• TMJ^6,7
• Neck Pain⁸
• Shoulder Pain^9,10,11
• Elbow & Joint Pain¹²
• Fibromyalgia¹³
• Low Back Pain^14,15
• Sciatica^16,17
• Arthritis¹⁸
• Sports Injuries^19,20
• Soft Tissue Damage²¹
• Plantar Fasciitis^22,23

 

Learn more about specific treatments based on Specialties. >

CLINICAL FAQS

 

 

Is there a certification to administer low level laser therapy?

Every clinician using a LightForce^® therapy laser is encouraged to complete certification training through the American Institute of Medical Laser Applications (AIMLA). LightForce^® provides access to this training to every clinical office or athletic training team that becomes a customer. In addition, LightForce^® provides onsite installation training from our clinically trained representatives. This secondary training certification accredits clinicians in the operation of the laser device.

 

 

What does power or wattage have to do with LLLT (laser therapy treatments)?

The biggest challenge in photobiomodulation therapy is getting light energy in sufficient quantity to injured tissues. Skin does an excellent job scattering and reflecting most of the light that it is introduced to it. Additionally, melanin absorbs most of the remainder of light into the skin, leaving very little to get transmitted below skin level. When normal white light or sunshine hits the skin, very few photons get past this impressive gate keeper.

As if the natural barriers to light weren’t enough, most injuries involve dozens to hundreds of square centimeters of tissue damage. When larger areas need to be treated, even more power is needed at the surface to maintain the same therapeutic dose at depth over the entire treatment area. Therefore, even if you are using a laser that has the appropriate wavelengths to penetrate tissue ideally, but has a very low level of overall power, you will only be able to effectively treat very small areas. Additionally, treatments may take 30 minutes or longer.

The higher wattage Class 4 lasers (anything above 0.5W) allow for sufficient laser energy to be passed onto nerve, muscle, ligament, tendon, and/or capsular tissue in a reasonable amount of time. Normal treatment sessions range from 3-10 minutes, which is quite acceptable in a clinical setting. Higher powered lasers will also allow clinicians to have the versatility to treat injured tissue in multiple areas in a given session, which greatly improves the overall effectiveness of the laser when adding it to a plan of care.

 

 

What’s the difference between a super pulsed laser, gated pulsing laser or continuous wave laser?

Photobiomodulation therapy can be delivered in either a continuous wave or pulsed mode. Typically, there are two types of pulsing used in therapy lasers—super pulsed or gated.

Super Pulsed. Various claims suggest there are ideal pulsing frequencies; however, there are no published reports that show Super Pulsing is more effective than constant wave forms of light therapy.

Gated. When the laser is used in gated mode, it is cycling its continuous wave power on and off and consequently delivering a lower average output power. In general, the use of pulsing decreases light delivered to the target due to photos being emitted in short bursts with slack periods between.

Continuous Wave. Continuous wave lasers deliver photobiomodulation therapy by having the laser “on” all the time. There is no period where the laser is “off” during the treatment. It is analogous to turning on a light to brighten a room. In most cases, LightForce^® recommends the use of its equipment in this fashion to maximize energy delivery to the treatment area. This helps promote consistent outcomes by making it easier to correctly dose tissue in less time.

 

 

What are the contraindications for laser therapy?

The following are contraindications with laser therapy.

• Do not treat over growth plates in children.
• Do not treat pregnant patients over the abdominal area or the low back/ pelvic area.
• Avoid treating around glandular tissue (such as thyroid, testes, ovaries).
• Do not treat over pacemakers or internal pain pumps.
• Do not treat patients taking photosensitive medications (such as steroids or antibiotics)

 

 

What are the side effects of laser therapy?

Based on peer-reviewed literature, there are no known significant side effects from laser therapy for most conditions. Increased blood flow is a positive benefit associated with laser therapy that can cause the skin to get flush and the feeling of warmth. These changes are short-lived, typically lasting for up to a few hours. Improper dosing can lead to increased swelling for acute injuries where there is a lot of inflammation present as well as increased nerve-related pain for certain conditions when irritable nerve tissue is over stimulated.  This is usually correctable by adjusting the treatment settings.  On these rare occasions, the setbacks usually reverse themselves within 24-36 hours.  Understanding proper dosing parameters minimizes this phenomena.

 

 

Is Class 4 laser a cold laser?

The term “Cold Laser” is a dated term.  It was created to help describe lower power Class 2 and 3 lasers that don’t have power densities (irradiance) sufficiently high enough to create surface heat when applied.  Therefore, Class 4 lasers, or Class IV lasers, are not technically “Cold Lasers” since they do create a warming sensation on the skin when applied in most cases.

Since 2015 , the correct term that encompasses all therapy lasers and LEDs is photobiomodulation (PBM).  This term describes all light sources that are designed to promote circulation, improve tissue repair, and reduce pain.

 

 

Can low level laser therapy be used with other modalities/treatments?

Yes, it generally works well with other modalities that are designed to promote tissue repair.  Examples might include blood flow restriction and shockwave devices.  The mechanisms that are associated with these modalities work well with laser therapy.  Generally using modalities that are designed to provide cryotherapy which generally reduce blood flow and promote vasoconstriction are not recommended as adjunctive therapies with laser.

 

 

Can laser be effective as a post-surgical treatment for pain?

Absolutely! Some of the most consistently reported benefits of laser therapy are related to reduced pain after treatment. Research has shown that PBM can speed up the healing process of certain tissues through increased cellular metabolism. For post-surgical patients, appropriate doses of light energy can be delivered to effectively reduce pain, without negatively impacting the body’s natural healing process⁵.

 

 

Can laser be used over metal/implants?

Yes, laser can be used over metal implants/ hardware.  At the irradiance levels used with LightForce equipment, light will simply bounce off of metal.  There will be no heating that takes place at depth when using LightForce^® lasers within recommended parameters.

 

 

Is laser effective for treating arthritis?

The suffix, –itis comes from the Greek that denotes inflammation. Several studies have shown that laser is an excellent therapy to help address the symptoms related to both osteo and rheumatoid arthritis. While it will not restore damaged cartilage, it can help improve ROM of the affected joints and help reduce pain so that functional levels can be maintained, NSAIDS can be reduced, and in some cases, more invasive procedures can be delayed or prevented.

 

 

Is there any literature supporting the use of low level laser therapy (LLLT) in rehabilitation?

Yes, there is a growing body of peer-reviewed clinical research supporting the use of Class 4, deep tissue lasers as a safe and effective treatment option for a myriad of conditions in rehabilitation. This body of literature includes numerous randomized control trials.

As of 2020, a search on Pubmed.com yielded over 7500 publications on “Low Level Laser Therapy” and over 1200 articles on the more recently coined term “Photobiomodulation”.