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Technology Overview

In 1917, Albert Einstein established the physical principle of “Light Amplification by Stimulated Emission of Radiation,” thus paving the way for the development of the laser. In June 1960, Theodoro H. Maiman constructed the world’s first laser using a ruby crystal, now known as the ruby laser. In 1965, doctors Sinclair, Knoll and Mester pioneered the way for therapeutic lasers through their research with human tissue. These lasers do not cut or destroy tissue, but biostimulate the tissue creating a therapeutic curative effect.

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Therapeutic lasers work by supplying energy to the body in the form of non-thermal photons of light. The body is able to absorb this external energy on a cellular level and transform light energy into chemical energy, which the body uses to accelerate the normal healing rate of tissue for a wide range of ailments.

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Laser Light vs. L.E.D Light

When people are introduced to laser therapy there is often confusion as to the difference between Laser light and L.E.D light. Laser is an acronym for Light Amplification by Stimulated Emission of Radiation. A laser is referred to as a coherent beam of light. Laser light is coherent because all of the light waves stream out in the same direction and phase. If one points a laser on a surface close to them, the laser light will have a noticeable diameter. If one pulls the laser further from that surface the diameter and intensity of the light will not change. L.E.D lights are referred to as non-coherent. In other words the light that is emitted from an L.E.D spreads out in all directions and are out of phase. If one points a L.E.D on a surface close to them, the L.E.D light will have a noticeable diameter. If one pulls the L.E.D further from that surface the diameter of the light will become larger and more diffused.

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Laser and the Language of the Body

The text you are reading is obviously written in English. You can read and understand these words and ether accept or reject the content. What if it were written in an unfamiliar language—Spanish, Japanese, German, Korean, or Swahili? Would you understand the content? Would you be able to make rational decisions based on what you can piece together? Like most people, probably not. This is the dilemma our bodies have when being treated by various therapies. Our bodies do not communicate in ultrasound or electrical stimulation—it communicates in coherent light. In the book, Energy Medicine: The Scientific Basis by James L. Oschman, multiple references are made to the communication within the body—from cell to cell as coherent (laser) light. It makes sense that we should stimulate the body with the same language that the cells in the body communicate. That is why there is so much success with wound healing, neurological rehabilitation, and illness reversal when using LLLT.

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Measuring Light

Light occurs in wavelengths and is measured in nanometers. A nanometer (nm) is one billionth of a meter, which can be represented by scientific notation as 10-9 meters or .000000001 meter = 1nm. The visible spectrum of light occurs in range of 380 – 760nm. Below 380nm we have ultraviolet light and above 760nm we have infrared light. Although all levels of light can have biological effect, most laser research suggests that the most advantageous levels of stimulation for healing purposes occur in the 630 – 640nm range. The biological effects that have been measured in this range have been proper oxygenation and detoxification of the cell, DNA replication, and regeneration of damaged nerve tissue.

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Tune in on Laser Communication

When listening to your radio, you must first choose a station— such as 102.7 KIIS FM. Similarly, when purchasing a laser, you must first choose a wavelength of light. Most lasers on the market used by professionals are in the red or infrared range. The advantage of using a red laser over an infrared is treatment time. It is much safer to use a red (630-640nm) laser over an area for a longer period of time without worry of damaging tissue. This makes it ideal for an unattended therapy. When working with infrared (760nm or higher) lasers more caution should be taken with treatment.

 

Pump up the Volume

The output of a laser is measured in Watts. It is easier to understand output as the volume of the laser. For example: when the Beatles’ song, “We All Live in a Yellow Submarine,” is playing on the radio, one can raise or lower the volume without affecting the message of the song. One can lower the output/volume of the song, “we all live in a yellow submarine,” and it occurs as a faint whisper possibly inaudible. Or one can blast the song, “WE ALL LIVE IN A YELLOW SUBMARINE,” and damage our eardrums. Regardless of the output/volume the message remains the same. The same occurs with laser. The output will not change the laser wavelength (i.e. 635nm); it will only determine the intensity.  Also keep in mind that there is a big movement in the laser industry that high powered infrared laser is the best way and most efficient way to use LLLT.  The only thing better is the deeper penetration faster.  Remember Absorption and not penetration is the key to efficient Cold Laser Treatments.   With our lower powered Red Beam lasers we will compete with any higher powered infrared laser and show how to

 

# 1, Get quicker and more efficient results.

# 2, longer lasting results with fewer treatments.

# 3, the real miracle’s of LLLT{activating the nervous system}.

 

Hot Laser

Most lasers used by medical professionals on the market are “HOT” or high powered lasers. Hot lasers are lasers that have an output larger than one Watt and ability to increase the temperature of what it is contacting—Ouch! Hot lasers are used for a variety of procedures from cutting and cauterizing tissue, removing tarter from teeth, hair removal, and even eye surgery.

