When it comes to Laser Therapy it is safe to say that most people have heard of Cold Laser Therapy. However, if you were to ask those people what Cold Laser Therapy is, most of them would have different answers. What one person calls Cold Laser, another may call Deep Tissue, or Light Therapy; or, what someone defines LLLT as may actually be LED, or Infrared, and the list of confusing the terminology goes on.
Even providers of Laser Therapy use different terminology interchangeably, leading to confusion for the client. It is important to know that each of these therapies are unique in their own way. And, we hope to help you have a better understanding of what you need to know when it comes to Laser Therapies.
From Confusion to Clarification
You can look no further than the medical community and Laser Therapy industry for why this trickle down effect of incorrect labels and misinterpretation has occurred in the first place and exists to this very day. Let’s just say, they had some catching up to do with the propelled advancements the industry was making.
New scientific information and cutting edge technology has been expanding at such a rapid rate, over a short time frame, within the Laser Therapy world, that it created a lapse in establishing standardization of the terminology and categorizations for these different therapies. Cold Laser (aka Low Level Laser Therapy, LLLT) became a blanket term that was marketed heavily and caught on like wildfire. This may be surprising for people, but today Cold Laser is no longer considered the crème de la crème of Laser Therapies; it’s now looked at as being outdated and not as effective as the latest technology. So, using this as a blanket term has been an injustice to the better quality, higher-level, better performing and stronger Laser Therapies on the market. Even the medical community was seeing the lack of standardization as an issue. This is why in September of 2014 the North American Association for Light Therapy and the World Association for Laser Therapy came together to discuss and establish standardization.
Their efforts were successful because, in 2016, the term Photobiomodulation Therapy was added to the MeSH database, which is part of the National Library of Medicine. As stated in an NCBI - PMC article for the US National Library of Medicine, “This distinguishes Photobiomodulation Therapy, and will likely have a significant impact on the safety and regulations of commercial products specifically marketed for this use. Universal acceptance and use of this new terminology will not only distinguish this application's uniqueness among the other forms of phototherapy, but will also promote better organization of the literature and future studies aimed specifically at this therapy.”
The Breakdown of Common PBM Therapies
What exactly is PBM? Photobiomodulation Therapy, PBM Therapy for short, is defined by the NCBI-PMC in an article for the US National Library of Medicine as “a form of light therapy that utilizes non-ionizing forms of light sources, including lasers, LEDs, and broadband light, in the visible and infrared spectrum. It is a nonthermal process involving endogenous chromophores eliciting photophysical and photochemical events at various biological scales. This process results in beneficial therapeutic outcomes including but not limited to the alleviation of pain or inflammation, immunomodulation, and promotion of wound healing and tissue regeneration."
There are many types of PBM Therapies, but the most common and cutting edge ones are what you need to know about. It is important to note that all therapy lasers are photobiomodulation lasers that have an objective of stimulating tissue through the use and application of light.
So, what are the similarities and differences in some of these light therapies?
Cold Laser Therapy (aka Low Level Laser Therapy, LLLT, Soft Laser, LPLT) This type of PBM Therapy utilizes irradiation with low-power, intensive lights. These lights stimulate the tissue and trigger damaged cells to regenerate. Class 2 and 3 lasers are Cold Lasers that do not possess enough power to create tangible heat on the skin. Cold lasers can be used to reduce pain, inflammation, minor aches, pains, superficial skin rejuvenation, sprains and assist healing of joints and tissues.
Deep Tissue Laser Therapy
Class IV therapy lasers are for Deep Tissue Therapy. These are higher-powered lasers with a higher wattage than what is used in Cold Laser Therapy. These factors allow the laser to reach deeper into the tissue and provide a faster treatment time. Deep Tissue Laser Therapy accelerates your body’s own natural healing process through photo-bio-stimulation. It can be used to treat many conditions, from superficial, deep tissue, acute, chronic conditions and more. Similar to Cold Laser Therapy, Deep Tissue Laser Therapy reduces pain and inflammation and accelerates healing.
LED Light Therapy (aka Light Emitting Diode Therapy, Red, Blue, or Light Therapy)
In this therapy, only energy from lights are used; heat is not emitted. In its early days, this therapy was utilized to speedup the healing process of post-surgical scars. Today it is most commonly used for dermatological and superficial conditions. Red light does have a deeper penetration than Blue light and sometimes Red Light is combined with some near-infrared lights. LED Light Therapy and Infrared Therapy do compliment one another, but they are considered different kinds of therapies. Our bodies absorb the light energy, which activates the mitochondria in our cells. So, your body is literally being fed energy from the light. This creates an increase in cell metabolism, growth and regeneration which generates new collagen, detoxifies the cells, reduces inflammation, minor aches and pains.
Infrared Therapy (Near, Mid and Far)
Not all Infrared wavelengths are suitable for Photobiomodulation (PBM) and not all are suitable for generating heat. It takes different and specific wavelengths of the Infrared spectrum to be effective in these areas. Infrared is invisible and penetrates deeper than Red Light. This is a therapy that is usually utilized in saunas, or in combination with Red Light Therapy devices. Most Infrared-A, B and C wavelengths are felt as radiant heat because our skin quickly absorbs them. Wavelengths from 600-950nm is known by scientists as the Infrared Window, or Optical Window, because it penetrates the human tissue far more effectively, thus boosting the cellular function.
