and Laser Questions - FAQ's
level lasers are also known as: soft lasers,
healing laser, cold laser, electrotherapy,
biostimulation and healing with light.
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This is where you will find the answers to frequently asked
about lasers, low level laser therapy and
Below are ten important questions
and the answers:
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1. What does LASER
LASER stands for Light Amplification by
Stimulated Emission by Radiation.
2. How does laser
light differ from "normal" light?
Light emitted from a laser diode is
monochromatic (having only one wavelength), parrallel and
coherent (having waves with similar direction, amplitude,
and phase). These qualities make laser light much more
valuable for therapeutic benefits.
3. Are low
level lasers SAFE?
4. How do low
level lasers work?
Pain results from trauma, inflamation
and/or cellular disruption, malfunction, or less than
optimal cellular function. Healing and pain relief come
with cellular normalization. Photons enable cells to
perform optimally by stimulating them to initiate
bio-chemical reactions, which produce enzymes and ATP
(usable energy). Use of low level lasers enhances cellular
function and it can also encourage the formation of
collagen and cartilage in damaged joints and the repair of
tendons and ligaments.
5. Where can
low level laser therapy be used?
Low level laser therapy may be used any
place there is acute or chronic pain or inflammation, and,
low level laser therapy may be effective on any disease or
disorder. Users have reported successes when using low
level laser therapy on: Arthritis, Carpal Tunnel Syndrome,
Tennis Elbow, Whiplash, Headaches, Back and Shoulder Pain,
TMD/TMJ, Burns, Cuts, Sprains, Colds and Cold Sores,
Sinusitis, and even Age Spots!
6. Have low level
lasers been scientifically studied and proven?
Low level lasers have been used world-wide
for nearly 40 years.
Over 3500 studies have shown that low level lasers:
(1) REDUCE PAIN by stimulating cells to produce their own
endorphins, a natural pain killer,
(2) PROMOTE FASTER HEALING by stimulating cells to increase
the production of two major healing enzymes by as much as
(3) REDUCE INFLAMMATION by as much as 75%,
(4) INCREASE BONE REPAIR SPEED by stimulating fibroblastic
and osteoblastic proliferation,
(5) RELAX MUSCLES and muscle spasms,
(6) DECREASE SWELLING by stimulating lymphatic
(7) ENHANCE THE IMMUNE SYSTEM by increasing the number of
"killer" cells by 400-900%, and most importantly,
(8) RE-ENERGIZE CELL MEMBRANES to allow transport of
essential nutrients across cell walls (nutrients will not
cross an injured or sick cell wall, thus slowing healing)
allowing a healthy new cell to grow.
7. How much do
low level lasers cost?
We have seen low level lasers advertised
for anywhere from $200 up to $20,000 each. Not all lasers
are created equal. Cheap lasers usually incorporate only
LED diodes, rather than true laser diodes. High quality
laser diodes combined with LED diodes create QUALITY laser
8. Does a
higher price always mean a better low level laser?
Not always. A VERY LOW price usually means
that the product contains only cheap LED's, and no true
lasers - and while "LED only" products may provide some
benefit, they are not as good as a product with both LED's
and true lasers. It is also not necessary to pay VERY HIGH
PRICES (over $5,000) for an individual low level laser
unit. Call our laser experts to explore your options. Phone
toll free 1-888-824-7558.
features should I look for in a quality low level
(1) A unit with both true Laser and LED
(2) Lasers that are designed to both Harmonize and Resonate
with the body's natural energy.
(3) The unit should be able to consistently control power
output (more is not necessarilly better) via a
Computer-Controlled, Rechargeable Power System.
(4) The laser should be able to produce Multiple Energy
Levels and Multiple Wave Lengths.
(5) All laser diodes should be Polarized so as to energize
the greatest number of cells.
(6) The laser energy should be Pulsed to encompass all
frequencies in the brain.
(7) Programmability - the unit should be able to be
reprogrammed as successful new frequencies are
(8) The unit should be Small and Convenient to use.
(9) Finally, the unit should be Reasonably Priced - meaning
a suggested retail price between $1800 and $4000 (depending
10. What low
level laser(s) meet all these requirements?
In order to clarify how low-level laser
therapy affects the body, it is necessary to review basic
laser physics and developmental anatomy.
Laser means Light Amplification by Stimulated Emission
of Radiation and was first theorized by Einstein. In 1960
Miaman developed the first laser, a ruby laser. This was a
tube laser with a metal chamber, which contained the
element ruby. When an electrical current excites the
enclosed element, the atoms give off photons or packets of
light energy. The photons bounced off a solid mirror on one
end of the tube and out holes in the mirror on the other
end of the tube. This light beam is unlike regular light in
that it is coherent i.e., the photons are well ordered and
synchronized. Laser light is also monochromatic, meaning it
is of one pure color.
