Low-level laser therapy

Source: Wikipedia, the free encyclopedia.
Not to be confused with Light therapy.
Low-level laser therapy
LLLT being applied for rheumatism in Sweden
MeSHD028022

Low-level laser therapy (LLLT), cold laser therapy, photobiomodulation (PBM)

oral mucositis.[8]

Mechanism

Research is ongoing about the mechanism of LLLT. The effects of LLLT appear to be limited to a specified set of wavelengths of laser,

mitochondria,[11][12]
which is the generally accepted theory.

Medical uses

Various LLLT devices have been promoted for use in treatment of several musculoskeletal conditions including

stem cell transplant with chemotherapy.[8][13] In other areas, evidence for LLLT remains conflicted. Some studies suggest that LLLT may be modestly effective in relieving short-term pain for rheumatoid arthritis,[7] osteoarthritis,[14] chronic low back pain,[15] acute and chronic neck pain,[16] tendinopathy,[9][17] and chronic joint disorders.[10] The evidence for LLLT being useful in dentistry,[18][19] and in the treatment of wound healing[20]
is unclear.

Veterinary use

Veterinary clinics use cold laser devices to treat a wide variety of ailments, from arthritis to wounds, on dogs and cats.[21][22] Very little research has been done on the effects of this treatment on animals. Brennen McKenzie, president of the Evidence-Based Veterinary Medicine Association, has stated that "research into cold laser in dogs and cats is sparse and generally low quality. Most studies are small and have minimal or uncertain controls for bias and error".[23][24] While allowing that some studies show promising results, he reports that others do not. While believing that there is enough evidence to warrant further study, he concludes that there is not enough evidence to support routine clinical use of cold laser in animals.

Society and culture

History

antibiotics for tuberculosis rendered light therapy obsolete for these diseases.[27]

Hungarian physician and surgeon Endre Mester (1903–1984) is credited with the discovery of the biological effects of low power lasers,[28] which occurred a few years after the 1960 invention of the ruby laser and the 1961 invention of the helium–neon (HeNe) laser.[11] Mester accidentally discovered that low-level ruby laser light could regrow hair during an attempt to replicate an experiment that showed that such lasers could reduce tumors in mice. The laser he was using was faulty and wasn't as powerful as he thought. It failed to affect the tumors, but he noticed that in the places where he had shaved the mice in order to do the experiments, the hair grew back more quickly on the treated mice than on those among the control group.[2] He published those results in 1967.[11] He went on to show that low level HeNe light could accelerate wound healing in mice.[11]

By the 1970s, he was applying low level laser light to treat people with

light emitting diodes by those studying this approach, it became known as "low-level light therapy", and to resolve confusion around the exact meaning of "low level", the term "photobiomodulation" arose.[2]

Names

The following terms are accepted as alternatives of low level light therapy term: LLLT, laser biostimulation, laser phototherapy, low-level laser therapy, low-power laser irradiation, low-power laser therapy, and photobiomodulation therapy. The term photobiomodulation therapy is considered the preferred term by industry professionals.[3][4] However LLLT has been marketed and researched under a number of other terms, including red light therapy,[30] low-power laser therapy (LPLT), soft laser therapy, low-intensity laser therapy, low-energy laser therapy, cold laser therapy, bio-stimulation laser therapy, photo-biotherapy, therapeutic laser, and monochromatic infrared light energy (MIRE) therapy.[31] More specific applications sometimes have their own terms, for example when administered to acupuncture points, the procedure is called laser acupuncture. When applied to the head, LLLT may be known as transcranial photobiomodulation, transcranial near-infrared laser therapy (NILT),[32] or transcranial low level light therapy.