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Cold Laser

Cold Laser is the common term for a Low Level Laser Therapy (LLLT) device. It is considered cold laser because it will not increase the thermal temperature of what it is contacting. When dealing with LLLT, the output is well below one Watt of energy, usually measured in milliwatts (mW). In scientific notation this is represented as 10-3 or .001Watts = 1mW. In the United States the FDA requires that all Low Level Lasers be 5mW or less at the point of aperture (where the laser light exits). Although very few people can actually feel a laser with this output, the positive biological effects are amazing. A wide range of professionals have used cold laser therapy with success including chiropractors, physical therapists, medical doctors, veterinarians, dentists, etc. The common goal among these practitioners is improved healing time and results for their patients.

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Results are Rapid and Sustainable

While some patients get immediate results, others usually require three to six treatments before they notice a lasting effect. Again, each patient will respond differently according to his or her own body’s natural healing rate.

Although it is recommended that you come in daily for the first three visits, following this two to three times per week is usually sufficient to maintain your cells in biostimulation. Your clinician is best able to develop a schedule tailored specifically to your condition.

There are three main components of tissue that affect the absorption of light specifically: water, hemoglobin (pigment that renders blood red) and melanin (pigment that gives skin its natural color.) The absorption curves for these three substances versus the laser wavelength will determine the precise impact that a particular laser will have on tissue.

This laser light has the unique properties of monochromaticity, (a single wavelength,) coherence (travels in a straight line) and defined location (concentrated beam). These properties are what allow lasers to penetrate the skin surface, non-invasively, delivering energy directly to the cells, which the cells then convert into chemical energy.

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True Lasers versus Super-luminous Diodes

True lasers such as the Lazr Pulsr System focuses all of their energy in one direction in a very concentrated line. A super-luminous diode, on the other hand, diffuses its energy in all directions with only a small percentage of the energy traveling in the direction of the treatment. A true laser system will deliver 90% more power to the treatment area than a super-luminous diode system.

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Oshiro’s Studies Confirm This Fact:

“A laser beam travels only in one direction from its source, unlike a light bulb. The resulting (true laser) beam has a considerably higher photo density than a monochromatic beam produced by filtering and collimating a conventional multi-wavelength light source. In in-vivo tissue targets, several layers of non-homogenous particulate matter have to be penetrated before the beam can reach the LLLT targets and it is the superior photon density of coherent light which ensures this penetration; even though actual coherence may be lost in the first few cell layers.”

Generally speaking, LLLT is remarkable in the fact that it safely and effectively reduces inflammation, relieves pain, and heals tissues. In healing tissues, the mechanism increases the synthesis of collagen—the same matrix found in cartilage. As the synthesis of collagen is increased, the cartilage begins to rebuild.

The fact that therapeutic lasers work by supplying energy to the body in the form of photons of light and allowing the body to effect its own repairs allows therapeutic lasers the ability to treat an extensive list of ailments. Ailments that involve skin, tendons, nerves, blood vessels or muscles can be treated with therapeutic lasers.

 

RESEARCH

Laser Photons and Pharmacological Treatments in Wound Healing

Farouk A.H. Al-Watban, MSc, PhD, and Bernard L. Andres, MT(AMT) Laser Medicine Research Section, Biological and Medical Research Department, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.

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The exploitation of photobiology in medicine has been of great interest to mankind. There is a growing interest in the use of lasers for treatment purposes because of the photochemical alterations induced in biomolecules by light energy. In this paper we present our data on laser biostimulation, the combination of pharmacological treatments SolcoserylTM (SS) and PolygenTM (PG) with light therapy using in-vitro and in-vivo models. In-vitro experiments indicate the ability of laser photons and pharmacological agents SS or PG to augment or abate the cloning efficiency of various cell lines. In-vivo studies focused on the dosimetry of various laser wavelengths and the use of wound healing drugs and 632.8nm laser in wound healing. The application of pharmacological treatments combined with laser therapy reveals the utility of light-drug treatment combinations. Given the ever-increasing cost of medical care, the burden incurred on patients, caregivers and society, this line of research fulfills the increasing need to develop treatment methods that enhance wound healing, especially in situations involving resistance to healing.

