Laser

Rating

Category: Allied Health Options

Injury Type: Acute

What is it?

Laser therapy involves the administration of red through to infra-red light to the tissues for the purpose enhancing the healing process and providing pain relief. It is provided by a small hand held device that makes contact with the skin. There are usually no sensations involved with the treatment, other than the light pressure of the device against the skin.

How does it work?

Laser therapy is believed to work on the principle of inducing a biological response through energy transfer. This occurs through the photonic energy delivered into the tissue by the laser which modulates the biological processes within specific tissues. Low dosages of photonic energy may stimulate those biological processes, and higher dosages may inhibit them. Low level laser therapy (LLLT) may be used to enhance wound healing and pain relief. The effect of LLLT is such that it is thought to accelerate remodeling of scar tissue.

Is it effective?

A synthesis of evidence showed that laser therapy was an effective intervention for general neck pain. It must be noted that this synthesis was not peer reviewed, as per routine process, and hence its findings should be considered with some caution.

Literature has shown that LLLT is effective in reducing pain in mechanical neck pain in the short term. However, long term benefits have not been reported. One good quality review showed that LLLT reduces pain immediately after treatment in acute neck pain and up to 22 weeks after completion of treatment in patients with chronic neck pain. However there is no consensus in the literature on the parameters of dosage for LLLT that are effective.

A recent prospective randomised trial suggests that multi wave High Power Laser Therapy may be an effective treatment for pain reduction and earlier return to work, in patients with whiplash injury (Grade 1 & 2), when compared to simple localised physical rehabilitation that included education and active involvement of the injured person.

Are there any disadvantages?

Laser therapy should not be used near the eyes. The treatment may not be suitable for everyone, therefore an appropriate assessment should be carried out prior to its application by a qualified professional.

Where do you get it?

Medical, dental, podiatric, physiotherapy, chiropractic, osteopathic and acupuncture practitioners may provide laser therapy. The portability and diversity of battery and mains-powered diode laser systems allows treatment to be carried out in various clinical, hospital and field locations.

Recommendations

The use of laser therapy following whiplash may be considered for short term pain relief. More research is required to determine the parameters that can be useful and the long term effectiveness of laser therapy.

Key References

  • Chow, RT, Johnson, MI, Lopes-Martins, RAb & Bjordal, RM 2009, ‘Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials’, Lancet, vol. 374, pp. 1897-1908.
  • Conforti, M & Fachinetti, GP 2013, ‘High power laser therapy treatment compared to simple segmental physical rehabilitation in whiplash injuries (1° and 2° grade of the Quebec Task Force classification) involving muscles and ligaments’, Muscles, Ligaments and Tendons Journal, vol. 3, no. 2, pp. 106-111.
  • Guzman, J, Haldeman, S, Carroll, LJ, Carragee, EJ, Hurwitz, EL, Peloso, P, Nordin, M, Cassidy, JD, Holm, LW, Côté, P, Velde, G & Hogg-Johnson, S 2009, ‘Task force on neck pain and its associated disorders’, Journal of Manipulative and Physiological Therapeutics, vol. 32, pp. 227-243.
  • Guzman, J, Haldeman, S, Carroll, L, Carragee, E, Hurwitz, E Peloso, P, Nordin, M, Cassidy, D, Holm, L, Coˆte, P, Van der Velde, G & Hogg-Johnson, S 2008, ‘Clinical practice implications of the bone and joint decade 2000–2010 task force on neck pain and its associated disorders; from concepts and findings to recommendations’, European Spine Journal, vol. 17, no. 1, pp. 199-213.
  • Hurwitz, E, Carragee, E, Van der Velde, G, Carroll, L, Nordin, M, Guzman, J, Peloso, P, Holm, L, Coˆte, P, Hogg-Johnson, S, Cassidy, D & Haldeman, S 2008, Treatment of neck pain: noninvasive interventions; results of the bone and joint decade 2000–2010 task force on neck pain and its associated disorders’, European Spine Journal, vol. 17, no. 1, pp. 123-152.
  • Leaver, AM, Refshauge, KM, Maher, CG & McAuley, JH 2010, 'Conservative interventions provide short-term relief for non-specific neck pain: a systematic review' , Journal of Physiotherapy, vol. 56, pp, 73-85.
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