Laser Therapy (LLLT), Physiological Effects, Therapeutic uses, Indication, Contraindication

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Introduction-

The word Laser is an acronym for which :-

• L– Light
• A– Amplification
• S– Stimulation
• E– Emission
• R– Radiation

–Laser Therapy involves application of low intensity laser light for the relieve of pain. It refers to the production of a beam of a radiation which differs from the ordinary light in several ways. These lights are now commonly used in the treatment of surgical incisions, Ophthalmology and gynecology.

-The Laser therapy is now frequently used in Physical Therapist because of low intensity lasers are use therapeutically for their non-thermal effects. Visible radiations are remarkably absorbed in the hemoglobin, where as infrared light is strongly absorbed by water. Absorption results in the transformation of energy in the body tissues. Human body consist of 70% water and 30% of organic material. Organic material which absorb visible light contains Chromophores. Chromophores are defined as the molecular structures which get excited by the visible spectrum due to its configuration. In human body hemoglobin and melanin contain chromophores and thus absorb laser energy.

Properties of Laser :-

1. Monochromatic- The word mono means one and chrome means color so we can say that laser light has single color only because laser light has definite frequency and single wavelength.
2. Coherence– It means similar behavior of laser beam. It has two different phenomenon firstly, the laser light is temporarily coherent which means that the photons are in same phase, secondly the photons are unidirectional .
3. Collimation– It means the beam of laser light are parallel to each other and they never diverge and the energy can be propagated to the larger distance.

Types Of Laser-

• Ruby Laser:- This is the emission of red light at a wavelength 694.3 nm from the ruby rod. When the ruby rod made up of aluminum oxide has a xenon flash tube. They are available as normal pulse lasers, with the pulse duration in the millisecond regime. Pulse energies range up to 400J. A Ruby laser still excel is their ability to generate pulse of very high peak power from relatively simple peak package.
• Helium-Neon Laser:- This device emits the red light at a wavelength of 633nm and has a frequency higher than Infrared laser. It’s frequency is depend upon the nature of the medium. He-Ne gaseous mixture at a low pressure has the depth of penetration shorter than the IR Laser.
• Infrared Laser:- This device which emit Infrared Radiation at a wavelength of 830 nm. The depth of penetration of this device is deeper than the He-Ne laser. In this device the electrons are excited by the application of the suitable electrical potential and their occupation of holes in the crystals lattice arrangement may leads to the emission of photon which stimulate identical photons, causes emission of the radiation which is emitted as a laser beam from one partially transparent end.

Classification of laser:-

Laser has been divided into classes as per their power and effects-

• Class 1: In this class have low power which is less than about 0.5mW devices operating in the visible and invisible region of the electromagnetic spectrum, which does cause any danger to the eye or skin.
• Uses- These are mostly used for blackboard pointers and super market barcode reader. It is not applicable for therapeutic use.
• Class 2: These laser have the power is about 1mW placed in the visible region of the electromagnetic spectrum. These lasers are safe for the skin and are safe for accidental momentary viewing,
• Class 3: These lasers are mid power laser of both visible and invisible ranges. These are further classified into two types which is – Class 3A – It is low medium laser with power output up to 5mW. Class 3B- It is medium laser with power output up to 500mW. The class 3 laser are used in therapeutic as well as laser pointers and basically safer for skin and harmful for the eye. It should be used with protective goggles by both therapist and the patient.
• Class 4 & 5– These are high power lasers because it has the power output more than 500mW. These are harmful for both skin and eye, but Class 4 laser are generally used for the treatment of musculoskeletal injuries.

Therapeutic Laser-

Low intensity Laser Therapy (Class 3 Laser Therapy)-

Low intensity laser therapy or Low Level Laser Therapy is the therapeutic application of relatively low output (<500mW) Lasers and monochromatic super luminous diodes for the treatment of disease and injuries at the dosage (usually <35J per cm square) generally consider to be too low to effect any detectable heating of the irradiated tissues. More recently, the term Low Level Laser therapy LLLT and Low intensity Laser Therapy LILT have been adopted. Oshiro and Calderhead suggest that LLLT involves treatment with a dose that causes no detectable temperature rise in the treated tissues and no microscopically visible change in tissue structure. The biological mechanism involve to get the beneficial effect of this modality is called Laser Photo-bio modulation.

Most of the therapeutic effects of lasers are Wound healing, Inflammatory arthropathies, soft tissues injury, Relief in pain, Reduction of edema.

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Therapeutic effects of Low- intensity Laser Therapy-

• Arthritic conditions- The condition such as Osteoarthritis, Rheumatoid Arthritic and Osteogenic pain has been treated with the therapeutic effects of laser therapy treatment.
• Musculoskeletal Disorder- These Laser therapy are widely used for the treatment of soft tissues and it significantly reduce pain and improvement of chronic joint disorders such as Myofascial pain and Lateral epicondylitis.
• Edema Relief- Laser modality is helpful in the reduction of edema which is associated with musculoskeletal injuries.
• Wound Healing- The Laser treatment accelerates the leukocytic and phagocytosis of fibroblasts and increase the collagen and procollagen RNA synthesis and as well as increasing the circulation of blood and inhibit the growth of bacteria.
• In Nerve injuries- The laser treatment is most benefitted in the nerve injuries because it increases the conduction of nerve and also promote nerve regeneration.
• Raynaud’s Disease- Laser treatment which has wavelength 670nm helpful in relieving symptoms of Raynaud’s Diseases.

Indication of Laser Therapy-

• Epilepsy.
• Fever.
• Areas of decreased sensation.
• Infected Tissues.
• Sympathetic Ganglia.
• Epiphyseal lines in children.

Contraindication of Laser Therapy-

• Patient with active Carcinoma.
• Pregnant Uterus.
• Locally to Endocrine Glands.
• Areas of Hemorrhage.

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