Power density is a key to laser energy. Power Density
(PD), or light concentration is measured in watts per
centimeter squared (W/cm2). The problem with most DC
battery driven lasers is that the battery bleeds off and
does not maintain a standard PD, which negatively affects
low-level laser therapy (LLLT) results. Recent developments
in miniature computers have enabled the patenting of
techniques that maintain a standard PD as well as to
control energy frequency.
Wavelengths are measured in nanometers. The most
beneficial wavelengths are in the visible and near infrared
ranges. These ranges are very safe ranges, far away from
the damaging ultraviolet, x-rays, gamma and cosmic rays.
Although the longer waves such as microwaves and radio
waves are usually considered safe, there are some that
think they might be damaging to the very sensitive
individual. All wavelengths used in low-level lasers are
safely divided from these potentially damaging waves. Many
people only think of lasers as cutting lasers. In order to
cut with lasers, it is necessary to increase the PD from
300 to 10,000 W/cm2. Lasers do not even have a warming
affect unless they are operated above 5 W/cm2. Low-level
lasers commonly use laser diodes that range in power from 5mW to 500mW. These are safe power ranges that will never heat or damage tissue and are thus, commonly referred to as cold lasers.
Low-level lasers today are manufactured using
semi-conductors, which are computer-like chips grown from
various pure elements or combinations thereof. Combining
the elements of InGaAlP makes visible light in the range of
630 to 685 nm; combining GaAlAs produces light in the range
of 780 to 870 nm; and, combining GaAs produces infrared
laser diodes in the 900nm range.
The visible light ranges, while quite beneficial, are
limited by its shallow penetration of 1 to 3 mm. The
invisible or infrared light range penetrates much deeper.
Research documents infrared penetrations from 10 to 15 mm,
but clinical results indicate that the infrared beam
penetrates 8 to 10 cm. Excellent results have been achieved
using the patented (Low Level Lasers, Inc.) concept of
"piggy backing" the beneficial effects of the visible upon
the penetrating ability of the invisible.
Low level lasers are used everywhere in our society,
such as bar code check out, laser printers, compact disc
players and for many medical procedures. In fact, without
lasers, our society and economy as we see it today would
World-wide studies have shown that laser
energy is accumulative as well as cascading and
reduces pain and inflammation via:
1. Bio-stimulation and
2. Endogenous opiate production
3. Slowing sensory nerve production.
4. Restoring cellular resonant energy.
5. Stimulating the Na/K pump mechanism in
the cell membrane.
6. Inhibiting bradykinin & leukotriene
Osmosis, a scientific fact taught in all
grade and high school science classes, states that no
nutrient can transfer across the depolarized membrane of an
injured cell. One of the most important functions of low
level laser therapy is to re-polarize sick and injured
cellular membranes. This allows for essential nutrients to
transfer from the blood into the cell. Research has shown
that low level laser therapy can increase cellular ATP
(body fuel) by as much as 150%.
- Light is energy
Photobioactivation is a term applied to a
light stimulus that initiates and/or accelerates a
physiological response. Other stimuli used in medicine, for
example, are temperature, ultrasound, electrical power,
electromagnetic fields, etc.
Laser Therapy was discovered in the 60s. Today,
thousands of clinical evaluations and over 100 double
blind studies confirm its efficiency in:
Wound healing (formation of granulation tissue,
epithelization, improved trophic condition)
Anti-inflammatory effect (enhancement of immune
Improvement of regenerative processes
These effects can be observed in
dermatology, neurology, surgery, rheumatology,
traumatology, orthopedics, gynecology, urology, dental
medicine and veterinary medicine etc.
Laser Therapy devices (Low Level Lasers up to approx. 500
mW (milliwatts) power output) do not have a thermal
effect. This means they provoke no immediate visible skin
reactions or sensations during therapy. Laser Therapy is
a soft therapy without side effects. This contrasts the
use of surgical application of LASERS, which coagulate,
vaporize and carbonize tissue with their high-energy
rates (<3 to <50 Watts).
The laser energy is
absorbed by metabolically active pigments of the
mitochondria in various cutaneous and subcutaneous layers:
here involved are the two enzymes of the oxidation chain,
Cytochrome a/a3 and Flavoprotein with absorption maxims of
It is supposed that the changes in the stereochemical
conformation induced by an electro magnetic field leads
to an increase in activity and improves the concentration
of ATP by up to 200%. In addition, an increase in oxygen
and glucose metabolism is observed. The main effect is an
optimized function of the Na-K pump at the cell membrane,
an increased protein synthesis (prostaglandin, enzyme)
and a significantly higher rate of mitosis.
