or hip joint. The tissues surrounding the
pelvic organs may have increased or decreased sensitivity and/or irritation
resulting in pelvic pain.
 PELVIC DYSFUNCTION:
Cold laser applies low-intensity laser light to
the tissue and may help with pain,
inflammation, and wound healing.
LLLT is able to relieve minor muscle aches,
joint pain and stiffness, and for relaxation of
muscle spasm, and increased local blood flow
where they are trapped or pinched by
muscles.

12. Arthritis currently affects 1 in 5 Americans. The primary advised treatment for
arthritis sufferers include anti-inflammatory drugs and painkillers which carry
the risks of potential heart attack, stroke, liver and kidney problems and
stomach bleeding.
 ARTHRITIS:
These drugs are recommended for short term
use, but for anyone suffering from Arthritis that’s
not possible, which means taking these drugs for
the long term and increasing the risk of long
term side effects.
The low level lasers of LLLT are able to alter
cellular function and have been found to be
effective in the treatment of Rheumatoid and
Osteoarthritis.

13. In a recent study published in The Journal of Rheumatology, LLLT reduced pain
in Rheumatoid Arthritis patients by 70% relative to the placebo and reduced
morning stiffness by 27.5% min, and increased flexibility of the hand by 1.3 cm.
A British study at the University of Dundee shows laser therapy used to
stimulate the same pressure points used in acupuncture significantly reduced
pain in patients suffering from Osteoarthritis.
Patients measured their pain on a scale
of one to 10. The results, published
in The Journal Physiotherapy showed
pain scores for those who received the
treatment dropped an average of 1.3
points and in some cases falling as
much as 2.4 points.

14. Achilles tendonitis is a common sports injury. It affects about 11% of all
running injuries. Achilles tendonitis can be quite debilitating, preventing the
sufferer from running and causing great difficulty walking, especially when the
pain is acute.
 ACHILLES TENDONITIS:
Achilles tendonitis tends to occur
more in middle-aged recreational
athletes than other age groups. This
is because the Achilles tendons,
like other body tissues become
more rigid, less flexible, and more
susceptible to injury as we age.

15. Achilles tendonitis is usually caused from overuse and associated with over-
pronation of the foot or changes in footwear or running routine. The primary
presenting symptom of Achilles tendonitis is posterior heel pain. Research
suggests LLLT can provide relief from pain and faster healing of tendonitis
than conventional treatments, which rely primarily on resting the injured
tendon and using ice to reduce inflammation.
Additionally a study published in Lasers in
Surgery and Medicine found, combining
ultrasound with LLLT helped accelerate
healing and increase tendon tensile
strength.

16. Lateral pain in the elbow also known as Tennis elbow affects up to 3% of the
population, and is usually an overload injury that often follows minor trauma to
extensor forearm muscles.
 LATERAL ELBOW TENDINOPATHY OR
TENNIS ELBOW:
Unfortunately pain and symptoms of
Tennis Elbow may persist for over 18
months to 2 years in up to 20% of
people.

17. In a review of studies published in BMC Musculoskeletal Disorders that
included patients with poor prognosis caused by failed steroid injections or
other treatment failures, or long symptom duration or severe baseline pain, it
showed that LLLT has an anti-inflammatory effect in 21 out of 24 controlled
laboratory trials and a bio-stimulatory effect on collagen production in 31 out
of 36 trials.
According to research, both of these
effects were dose-dependent and could be
induced by all wavelengths between 630
and 1064 nm with slight variations in
therapeutic dose-ranges according to the
wavelength used.
What this means is the anti-inflammatory
effect and increase in collagen fiber
production is seen in higher therapeutic
doses of LLLT.