When used in saunas, they should be using Far-Infrared, IR-C wavelengths because they are most effective for generating radiant heat. A normal sauna utilizes convection heat and does have health benefits, but not to the extent of a Far-Infrared sauna. Radiant heat directly raises the core temperature of the body, creating heat stress, activating the protein metabolism process (as if you were working out), triggering the nitric oxide, molecular process. This increases vasodilation, circulation, blood flow, heart rate and more. It enables easier breathing, faster muscle recovery, reduces inflammation, stress, pain, detoxes the body, helps with chronic illness, heart disease, skin conditions, weight loss and more. When Infrared is used with Red Light Therapy it works through the Photobiomodulation process. Please refer to the LED Light Therapy treatments and benefits listed above to understand the benefits and process.
Utilizing Noninvasive Treatments
There are decades of research/science that back these therapies and the benefits we reap from them. Drugs and surgeries do not always have to be the answer. Your body is truly the greatest instrument you will ever own. There are many non-invasive technologies and discoveries that can be applied to utilizing the human body for natural healing and recovery. These Laser and Light Therapies are fantastic tools that are available to try before jumping into the more invasive options out there.
If you are considering one of these therapy options make sure you conduct your own research and find a professional that you trust to consult with. If you decide to go with Deep Tissue Laser Therapy, or Cold Laser Therapy, we can provide these for you at Envision Sport Physical Therapy & Pilates. Feel free to give us a call to schedule your appointment. And, never forget how crucial it is to be your own health advocate!
(1) Shui S., Wang X., Chiang J. Y., Zheng L. Far-infrared therapy for cardiovascular, autoimmune, and other chronic health problems: a systematic review. Experimental Biology and Medicine. 2015;240(10):1257–1265. doi: 10.1177/1535370215573391.
(2) Anders J.J., Lanzafame R.J., Arany P.R. Low-level light/laser therapy versus photobiomodulation therapy. Photomed. Laser Surg. 2015;33:183–184. doi: 10.1089/pho.2015.9848.
(3) Scoon GS1, Hopkins WG, Mayhew S, Cotter JD. Effect of post-exercise sauna bathing on the endurance performance of competitive male runners. J Sci Med Sport. 2007 Aug;10(4):259-62. Epub 006 Jul 31.
(4) Crinnion WJ1. Sauna as a valuable clinical tool for cardiovascular, autoimmune, toxicant- induced and other chronic health problems. Altern Med Rev. 2011 Sep;16(3):215-25.
(5) By Nick84 – http://commons.wikimedia.org/wiki/File:Solar_spectrum_ita.svg, CC BY-SA 3.0
(6) Hamblin, M. Mechanisms of low-level light therapy. Retrieved from http://photobiology.info/Hamblin.html.
(7) Karu, T. I., Pyatibrat, L. V., Kalendo, G. S. and Esenaliev, R. O. (1996), Effects of monochromatic low-intensity light and laser irradiation on adhesion of HeLa cells in vitro. Lasers Surg. Med., 18: 171–177.
(8) Sun Stream Saunas. Sept. 2006, from http://www.infraredsaunacanada.ca/infrared-heaters#!__infrared-heaters-test
(9) Ncbi.nlm.nih.gov. Low-Level Light Therapy – MeSH – NCBI. 2016. Available at: http://www.ncbi.nlm.nih.gov/mesh/?term=photobiomodulation. Accessed February 25, 2016.
(10) Anders J, Lanzafame R, Arany P. Low-Level Light/Laser Therapy Versus Photobiomodulation Therapy.Photomedicine and Laser Surgery. 2015;33(4):183-184. doi:10.1089/pho.2015.9848.
(12) Kim, W.-S., & Calderhead, R. G. (2011). Is light-emitting diode phototherapy (LED-LLLT) really effective? Laser Therapy, 20(3), 205–215. http://doi.org/10.5978/islsm.20.205
(13) Azadgoli B, Baker RY. Laser applications in surgery. Annals of Translational Medicine. 2016;4(23):452. doi:10.21037/atm.2016.11.51.
(14) Knappe, V & Frank, Frank & Rohde, Ewa. Principles of Lasers and Biophotonic Effects. Photomedicine and Laser Surgery. 2004;22: 411-7. 10.1089/pho.2004.22.411.
(15) Harry T. Whelan, et al. “Effect of NASA Light-Emitting Diode Irradiation on Wound Healing .” Journal of Clinical Laser Medicine & Surgery. July 2004, 19(6): 305-314. https://doi.org/10.1089/104454701753342758
(16) Panton, Lynn, et al. “Effects of Class IV Laser Therapy on Fibromyalgia Impact and Function in Women with Fibromyalgia.” The Journal of Alternative and Complementary Medicine. May 2013, 19(5): 445-452. https://doi.org/10.1089/acm.2011.0398
(17) Vallone, Francesco, et al. “Effect of Diode Laser in the Treatment of Patients with Nonspecific Chronic Low Back Pain: A Randomized Controlled Trial.” Photomedicine and Laser Surgery. August 2014, 32(9): 490-494.
(18) Campbell, Leigh. "Exactly What LED Light Therapy Is And Why It's Good For Your Skin." Huffington Post, 13 May 2016. www.google.com, www.huffingtonpost.com.au/2016/05/12/exactly-what-led-light-therapy-is-and-why-its-good-for-your-ski_a_21376338/. Accessed 31 July 2018.