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Low Level Laser Therapy

What is Low Level Laser?

Low Level Laser or Photobiomodulation Therapy as it is often referred to as, is the use of red LED light and near infra-red lasers for therapeutic affect in musculoskeltal conditions and disorders. Researchers world wide are trying to establish the efficiency of the treatment modality and evidence is being gathered daily on how effective it is on treating a wide range of conditions. Personally, I have not carried out any Individual Research on this, however I have carried out a wide literature review on the topic. 

Low Level Laser Therapy has mixed evidence with regards to its effectiveness and has no inclusion in NICE guidelines. However, a number of studies have stated that LLLT is effective in pain reduction (Haslerud et al., 2014; Saunders, 1995) with Kelle and Kozanoglu (2014) stating that LLLT was as effective as corticosteroid injection in pain relief. This, this can be contested Tumility et al., (2012) suggested that in their study for Achillies tendinopathy that there was no clinical benefit of adding LLLT to eccentric exercises for the treatment of the condition.

Some researchers suggest that the number of negative results is solely due to incorrect dosage levels. Lanzafame et al., (2007) demonstrated a biphasic response when using LLLT. Huang et al., (2009) concluded LLLT delivered at low doses tends to work better than the same wavelength delivered at high levels. This is in agreement with the biphasic response illustrated below 

From a purely anecdotal perspective, LLLT is so effective in the treatment of acute conditions it is an amazing addition to my tool box, so much so it has become my MUST INCLUDE Treatment  for Acute Low Back Pain.

How Does It Work?

As I said earlier, anecdotally, LLLT is very effective at treating acute low back pain, but it begs the questions why does it work? or to re-phrase that slightly, how does it work?

Thor state that LLLT there is useful for treating damaged cells or "stressed cells". When a cell is functioning perfectly normal, an enzyme called cytochrome c oxidase is responsible for the addition of oxygen (O2) to NADH at the mitochondria inside the cell. It is inside the mitochondria that hydrogen (H+) ions are produced for the production of ATP in an process called ATP Synthase. Basically, its the production of energy inside a cell. 

However, when a cell is injured, diseased or maybe just ageing, this process becomes faulty. 

the mitochondria produces nitric oxide (NO). This competitively displaces oxygen from cytochrome c oxidase consequently reducing ATP (an essential intracellular cellular energy and extracellular signalling molecule) and causing an over production reactive oxygen species (ROS) and leading to oxidative stress. Oxidative stress is well known to lead to inflammation an cell death via the gene transcription factor NF-Kb.

Low Level Laser Therapy (LLLT) of the correct wavelength and density, dissociates NO allowing oxygen back in, so ATP is restored and oxidative stress reduced. Once normal mitochondrial function is restored by LLLT then cell metabolism is improves, and the patient gets better more quickly.

There is a chance all this may be a bit much, so thankfully Thor has put together a really useful video for you to look at.

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