Q & A
What is Cold Laser Therapy?
Cold laser therapy is a relatively new technology (about 30 years old) when compared to many alternative therapies like acupuncture (which has been used since 8000-3500 B.C.), chiropractic (since 1895), and physical therapy. Just like the abacus evolved into the computer, many alternative medicine practices are evolving to include laser therapy.
Recent innovations in low-level lasers now make it possible for practitioners or consumers to own high quality cold laser equipment. The first cold laser was FDA cleared in 2001. Cold lasers are sometimes called Low Level Lasers (LLL) or soft lasers.
In general, cold lasers can be used in 2 distinct ways:
- Targeting acupuncture trigger points (similar to acupuncture but without the needles)
- Broad coverage of tissue and bone with IR or red light photons to reduce pain and stimulate healing
Cold laser therapy offers a non-intrusive option to acupuncture and surgery. It also provides a non-addicting treatment that eliminates the complications of long-term drug treatment programs. Cold lasers are FDA cleared and widely used for treatment of:
- Acute and chronic pain
- Ligament sprains
- Muscle strain
- Soft tissue injuries
- Tennis elbow
- Back pain
- Carpal Tunnel Syndrome
Healing With Cold Lasers
The cold laser produces an impulse of light at a specific wavelength (usually 600 to 980nm) that minimizes reflection and scattering but maximizes absorption of the the energy (in photons) at a desired depth.
Some conditions like joint pain require a deep penetration (4-5 inches) that can only be achieved using a powerful laser emitter. Many systems also have other lower wavelengths and lower power emitters for treating shallow tissue (like the lymphatic system or surface scars). For shallow treatments, light emitting diodes (or LEDs) with a shorter wavelength (600 to 700nm) are more cost effective for adding photons to the shallower tissue. In addition, red light diodes with a wavelength of 630 to 680 nm may be used to add energy to even shallower levels of tissues.
It is the general consensus that wavelengths below 660 nanometers are very easily absorbed in the surface tissue and are not optimized for deep tissue healing. Erchonia is the only company that has product that only operates in the 600 -700 nm wavelengths. Products like the Avant and TerraQuant operate in both the lower and upper wavelengths.
The goal of laser therapy is to deliver light energy units from red and infrared laser radiation--called photons-- to damaged cells. It is the consensus of experts is that photons absorbed by the cells through laser therapy stimulate the mitochondria to accelerate production of ATP. This biochemical increase in cell energy is used to transform live cells from a state of illness to a stable, healthy state.
Over 4,000 studies have been conducted in recent years to validate the effectiveness of cold laser therapy. Cold laser treatment systems may be cleared by the FDA.
Benefit of Cold Lasers
- Easy to apply
- Extremely safe
- No side effects or pain
- Cost effective for both the practitioner and patient
- Highly effective in treating ailments (more than 90% efficacy)
- Superior alternative to analgesics, NSAID's and other medications
- Reduces the need for surgery
- Works synergistically with other modalities like chiro, acupuncture, and PT
General Therapeutic Laser Biological Effects
- Increased Cell Growth: Laser photons accelerate cellular reproduction and growth
- Increased Metabolic Activity: Photons initiate higher outputs of specific enzymes, greater oxygen and food particle loads for blood cells, and thus greater production of the basic food source for cells, Adenosine Tri-Phosphate (ATP)
- Faster Wound Healing: Cold laser photons stimulate fibroblast development and accelerate collagen synthesis in damaged tissue
- Anti-Inflammatory Action: Laser photons reduce swelling caused by bruising or inflammation of joints resulting in enhanced joint mobility
- Increased Vascular Activity: Laser photons induce temporary vasodilation that increases blood flow to effected areas
- Reduced Fibrous Tissue Formation:Laser photons reduce the formation of scar tissue following tissue damage from cuts, scratches, burns, or post surgery
- Stimulated Nerve Function: Laser photon exposure speeds the process of nerve cell reconnection to bring the numb areas back to life
- Pain Reduction: Almost all systems have a mode of operation specifically designed to reduce pain
Classes of Cold Lasers
The U.S. government classifies cold lasers based on the ability of the laser to do damage, primarily to the eye. Many manufacturers are pushing the power levels to the maximum as a marketing tool. It is true that power is a very important part of laser therapy but more power is not always better. There is an optimum power level like the peak of a mountain. If the tissue gets the optimum level of photons, it has a maximum stimulating effect.