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The Biological Effects of Laser Therapy and Other Physical Modalities on Connective Tissue Repair Processes

Chukuka S. Enwemeka, P.T., Ph.D., FACSM, G. Kesava Reddy, Ph.D., Department of Physical Therapy and Rehabilitation Sciences, University of Kansas Medical Center, Kansas City, KS 66160-7601, USA

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Connective tissue injuries, such as tendon rupture and ligamentous strains, are common. Unlike most soft tissues that require 7-10 days to heal, primary healing of tendons and other dense connective tissues take as much as 6 - 8 weeks during which they are inevitably protected in immobilization casts to avoid re-injury. Such long periods of immobilization impair functional rehabilitation and predispose a multitude of complications that could be minimized if healing is quickened and the duration of cast immobilization reduced. In separate studies, we tested the hypothesis that early function, ultrasound, 632.8 nm He-Ne laser, and 904 nm Ga-As laser, when used singly or in combination, promote healing of experimentally severed and repaired rabbit Achilles tendons as evidenced by biochemical, biomechanical, and morphological indices of healing. Our results demonstrate that: (1) appropriate doses of each modality, i.e., early functional activities, ultrasound, He-Ne and Ga-As laser therapy augment collagen synthesis, modulate maturation of newly synthesized collagen, and overall, enhance the biomechanical characteristics of the repaired tendons. (2) Combinations of either of the two lasers with early function and either ultrasound or electrical stimulation further promote collagen synthesis when compared to functional activities alone. However, the biomechanical effects measured in tendons receiving the multi-therapy were similar, i.e., not better than the earlier single modality trials. Although tissue repair processes in humans may differ from that of rabbits, these findings suggest that human cases of connective tissue injuries, e.g., Achilles tendon rupture, may benefit from appropriate doses of He-Ne laser, Ga-As laser, and other therapeutic modalities, when used singly or in combination. Our recent meta-analysis of the laser therapy literature further corroborate these findings.

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Thermographic Study of Low Level Laser Therapy for Acute-Phase Injury

Yoshimi Asagai, M.D.1, Atsuhiro Imakiire, M.D.2, Toshio Ohshiro, M.D.3, 1. Shinano Handicapped Children’s Hospital Shimosuwa, Nagano, Japan 2. Department of Orthopedic Surgery, Tokyo Medical University Shinjuku, Tokyo, Japan 3. Japan Medical Laser Laboratory, Shinanomachi, Tokyo, Japan

 

Acute-phase injury is generally treated by localized cooling of the region, and rarely by the active use of low level laser therapy (LLLT) in Japan. Thermographic studies of acute-phase injury revealed that circulatory disturbances at the site of trauma occurred due to swelling and edema on the day following the injury, and that skin temperature was high at the site of the trauma and low at the periphery. Following LLLT, circulatory disturbances rapidly improved, while temperature in the high temperature zone around the site of trauma fell by 3 degrees on the average, but at the periphery the low temperature rose by 3 degrees on the average to nearly normal skin temperature. Clinically, swelling and edema improved. LLLT was also useful in treating necrosis of the skin in the wound area and in accelerating healing of surgical wounds of paralytic feet, which are prone to delayed, wound healing and also wounds due to spoke injury. LLLT is useful in treating swelling and edema in acute-phase injury and in accelerating healing of surgical wounds.

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Advances in Laser Therapy for Bone Repair

A. Barber 1, JE. Luger 1, A. Karpf 1 , Kh. Salame 2 , B. Shlomi 3,G. Kogan 3, M. Nissan 4, M. Alon 5, and S. Rochkind 2,6.

1Foot & Ankle Unit, Departments of Orthopedic Surgery "B", Departments of 2Neurosurgery, 3Oral and Maxillofacial Surgery, and 5Rehabilitation, 6Division of Peripheral Nerve Reconstruction, Tel Aviv Sourasky Medical Center, Tel Aviv University; 4Ben Gurion University, Israel.

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During the last decade, it was discovered that low-power laser irradiation has stimulatory effects on bone cell proliferation and gene expression. The purposes of this review are to analyze the effects of low- power laser irradiation on bone cells and bone fracture repair, to examine what has been done so far, and to explore the additional works needed in this area. The studies reviewed show how laser therapy can be used to enhance bone repair at cell and tissue levels. As noted by researchers, laser properties, the combinations of wavelength and energy dose need to be carefully chosen so as to yield bone stimulation. With better study designs, the results will be more credible, allowing for greater recognition of advances in bone repair using laser therapy. Many studies on the effects of laser therapy on bone healing and fracture repair have used biochemical and histological methods. However, in order to establish the effects of laser treatment on bone, additional studies need to be performed using biomechanical tests, the ultimate evidence of bone repair. Finally, future studies are needed to demonstrate that the same bone stimulation effects occurring in animals may also be seen in humans.

