Frequently Asked Questions

How do therapeutic lasers work?

Therapeutic medical lasers heal tissue ailments by injecting billions of photons of visible and /or invisible laser light deep into tissue structures. Tissue naturally contains protein strands called chromophores and cytochromes located in the mitochrondria of a cell, which have the unique ability to absorb laser light energy and transform it into chemical energy for the cell. This chemical energy is utilized by the tissue to significantly accelerate the healing process and reduce pain in the body naturally.

What conditions can be treated with Low Level Laser Therapy?

Theralase® therapeutic lasers have been cleared by Health Canada and the FDA to treat chronic knee pain. Over 4,000 clinical studies have been conducted worldwide validating the effectiveness of low-level laser therapy (LLLT) on over 100 treatment conditions, including arthritis, wound healing, addiction rehabilitation, weight loss, anti-aging, headaches/migraines, and carpal tunnel, among many others. Ultimately, it is at the discretion of the practitioner to determine based on the best available clinical evidence which areas and conditions can be treated with low-level laser therapy systems.

What scientific documentation is there on Low Level Laser Therapy?

There are thousands of published studies that describe the positive effects of laser therapy. These studies range from studies on individual cell types to in vivo double blind control studies. The areas of study range from wound healing to muscular skeletal conditions and have been conducted on different types of laser devices. Medicine is a very good medical database search engine that can provide abstracts and can sell literature. There are also many books on the subject. One very good text is "Low Level Laser Therapy - Clinical Practice and Scientific Background", written by Jan Turner & Lars Hode.

How deep into tissue can a laser penetrate?

The depth of penetration of laser light depends on many parameters such as the laser's wavelength, the power, the type of device driver (pulse or continuous wave mode) and lastly the technique used. The higher the wavelength typically, the deeper the penetration; however, with wavelengths greater than 950 nm the water in the tissue absorbs light and the depth of penetration is drastically reduced in addition to causing heat. Secondly, devices of greater power can provide better penetration. Thirdly, the peak power of the unit is the most critical factor in providing depth of penetration. Thus, devices which are true pulsed have better penetration versus continuous wave devices because they have greater peak power densities for superior photon concentrations at depth. *The TLC-1000 series of Therapeutic Medical Lasers can provide a direct penetration of tissue 5 cm into tissue and an indirect penetration up to 10 cm.

What is the relationship between peak power and average power?

Typically, clinicians calculate the Energy Density (E.D.) in J/cm2 for a specific treatment using the following equation:

E.D. (J/cm2) = (Average Power (Watts) x Time (seconds)) / Surface Area (cm2)

Hence;

Time (seconds) = (E.D. (J/cm2) x Surface Area (cm2)) / Average Power (Watts)

The surface area is the beam spot size of the laser device used. Since the beam spot size in true lasers is usually quite small, typical E.D.'s for treatment protocols are in the hundreds of J/cm2. Some manufacturers of weaker power devices will advertise use of E.D's less than 10 in order to advertise shorter treatment times.

Since many clinicians use the grid technique and direct contact on the skin, the surface area in the above equation should be 1 cm2. This makes calculating treatment time very straightforward. It also becomes evident that devices with higher average powers will take less time to obtain the same density.

How do I compute the dosage for a laser treatment?

Since laser energy is absorbed by water, hemoglobin and melanin, different people will require different dosages so that the target tissue of interest obtains the desired energy density. The depths of the target will also play a major part in this decision. Since light energy will be absorbed by other tissues that lie between the target tissue and the skin surface, one should increase the dose to obtain the desired dosage at the target site. In order to bio-stimulate the tissue, light must reach the target in a sufficient dose otherwise bio-stimulation will not occur.

Are there any harmful side effects or contraindication?

No, although one must never shine the laser directly into the eye. Otherwise, we recommend that laser devices not be used on the abdomen of a pregnant woman, in the presence of photosensitive compounds or directly on any cancerous tissue.

What is the difference between normal light and laser light?

The major difference between laser light and normal light is the laser beam's ability to travel long distances without being dispersed. This is known as coherence, and it enables the laser to focus its power within a small circumference. Pulsated laser light has been shown to have a strong therapeutic effect on cells and muscle tissue. A Theralase® LLLT laser, for instance, doesn't produce heat or cut organic tissue like industrial lasers or surgical lasers. Instead, it pulses a focused or culminated light beam at body tissue (bone, skin, muscle, etc.) which in turn has profound beneficial effects on the functioning of human cells the building blocks of the body.

How does cold laser help in the treatment of Rheumatoid Arthritis?

Rheumatoid Arthritis (RA) is an autoimmune disorder that attacks the joints causing swelling and tissue damage. RA is different than non-inflammatory problems of the joints and often mistaken for Osteoarthritis, which is inflammation caused by wear and tear on the joints.

Cold laser treatment works by reducing the pain and inflammation caused by Rheumatoid Arthritis. The initial treatment schedule can vary dependent upon the severity of the condition and the length of onset, though the average patient will receive 2-3 treatments per week for a duration of 10-25 treatments. Since RA is an autoimmune disorder and is non-curable, in order to maintain quality of life a patient is placed on a maintenance program of one to two treatments per month thereafter to maintain pain reduction, inflammation and increased range of motion.

What is photon dosage?

Photon dosage is defined as the amount of light at tissue depth determined by the amount of light delivered to the tissue surface, affected by both power and time.

Why is photon dosage at tissue depth important?

The attenuation or diminishment of light through tissue follows a 1/e formula significantly reducing the amount of light at tissue depth. To provide better treatment outcomes a practitioner needs to maximize the amount of photon light at the tissue surface by increasing the power of the laser and time of the treatment. The limiting factor with laser is the amount of light that tissue can absorb non-thermally, this is known as the Maximize Permissible Exposure or MPE. To date, a super-pulsed laser, flickering off and on, delivers the most amount of photonic energy without exceeding the MPE.

Why is cold laser dosage important?

Laser irradiation is dose dependent. In a recent clinical study by our clinical researchers 100 mW of power with the Theralase® TLC-1000 was too much power for a mouse knee joint and only increased the iNOS expression 200%, but 25 mW of power, which was more suitable for a mouse knee joint, increased the iNOS expression 700%. This is startling evidence that can now help us further fine tune our laser protocols.