Exceeding the optimum power level decreases the stimulation and can actually cause inhibition (reduced pain). If pain control is the only goal, then higher power lasers are better. If healing is the goal, then optimum power is the key. Research has also shown that longer treatments at lower power levels produce better results.
So, if you want a device to help with pain control only and you are not worried about safely, higher class lasers are your best choice. If you are trying to maximize healing, look at pulsed lasers.
Class 1 Continuous and Modulated Lasers (Available over-the-counter)
Class 1 lasers are the safest. In fact they are so safe that they can be purchased for home use. The problem is that continuous wave Class 1 lasers are very low power. Luckily, there are modulated, pulsed, and super-pulsed lasers that provide higher power levels while still qualifying as a Class 1 laser because they are pulse- off enough of the time that they have a minimal chance of damaging the eye.
Because of their low cost, Class 1 lasers are widely used in practitioner's offices and they have a proven track record. Class 1 therapeutic lasers typically have much longer treatment times and protocol duration than higher power products. Just be careful not to buy anything that looks like a laser pointer because it just might be a fake. Anyone can buy a Class I cold laser for home use without a prescription.
Class 2 Cold Lasers (Available over-the-counter)
Modulating or super-pulsing the laser output power (turning it on and off in less than 1 billionth of a second) provides a unique combination of benefits. It allows the use of very high power levels (up to 50 watts) while insuring that there is no heat or damage. The ratio between the on and off times is called the duty cycle.
In general a super-pulsed Class II laser can provide more power to the treatment area than a Class IV continuous laser without a risk of damage. Modulated lasers provide a good combination of safety and power. Anyone can buy a Class II cold laser for home use without a recommendation from a health care provider.
Class 3 and 3b Cold Lasers (Requires a recommendation)
Class 3 cold lasers can have up to 500mW in a single continuous wave beam and still be qualified as a Class 3 lasers. Many devices have multiple beams so they can have higher total power. These devices typically require a target light since wavelengths in the IR range are invisible to the naked eye but can still do serious damage to the eye. They may also have a warning tone, a key lock, or an interlock. The interlock will automatically turn the laser off when someone opens the door to the treatment room. You must be a trained health care provider or get a recommendation from a trained health care provider to buy a Class III cold laser.
Class 4 Continuous Lasers (Only sold to professionals)
Class 4 lasers have the greatest ability to do damage to the eye and may cause tissue damage if used improperly. Tissue damage is very rare and the manufacturers work very hard to find the best combination of divergent beams that will provide a balance between power and safety. If any single laser beam is over 500 milliwatts, the device is a Class 4 product, but many of the most popular models have multiple beams. This allow for some Class 3 lasers to have a combined power that is higher than a Class 4.
Also many lasers diverge the beam at 28 to 30 degree angle to cover a wider area so they have better healing results. This also results in a safer product. The Apollo lasers use 4 divergent beams to produce 5 watts of power without the risk of tissue damage (it still has ability to do eye damage). The increase in the power of Class 4 continuous wave lasers shortens treatment times, which is critical for practitioners like pain clinics but typically less critical for the average user. All Class 4 lasers require some type of safely interlock on the device to prevent accidental exposure. You must be a trained health care provider to buy a Class 4 laser.
In general, the class of a cold laser is proportional to the ability to do damage to a person or animal, but it is NOT proportional to the efficacy of the product. There are definitely products on the market with too little power to be very effective. There are also some products with too much power for many applications. If you call 1-800-388-0850, we can help you find the right amount of power for your application.
Today, lasers are used extensively in the traditional medical industry for everything from cosmetic surgery, eye surgery, and heart surgery. The ability to put just the right amount of energy into a critical area of the human body has been a huge advancement in the medical field. Cold lasers are an important addition to these other established medical laser treatments, and the recent development of low-cost professional cold lasers means that cold laser therapy will be a rapidly growing medical treatment option.
ColdLasers.Org sells a wide range of products from Class I to Class IV lasers. If you are looking for a health care provider in your area, you can check out our limited directory of practitioners with cold lasers. If you are considering buying a therapeutic laser, you can read our guides to cold lasers for home use, cold lasers for office use, and lasers for equine therapy.