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Attenuation and Penetration of Visible 632.8nm and Invisible Infrared 904nm Light In Soft Tissues

Chukuka S. Enwemeka, Ph.D., FACSM Department of Physical Therapy & Rehabilitation Sciences, University of Kansas Medical Center, Kansas City, KS, and Department of Veterans Affairs Medical Center, Kansas City, MO, U.S.A.

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We studied the depth of penetration and the magnitude of attenuation of 632.8nm and 904nm light in skin, muscle, tendon, and cartilagenous tissues of live anaesthetized rabbits. Tissue specimens were dissected, prepared, and their thicknesses measured. Then, each wavelength of light was applied. Simultaneously, a power meter was used to detect and measure the amount of light transmitted through each tissue. All measurements were made in the dark to minimize interference from extraneous light sources. To determine the influence of pulse rate on beam attenuation, the 632.8nm light was used at two predetermined settings of the machine; continuous mode and 100 pulses per second (pps), at an on:off ratio of 1:1. Similarly, the 904nm infra-red light was applied using two predetermined machine settings: 292 pps and 2,336 pps. Multiple regression analysis of the data obtained showed significant positive correlations between tissue thickness and light attenuation (p < .001). Student's t-tests revealed that beam attenuation was significantly affected by wavelength. Collectively, our findings warrant the conclusions that (1) The calf muscles of the New Zealand white rabbit attenuates light in direct proportion to its thickness. In this tissue, light attenuation is not significantly affected by the overlying skin, a finding which may be applicable to other muscles. (2) The depth of penetration of a 632.8nm and 904nm light is not related to the average power of the light source. The depth of penetration is the same notwithstanding the average power of the light source. (3) Compared to the 904nm wavelength, 632.8nm light is attenuated more by muscle tissue, suggesting that is absorbed more readily than the 904nm wavelength or conversely that the 904nm wavelength penetrates more. Thus, wavelength plays a critical role in the depth of penetration of light.

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Biomodulation Effects on Cell Mitosis After Laser Irradiation Using Different Wavelengths

R. Sroka, C. Fuchs, M. Schaffer, U. Schrader-Reichardt, M. Busch, T. Pongratz, R. Baumgartner LFL Laser – Research Laboratory – Clinic of Urology and Clinic of Radiotherapy, University Munic, FRG

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The biostimulative effects on cell mitosis induced by laser light at different wavelengths in cell cultures was investigated. Murine skeletal fibroblasts (C2), normal urothelial cells (HCV29), human squamous carcinoma cell line of the mouth (ZMK) and urothelial carcinoma cells (J82) were irradiated with laser light at ^=488, 630, 640 and 805+25 pm using a computer controlled irradiation chamber. The irradiance was set to 10mW/cm(2) and 100mW/cm(2), while the irradiation varied between 2 and 201/cm(2). The mitotic was determined by single cell counting after Orecein staining 24h post irradiation. The mitotic rate showed a wavelength dependency with maxima at ^=635 and 805+nm for HCV29 and J82 cells. While the mitotic rate of C2 and J82 cells has the maximum value at about 41/cm(2), the maximum was at about 81/cm(2). ZMK cells showed no increase. At ^=805+25pm C2 and ZMK cells showed slight decrease in the mitotic rate after irradiation with 201/cm(2). An irradiation of 10mW/cm(2) was more effective than with 100m/Wcm(2). The biostimulation of the mitotic rate of both normal and tumor cells depends on the wavelength, irradiation and irradiance on the cell line. The wavelength dependency in the ^=630 to 640nm range could indicate a participation of endogenous porphyrins. Because the results show stimulative as well as inhibiting effects it should be considered to change the term biostimulation into “biomodulation.” Information Application: Supports laser induced biomodulation.

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Stimulation and Inhibition Effect of Lasers for Wound Healing on Rats

Farouk AH Al-Watban, Msc PHD and Xing Y Zhang, M.D. Laser Research, KFSH&RC, Kingdom of Saudi Arabia

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The comparison of wound healing stimulation effects on rats using HeCd, Argon, He Ne, and GaAIAs lasers (for 0.39 cm 2 wound size and three times per week treatment schedule) were carried out. The inhibition effect of low power Argon laser of wound healing was also investigated. The results showed that the % of acceleration in healing days were of 15.09, 22.93, 23.21 and 20.37 in 442nm, 514nm, 632nm, 786nm and 830nm at the incident dose of 20 J/cm 2 , respectively. The results also suggested that He Ne laser with 632nm was the most effective in promoting wound healing in all wavelength used in this study. The inhibitory effect of low power Argon laser showed the zero bioactivation at the incident dose of 80 J/cm 2 and the deceleration in healing days was –8.65% at the incident dose of 130 J/cm 2.

