Low-level laser therapy ( LLLT ) is an alternative form of treatment that uses low level laser (low power) or light-emitting diode (LED) to the surface or orifices of the body. While high power lasers are used in laser treatment to cut or destroy tissues, low power lasers are claimed to relieve pain or to stimulate and enhance cell function.
The LLLT effect appears to be limited to a certain set of laser wavelengths, and the administration of LLLT below the dose range appears to be ineffective.
Despite the lack of consensus on its validity, several studies have shown that LLLT may be very effective, in reducing short-term pain for rheumatoid arthritis, osteoarthritis, acute and chronic neck pain, tendinopathy, and possibly chronic joint disorders. Evidence for LLLT useful in the treatment of low back pain, dentistry and wound healing is unclear.
Video Low-level laser therapy
Name
LLLT variations have been through various alternative names including low-energy laser therapy (LPLT), soft laser therapy, low intensity laser therapy, low-energy laser therapy, cold laser therapy, bio-stimulation laser therapy, photobiomodulation, photo-biotherapy, laser therapy, and monochromatic infra-red energy therapy (MIRE). When LLLT is given on so-called "acupuncture points", this procedure can be called an acupuncture laser. When applied to the head, LLLT may be known as transcranial photobiomodulation, near-infrared laser therapy (NILT), or transcranial low-light therapy.
Maps Low-level laser therapy
Medical use
Various LLLT devices have been promoted for use in the treatment of several musculoskeletal conditions including carpal tunnel syndrome (CTS), fibromyalgia, osteoarthritis, and rheumatoid arthritis. They have also been promoted for temporomandibular joint disorders (TMJ), wound healing, smoking cessation, and tuberculosis. Although this treatment can briefly help some people with pain management, the evidence does not support the claim that they alter long-term outcomes, or that they work better than others, low-tech ways to apply heat.
LLLT appears to be effective in preventing oral mucositis in stem cell transplant recipients with chemotherapy.
Mechanism
Ongoing research on LLLT mechanisms. The LLLT effect appears to be limited to a certain set of laser wavelengths, and the administration of LLLT below the dose range appears to be ineffective. Photochemical reactions are well known in biological research; may be the light used in low-level laser therapy may react with the cytochrome c oxidase respiratory enzymes involved in the electron transport chain in the mitochondria.
History
Hungarian physician and surgeon Endre Mester (1903-1984) is credited with the discovery of the biological effects of low-power lasers, which occurred several years after the 1960s discovery of the ruby ​​laser and the 1961 invention of the laser helium-neon (HeNe). Mester inadvertently discovered that low-grade ruby ​​laser rays can regrow hair during attempts to mimic experiments showing that the laser may reduce tumors in mice. The laser he uses is broken and not as strong as he thinks; failed to affect the tumor but he realized that in places where he shaved mice for experiments, hair grows back faster in mice he treated than placebo. He published the results in 1967. He went on to point out that low-grade HeNe light can accelerate wound healing in mice. In the 1970s he applied a low-level laser beam to treat people with skin ulcers. In 1974 he founded the Laser Research Center at Semmelweis Medical University in Budapest, and continued to work there for the rest of his life. His sons did his job and took him to the United States.
In 1987 companies selling lasers claimed that they could treat pain, accelerate the healing of sports injuries, and treat arthritis, but there was little evidence for this at the time. By 2016 they have been marketed for wound healing, smoking cessation, tuberculosis, and musculoskeletal conditions such as temporomandibular joint disorders, carpal tunnel syndrome, fibromyalgia, osteoarthritis, and rheumatoid arthritis, and there is little evidence for this use, muscle or joint pain. Mester originally referred to this approach as "laser biostimulation", but was soon known as "low-level laser therapy" and by the adaptation of light-emitting diodes by those who studied this approach, it was known as "low-level light therapy", and to resolve confusion around meaning right from the "low level", the term "photobiomodulation" appears.
Society and culture
Returns
In the US in 2006 the Medicare and Medicaid Service Centers do not provide coverage for LLLT, by 2014 Aetna does not provide coverage, and by 2016 Cigna does not provide coverage.
Blue Cross and Blue Shield Association in 2017 provide protection if for the prevention of oral mucositis.
Research
Musculoskeletal
A Cochrane Library review of 2008 concluded that LLLT did not have sufficient evidence for the treatment of unspecified lower back pain, a finding echoed in the 2010 review of chronic low back pain. 2015 Reviews found benefits in chronic non-specific lower back pain.
LLLT may be useful in the treatment of acute and chronic neck pain. However, in 2013, a systematic review and meta-analysis of LLLT for neck pain showed that the benefits were not very important and that the evidence had a high bias risk.
There are tentative data that LLLT is useful in the short-term treatment of pain caused by rheumatoid arthritis, and possibly chronic joint disorders. Although it does not seem to increase pain in temporomandibular disorders, it can improve function. The evidence for usefulness in osteoarthritis is poor.
There is tentative evidence of the benefits in tendinopathy. A review of 2014 found a benefit in shoulder tendinopathy. The 2014 Cochrane Review finds tentative evidence that it may help in a frozen shoulder.
Evidence does not support the benefits of delayed muscle pain. It may be useful for muscle aches and injuries.
Mouth
Similarly, the use of lasers to treat chronic periodontitis and accelerate the healing of infections around dental implants is recommended, but there is insufficient evidence to demonstrate superior use of traditional practices. There is tentative evidence for dentin hypersensitivity. It seems useless for orthodontic pain LLLT may be useful for the extraction of molars (complications) and oral mucositis.
Hair loss
LLLT has been studied as a treatment for hair loss; a review in 2012 found little evidence to support the use of lasers to treat hair loss. A 2014 review found temporary evidence for laser benefits, while another 2014 review concluded that the outcome was diverse, had a high bias risk, and its effectiveness was unclear. The 2015 review found evidence of temporary benefits.
Brain injury
LLLT has been studied for traumatic brain injury (TBI) and stroke among other conditions. When applied to the head it is known as transcranial photobiomodulation or transcranial low-level light therapy.
Cancer
LLLT has been studied as a way to reduce pain and swelling in breast cancer-related lymphedema. Stephen Barrett, writing for Quackwatch, concluded in 2009 there was evidence to support the use of LLLT for temporary relief of pain, but "there is no reason to believe that they will affect the course of the disease or more effectively than other forms of heat delivery. Barrett's position has not changed in 2017.
Stem cells
The ongoing field of research is the application of LLLT to increase cell proliferation, including stem cells.
Veterinary use
Animal clinics use cold laser devices to treat various diseases, ranging from arthritis to wounds, to dogs and cats. Very little research has been done on the effects of this treatment on animals. Currently, laser therapy equipment is marketed aggressively to veterinarians as a therapeutic tool and revenue generator that is said to be strong. Brennen McKenzie, president of the Evidence-Based Animal Medicine Association, has stated that "research on cold lasers in dogs and cats is rare and generally of low quality.Most small studies and have minimal or uncertain controls for bias and errors". Although it allows some research to show promising results, he reports that others do not. While believing that there is ample evidence to warrant further research, he concluded that there was not enough evidence to support the routine clinical use of cold lasers in animals.
If the veterinarian wants to try this therapy, they have an obligation to explain to the client that the risks and benefits have not been established and that the treatment is essentially experimental. There is nothing wrong with using such treatment provided with appropriate informed consent, but aggressive marketing of laser equipment to vets as a beneficial treatment is ethically questionable given the lack of good evidence that it is a truly safe and effective treatment for any condition.
See also
- Photomedicine
- Light therapy
- Blood irradiation therapy
References
Source of the article : Wikipedia
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