Depending on the stimulated type of cells,
the following cell physiological reactions are
Enhanced fibroblast formation and
collagen synthesis with improved tissue strength
Neovascularization of lymphatic and blood vessels as
well as vasodilatation, improve microcirculation and
lymphatic drainage (resorption of oedema)
Larger quantity of granulation tissue and accelerated
Increased activity of osteoblasts promote the
formation of callus
Regulation of muscle tissue including myocardium
Enhancement of peripheral nerve re-growth
Prevention of central nerve degeneration and
regeneration of peripheral axons after injury
Measurable changes in the potential
of nerve cell membranes lead to its hyperpolarization as a
good analgesic mechanism
Improved release reaction of ß-endorphines
Changes in transmitter concentration at the
Accumulation of 5-OH-indoleacetate (serotonin
Relaxation of muscle induced by the neuromuscular unit
Effect on the immune system (immune
Activation of proliferation of
immune cells including macrophages
Immune suppressive effect by reduced antigen
perception of the T-lymphocytes (increased acceptance of a
Optical window of the skin
The skin is a non-homogenous tissue and yet
shows in its spectral analysis an optical window with an
optimal transmission capability of light between >600 nm
(visible red) and <1300 nm (infrared). Wavelengths
(colors) outside of this optical window are mostly being
absorbed before they reach deeper layers.
listed in the
World Literature of Laser Therapy
Laser Therapy is a regulative medical
treatment modality, which is used most in medical
specialties including Dermatology, Traumatology, Sports
Medicine, Orthopedics, Dental Medicine, Urology,
Gynecology, General Medicine, Veterinary Medicine, Physical
Therapy, Natural Medicine etc.
Enhances proliferation of
immune cells (enhancement of immune response, increase of
NK cell activity etc.)
Enhances lymphatic activity
Reduces swelling (oedema
& haematoma resorption)
Reduces infarct zone size in heart
Reduces mucositis after
irradiation & chemotherapy
Postoperative wound healing-
Herpes simplex & zoster
Ulcus cruris, diabetic foot
Increases the measurable
potential on nerve cell membranes
Relaxation of muscle tension
and increase of pressure pain threshold
Reduction of trigger activity
(f.e. myofacial pain and fibromyalgia)
injuries (Carpal Tunnel Syndrome, tennis elbow
Frozen shoulder, tension
neck, tension headache, lumbago
Stimulates the rate of
mitosis in repair mechanisms (bone, epithel and muscle
Enhances peripheral nerve
regeneration after injury
Reduces degenerative process
on central nervous system
Enhances survival of brain
cells after transcient ischemia
Reduces or eliminates scar
Increases collagen synthesis
(fibroblast proliferation, tensile strength and
Wound healing, bone
Inner Ear problems
Wound healing, post
Post operative etc.
are no absolute contraindications for (LT) laser
therapy. However, it is always better to be
cautious when treating patients in high-risk categories.
Laser therapy should be given with special caution in the
Patients with pacemakers Pacemakers are electronic devices and well protected
inside a cover and insensitive to light. All therapy lasers
are approved medical devices and have an EMC approval
(Electro Magnetic Compatibility) therefore should not
interact with pacemakers.
Patients with a history of cardiac arhythmias or
unexplained chest pain Laser
therapy applied to mid-thoracic area (Th4-7) para spinally
may induce transient coronary spasm and/or arrhythmias in
Patients who are pregnant Laser therapy should not be applied directly over the
fetus. The same applies to the so-called forbidden
acupuncture points (e.g. Hegu (LI4), Sanyinjiao (SP6), and
points in lumbosacral region) to avoid uterine
contractions. However, nausea and vomiting (hyperemesis
gravidarum) may be treated through Neiguan (PC6)
Patients with labile epilepsy
As pulsing light (especially with 5-10 Hz
frequency) can induce epileptic attacks laser therapy using
visible low frequency pulsed emission should be avoided
when treating these patients. Note! Remember to use eye
Endocrine glands According to Spanish studies thyroid gland seems to
be sensitive to light. Therefore laser therapy over the
thyroid gland should be avoided unless there is a need for
activation of thyroid function.
Patients with tumors Laser therapy has not induced or accelerated tumor
growth in any of the reported in vivo studies. However,
laser therapy should not be directed over the tumor tissue
as the precise reactions of existing tumors to laser
therapy is unknown.
