PHOTOTHERAPY is a therapeutic physical modality using photons (light energy) from the visible and infrared spectrum for tissue healing and pain reduction as defined by the North American Association of Laser Therapy.

It is also known as “low level laser therapy (LLLT), cold or soft laser therapy, low energy laser or just laser therapy. “Laser” means light amplification by stimulated emission of radiation.” The therapeutic light energy can be produced by either LED (light emitting diodes), SLD (superliminous diodes, or super bright LEDs), or low level laser diodes.

Just as we know that sunlight is absorbed by plants which convert the light energy into energy to grow (photosynthesis), light energy penetrates through the skin and is absorbed by the mitochondria of cells of all types in the body. This light energy is converted in the body into biochemical energy, and restores normal cell function. More technical explanations are available, and include increasing the permeability of cell membranes which leads to triggering immune response, increased synthesis of procollagen in fibroblasts, increasing number of mast cells, serotonin synthesis, endorphin synthesis, decreasing C-nerve fibre activity (reduces pain), decreasing bradykinin, and more.

(references….. Tiziano in Pain Management, 2004;37-42 and Richard in Laser-Accelerated Inflammation/Pain Reduction and Healing, 2003;2-25).

The wavelength, power (dosage measured in joules), and energy delivered determine the depth of penetration of the light and therefore the therapeutic effect.
Visible red (600-700 nanometers {nm}) penetrates up to 1 cm for SLD and laser devices.
Infrared (700-1,000 nm) penetrates deeper, from 2-5 cm.Both SLD and laser have direct and indirect effects. Deeper body tissues to be targeted require more energy to achieve therapeutic effects.

We employ BOTH SLD (two superliminous diodes) which deliver 1 joule of energy per centimeter squared for 40 seconds and which provide broad-based, less deep, even distribution of energy, specifically, 500 (mW) milliwatts of visible red light (633 nm) plus infrared (880 nm), + hand-held laser (deeper, focused delivery of 1 joule of energy via 200 mW of infrared energy (785 nm). The manufacturer is Tanda Professional.’ (website is www.pharoslife.com).

Can phototherapy / laser be used in conjunction with other treatment approaches?

Yes. One should use these after ice therapy, or before any heat-based therapy such as uiltrasound, phono or iontophoresis. It can also be used in conjunction with electrical muscle stimulation, hands-on therapies, etc.

Yes. Laser should not be used directly into the eyes, over pregnant abdomen, over any suspicious or active carcinoma, over thyroid gland, over areas recently injected with steroids or other anti-inflammatory drugs. Phototherapies can be used on people with pacemakers, but of course not over the pacemaker itself, and can used on people with surgical hardware implants.

While much research ahs been conducted by the dentistry and oral surgery fields, there is also much to read about tendonitis and other inflammation conditions.

eg. Achilles tendonitis was successfully treated by laser therapy (British Journal Sports Medicine 2006;40(1)76);; also promoted neovascularization of partially ruptured Achilles tendons (Photomed. Laser Surg. 2005;(5):470; also in Lasers Surg. Med. 2005(4):293).

eg. swelling of finger flexor tendons was significantly reduced with laser (J. Clin. Laser Med. Surg. 2004(2):105).

eg. laser therapy  was proven to significantly accelerate healing of surgically-induced medial collateral knee ligament damage (Laser Surg. Med. 20004;34(3):285 and same journal 2003;32(4):286 and 2002;31(2):91).

eg. laser has rapidly increased healing of wounds in rabbits and humans and other injuries (J. Clin. Laser Med. Surg. 2000(2):67).

eg. bone repair was accelerated (Photomed. Laser Surg. 2005;232:212).

eg. bone nodule formation is enhanced with laser (J. Clin. Laser Med. Surg. 2003(5):271 and in Lasers Med. Sci, 2003;18(2):89)

eg. carpal tunnel syndrome – laser therapy was deemed as promising conservative treatment for CTS (Photomed. Laser Surg. 2006(2):101 and Archives Physical Medicine Rehab. 2002;83(7):978).

eg. chronic neck pain can be improved (Pain 2006;124(1-2)20.

eg. Journal of Oral Rehab. 2005;32(11)800

eg. Photomed. Laser Surg. 2005;232:177

eg. Oral Surgery 2006;102(5).

eg. Journal of Photochem. Photobiology 2006

eg. 39 patients with TMJ (jaw) pains reported statistically significant reduced pain and increased jaw mobility with laser therapy (Photomed Laser Surgery 2006;24(5)637and same journal 2006;(24)1:45).

eg. post-traumatic nerve regeneration was proven accelerated with laser (Lasers Med Sci.2004;19(1)

eg. Microsurgery 2005;25(1):83

eg. American Journal Physical Medicine 2004(10):758 reported helping osteoarthritis

eg. In Vivo 2004;18(5):585

eg. Journal Invest. Dermatol. 1996;107(4):593

eg. laser increases chondrocyte density and glucoaminoglycan content which resulted in greatly reduced pain in osteoarthritic knees (Biomed. Tech. 2006;51(3)31

eg. laser reduces osteoarthritis neck pain (Int. Tissue React. 2004;25(4):131

- Sharma et al in The Journal of Bone & JointSurgery 2005;87:187 (healing and repair of tendon injury and tendonopathy)

- Astrom et al in Clinical Orthopaedics 1995;(316):151 – survey of surgical and histopathological findings.

- Cooper et al in Oral Disease 1999;5:329 tempormandibular joint tissue studies.

- Fung et al in Laser Surgery Med. 2003;32(4) compared effect of low level laser on the ultrastructural morphology of medial collateral ligament.

- Oliviera et al in Lasers Surg. Med. April 2009;41(4):271 Laser therapy for tissue repair of partial lesion of calcaneal tendon.

- Bjordal et al in BMC Musculoskeletal Disorders May 2008;(9);75 laser therapy for lateral epicondylitis of elbow.

- Lam et al in Photomed Laser Surg. 2007;(2):65 effects of 904 nm low level laser therapy for lateral epicondylitis, randomized controlled trial.

- Simunovic et al in Journal Clinical Laser Surg. 1998;16(3):45 multicentre double blind placebo-controlled clinical study of 324 patients.

- Oken et al in Journal Hand Ther. 2008; Jan.-March  comparison of laser/ultrasound/brace for lateral elbow epicondylitis; randomized controlled clinical trial.

- Stergioulas in Photomed Laser Surg. 2007;June 25(3):205 laser for lateral epicondylitis.