Laser therapy
Low-level laser therapy (LLLT) is a medical treatment that uses low-level lasers or light-emitting diodes to alter cellular function.
Clinical applications
LLLT has primarily been shown useful in the treatment of acute pain caused by rheumatoid arthritis, osteoarthritis, tendinopathy, and possibly chronic joint disorders. LLLT has also been useful in the treatment of both acute and chronic neck pain. A Cochrane library review concluded that low level laser therapy (LLLT) has sufficient evidence for treatment of nonspecific low back pain, a finding echoed in a later review of treatments for chronic low back pain. Though it has been suggested for decades that LLLT could b e useful in speeding wound healing, the appropriate parameters (dose, type of laser, materials, wavelength, etc.) have to be identified. Similarly, the use of lasers to treat chronic periodontitis and to speed healing of infections around dental implants is suggested, but there is insufficient evidence to indicate a use superior to traditional practice.
Mechanism
LLLT reduce pain related to inflammation by lowering, in a dose-dependent manner, levels of prostaglandin E2, prostaglandin-endoperoxide synthase 2, interleukin 1-beta, tumor necrosis factor-alpha, the cellular influx of neutrophil granulocytes, oxidative stress, edema, and bleeding. The appropriate dose appears to be between 0.3 and 19 joules per square centimetre. Another mechanism may be related to stimulation of mitochondrion to increase the production of adenosine triphosphate resulting in an increase in reactive oxygen species, which influences redox signalling, affecting intracellular homeostasis or the proliferation of cells. The final enzyme in the production of ATP by the mitochondria, cytochrome c oxidase, does appear to accept energy from laser-level lights, making it a possible candidate for mediating the properties of laser therapy