Patients with prostheses Although laser therapy does not increase the
temperature of deeper tissues (muscles, cartilage, bone) or
that of materials used in prostheses markedly, some very
sensitive patients may react to laser therapy over the
prosthesis by temporary increase of pain.
Risk of eye injury As
the cornea and lens focus radiation onto the retina, the
power density may increase to more than 100,000 times
higher than the primary energy density on the skin or
cornea. The cornea, aqueous humour, lens and vitreous
humour are more conductive of radiation with a wavelength
of 450-900 nm. The risk of retinal injury is reduced if
laser therapy is given in a bright light when the pupil
size is at the minimum. IR lasers are more dangerous than
those emitting at visual wavelengths, as the invisible beam
does not provoke an eye-blink reflex.
To date, no retinal injuries have been reported during
or after laser therapy. Due to the individual
characteristics of each laser beam (parallel, focalized or
divergent) and in order to avoid any future discussions of
possible eye injuries it is recommended that patients
always wear goggles. On the contrary, laser therapy may be
applied through the lids and eyeball to alleviate
inflammatory reaction after high power laser irradiation to
correct retinal detachment or even retinal lesions from
accidental direct laser beam exposures.
Patients with solar eczema or hypersensitivity to
sunlight may react to laser
therapy when high photon densities are used. Avoid
photosensitizers when laser therapy is given over the newly
abrased skin, especially in the face.
Note! Discoloration due to pigment
reaction is possible. Radiation over dark skin or tattoos
may cause thermal reactions.
Hematological interactions There is no evidence that LT could induce either
thrombosis or prolonged bleeding time. Instead LT is
indicated for its anti-inflammatory and pain relieving
effect in acute injuries from fresh wounds and bruises to
joint injuries and fractures. Increase of microcirculation
and lymphatic flow prevent stasis and reduce existing
oedema, and form basis for fast recovery.
When adequate LT provides only a short
lasting relief of pain and dysfunction and this response is
not getting better with repeated treatments the underlying
disturbances in homeostasis (e.g. systemic disease,
infection, tumours) or interactions with medication
should be taken into account.
There is clinical evidence that cholesterol lowering
drugs like fibrates and statins (e.g. serivastatin) may
induce muscle pain and fatigue in about 1-2 percent of
patients, in rare cases increase of S-CK and rhabdomyolysis
leading to myoglobinaemia, myoglobinuria, kidney failure
and death. More common is poor response to adequate pain
therapy with any form of peripheral stimulation including
LT. Increased muscle pain and fatigue 1-2 months from
beginning of statin medication is a clear sign of this side
effect. The normal response to LT may take some 2-4 weeks
after cessation of medication. Statins provide valuable
protection against cardiovascular accidents and should be
terminated gradually and not stopped abruptly. Other drugs
that may interact with statins are macrolides (e.g.
erythromysin), cyclosporins, konazoles, nicotinic acid and
Pekka J. Pöntinen, MD, PhD, FICAE,
Assoc. Prof. Tampere University
Today, LASERS play a very important role in
industry, medicine and research.
Lasers are applied in measuring distances, laser imaging,
cutting materials and identifying materials. In
communications, LASER enables faster data transmission.
Three characteristics make the LASER a unique form of
capability of parallelism. LASER
stands for: Light Amplification by Stimulated Emission of
A term, which describes electromagnetic
radiation (light) of only one precise wavelength (or
Low level LASER devices applied in Laser
therapy, however, are non thermal light sources emitting
always the same light color without significantly changing
the skin temperature.
Coherence means that all the light waves
are of the same phase. Coherence guarantees an orderly
photon emission and an optimized photon density. This is a
LASER specific property. Laser light has some sort and
degree of polarization.
Laser light can be emitted into one direction in a
parallel way. In the present, most Therapy-Lasers are
emitting a slightly divergent beam for safety
By contrast to laser light, the white
light as emitted by normal bulbs or daylight (sun) is a
mixture of all wavelengths. In other words, sunlight
contains all spectral colors of the visible part from 400
nm to 750 nm, including some ultraviolet and considerable
infrared portions. The latter quality in an average power
light bulb of 60 Watts causes perceptible heat. This is
also called thermal radiation. Moreover, the light of
bulbs is emitted in a spontaneous and non-coherent
Laser light in medicine
The active LASER media determines its
possible application in medicine according to its
characteristic color (wavelength) and operation mode
(pulsed or continuous waves). The specific wavelength
determines its possible absorbers and leads to
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Answers to Questions about lasers, laser physics and biostimulation