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Computerized Morphometric Assessment of the Effect of Low Level Laser Therapy on Bone Repair: an Experimental Animal Study

Silva Júnior AN, Pinheiro AL, Oliveira MG, Weismann R, Ramalho LM, Nicolau RA. J Clin Laser Med Surg. 2002; 20: 83-87

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The aim of this study was to evaluate morphometrically the amount of newly formed bone after GaAlAs laser irradiation of surgical wounds created in the femur of rats. Low-level laser therapy (LLLT) has been used in several medical specialties because of its biomodulatory effects on different biological tissues. However, LLLT is still controversial because of contradictory reports. This is a direct result of the different methodologies used in these works. In this study, 40 Wistar rats were divided into four groups of 10 animals each: group A (12 sessions, 4.8 J/cm2 per session, observation time of 28 days); group C (three sessions, 4.8 J/cm2 per session, observation time of 7 days). Groups B and D acted as nonirradiated controls. The specimens were routinely processed to wax and cut at 6-microm thickness and stained with H&E. For computerized morphometry, Imagelab software was used. RESULTS: Computerized morphometry showed a significant difference between the areas of mineralized bone in groups C and D (p = 0.017). There was no difference between groups A and B (28 days; p = 0.383).

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Therapeutic Low Energy Laser Improves the Mechanical Strength of Repairing Medial Collateral Ligament

Fung DT, Ng GY, Leung MC, Tay DK. Lasers Surg Med. 2002; 31:91-96.

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Twenty-four rats received surgical transection to their right MCL and eight received sham operation. After surgery, 16 received a single dose of gallium aluminum arsenide laser to their transected MCL for 7.5 minutes (n = 8) or 15 minutes (n = 8) and eight served as control with placebo laser, while the sham group didn't receive any treatment. The MCLs were biomechanically tested at either 3 or 6 weeks post-operation. The normalized ultimate tensile strength (UTS) and stiffness of laser and sham groups were larger than control (P < 0.001). The UTS of laser and sham groups were comparable. Laser and sham groups had improved in stiffness from 3 to 6 weeks (P < 0.001). A single dose of low energy laser therapy improves the UTS and stiffness of repairing MCL at 3 and 6 weeks after injury.

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Research Summary

Laser Stimulation of 630-640nm Promotes:

Wound Healing – Various studies suggest that laser therapy is effective for reducing wound size and increasing healing time.

Nerve Regeneration – Various studies have demonstrated the regenerative effects that laser has on damaged spinal cord and peripheral nerve tissue.

Biomodulation – Refers to the balancing effect that laser therapy has on tissue. It stimulates damaged tissue towards repair and inhibits hyper-active tissue.

Cellular Oxygenation – Research suggests that coherent (laser) light of 630nm is released during DNA replication.

Cellular Detoxification – Research suggests that coherent (laser) light of 634nm is released during phagocytosis.

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Reasons That Using Low-Level Laser Therapy Will Enhance Your Practice and Patient Results:

• Low level laser therapy causes certain photochemical reactions to occur to help control pain, reduce inflammation, and accelerate healing of damaged tissue. Low level laser therapy treats a variety of conditions including arthritis, tendon and ligament problems, nerve root irritation, shoulder and back pain, repetitive strain injuries, TMJ, plantar fasciitis, burns, wounds, and a variety of other skin conditions

• Low level laser therapy is painless and gives great clinical results with a minimum time involvement. Low level laser therapy will increase your patient compliance and satisfaction through efficient and highly effective treatment.

• You will grow your practice by providing additional proven pain management rehabilitation to your existing patient base. Many patients have claimed that the laser is what made the difference in accelerating their healing and getting them well. You will find that many returning patients specifically request to have laser therapy.

• You will attract new patients which will seek your care due to the need for therapeutic laser rehabilitation treatments. Referrals will come in from medical doctors, healthcare practitioners and coaches who know you use low-level laser therapy.

• You will set your clinic apart from the competition by providing the most modern form of therapeutic technology.

• Increase the profitability of your practice though additional billable services.