18. Carpal Tunnel Syndrome (CTS) develops from nerve problems in the wrist,
which cause persistent pain, numbness and tingling. These symptoms of CTS
progress gradually and can become debilitating, leading to work disability and
the need for surgery. It is estimated 260,000 carpal tunnel surgeries are
performed each year in the U.S.
 CARPAL TUNNEL SYNDROME:
However, if caught early and treated CTS is
reversible. Unfortunately, if not treated, the
insulation on the nerves may wear away, and
permanent nerve damage may develop
resulting in the need for surgery.
A recent study published with The National
Center for Biotechnology showed that low
level laser therapy significantly improved grip
strength, functionality and lowered pain in
carpal tunnel patients.

19. Temporomandibular joint (TMJ) pain can be a significant problem. More than 10
million Americans complain of jaw pain. The Temporomandibular joint (TMJ)
guides jaw movement. Problems with the TMJ are known as
Temporomandibular joint disorder or dysfunction (TMD).
 TEMPOROMANDIBULAR JOINT (TMJ):
TMD has a number of causes: bad posture, chronic
clenching, poor teeth alignment, fracture, surgery
or what is called “lockjaw”. TMD can cause a whole
host of other problems, as the pain radiates to
other areas of the body. TMD can not only cause
jaw pain, but also fatigue, difficulty opening the
mouth, ringing in the ears.

20. By using LLLT in the treatment of TMJ, the low level lasers of LLLT are able to
alter cellular function, reduce pain, inflammation and increase the flexibility
of the jaw joint.
In a meta-analysis of studies including those using a
double-blind and placebo-controlled trial, showed
that LLLT seemed to be effective in reducing pain,
providing an anti-inflammatory, healing and
analgesic effect in TMJ as well as in the masticatory
muscle painful area. However, it must be noted that
reducing pain levels is dose-specific when using
LLLT.

21. Diabetic neuropathy is the most common diabetes-related comorbidity.
Diabetic neuropathy impacts between 60 to 70 percent of all patients with
diabetes. Neuropathy can have serious detrimental effects on a patient’s
quality of life. Patients with diabetic neuropathy have a 1.7-fold greater risk of
amputation and a 25 to 50 percent higher mortality rate in comparison to
those diabetic patients without neuropathy.
 DIABETIC NEUROPATHY:
Current therapy for Diabetic Neuropathy is
purely symptomatic, aiming to relieve the
pain through the administration of various
analgesic drugs. These drugs are effective,
but no more than 40–60% of patients show
adequate symptomatic relief.

22. However, research has shown that LLLT is an effective treatment option for
Diabetic Neuropathy. According to a study published in The Journal of
Advanced Research patients receiving LLLT had a 26.4% decrease of pain level
through four weeks of treatment.
The reduction in pain is thought to be due to
increased ATP production by the mitochondria,
and increased cellular oxygen consumption,
increased serotonin and endorphins, anti-
inflammatory effects and improved blood
circulation in some cases.

23. The diversity of pain conditions in patients requires a diversity of research and
treatment approaches. The costs of unrelieved pain can result in longer
hospital stays, increased rates of re-hospitalization, increased outpatient
visits, and decreased ability to function fully which leads to loss of income and
insurance coverage.
According to a recent Institute of
Medicine report: “Relieving Pain in
America:

24. A Blueprint for Transforming Prevention, Care, Education, and Research”, pain
is a significant public health problem that costs society at least $560-$635
billion annually, an amount equal to about $2,000.00 for everyone living in the
U.S.
This includes the total incremental
cost of health care due to pain from
ranging between $261 to $300
billion and $297-$336 billion due to
lost productivity (based on days of
work missed, hours of work lost).
These costs don’t even take into
account the psychological cost of
living with chronic pain.

25. In physical therapy, treatment regimens for pain are a combination of hands-
on therapy, therapeutic exercise and treatment modalities. As we’ve
discussed, studies have shown time and again that Low Level Laser Therapy is
an effective partner in physical therapy treatment especially when LLLT was
combined with ultrasound therapy.
LLLT is effective not only in pain reduction, but is also non-invasive,
cost and time-efficient. The benefits of LLLT over a broad-range of
diagnoses make it an important tool in any physical therapy practice.

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