Government action

The FDA filed a complaint for injunction in 2014, alleging that company QLaser PMA were marketing their devices as being able to treat “over 200 different diseases and disorders,” including cancer, cardiac arrest, deafness, diabetes, HIV/AIDS, macular degeneration, and venereal disease. This case resulted in a permanent injunction against the manufacture, marketing, sale, and distribution of those devices in 2015.[33]

In 2017, the owner of QLaser, Robert Lytle, and two of QLaser's distributors were charged with a criminal conspiracy to commit fraud. Lytle pleaded guilty to one count of conspiracy to introduce misbranded medical devices into interstate commerce with the intent to defraud and mislead, and one count of criminal contempt in January 2018. Lytle was sentenced to serve 12 years in prison and made an initial restitution payment of $637,000. Lytle's conspirators were sentenced to 24 months and 15 months, respectively.[34][35]

Reimbursement

Centers for Medicare and Medicaid Services does not provide coverage for LLLT.[38] Cigna lists LLLT as "experimental, investigational, or unproven for any indication" and provides literature review summaries for a number of conditions.[39]

Research

Demonstration of LLLT with intranasal irradiation

Musculoskeletal

Evidence does not support a benefit in delayed-onset muscle soreness.[40] It may be useful for muscle pain and injuries.[41] A 2008 Cochrane Library review concluded that LLLT has insufficient evidence for treatment of nonspecific low back pain,[42] a finding echoed in a 2010 review of chronic low back pain.[43] A 2015 review found benefit in nonspecific chronic low-back pain.[15] LLLT may be useful in the treatment of both acute and chronic neck pain.[16] In 2013, however, a systematic review and meta-analysis of LLLT for neck pain indicated that the benefit was not of significant importance and that the evidence had a high risk of bias.[44] In a study testing the efficacy of low-level laser therapy treating plantar fasciitis found that LLLT significantly reduces pain in lower extremity tendinopathy and plantar fasciitis in the short and medium terms. [45] The same study also stated that while comparing the effect of LLLT to that of therapeutic ultrasound in persons with patellar tendinopathy, and they found a statistically significant effect in favour of LLLT, both on pain reduction and function.[46]

There are tentative data that LLLT is useful in the short-term treatment of pain caused by rheumatoid arthritis,[7] and possibly chronic joint disorders.[10] Research that compared the effects of LLLT against other treatments, sham treatments, or no treatment at all, and randomized adult patients with rheumatoid arthritis to receive it were considered. These outcomes included pain, functional capacity, adverse events, inflammation, disease activity, range of motion, stiffness in the morning, muscle strength, and quality of life.[47] The findings indicate that the differences between utilizing a sham and an infrared laser may be negligible or nonexistent in terms of pain, stiffness in the morning, grip strength, functional ability, inflammation, range of motion, disease activity, and side events. We also discovered that the data about the effects of laser acupuncture against reflexology in terms of functional ability, quality of life, and inflammation is quite hazy, and about the effects of red laser versus sham in terms of pain, morning stiffness, and side events.[48] The usefulness of red laser, laser acupuncture, and reflexology in the treatment of RA patients is not well enough demonstrated. [49] A 2019 systematic review and meta-analysis found evidence for pain reduction in osteoarthritis.[14] While it does not appear to improve pain in temporomandibular disorders, it may improve function.[50]

There is tentative evidence of benefit in

frozen shoulders.[52]

Mouth

Similarly, the use of lasers to treat chronic periodontitis[18] and to speed healing of infections around dental implants[19] is suggested, but there is insufficient evidence to indicate a use superior to traditional practices.[53] There is tentative evidence for dentin hypersensitivity.[54] It does not appear to be useful for orthodontic pain[55][56] LLLT might be useful for wisdom tooth extraction (complications).[57]

Hair loss

LLLT has been studied as a treatment for hair loss; a review in 2012 found little evidence to support the use of lasers to treat hair loss.[58] A 2014 review found tentative evidence for benefit for lasers,[59] while another 2014 review concluded that the results were mixed, had a high risk of bias, and that its effectiveness was unclear.[60] A 2015 review found tentative evidence of benefit.[61] Additionally, a 2017 review of clinical trials found 10 of 11 trials reviewed "demonstrated significant improvement of androgenic alopecia in comparison to baseline or controls when treated with LLLT."[62]

LLLT is shown to increase hair density and growth in both genders. The types of devices (hat, comb, helmet) and duration did not alter the effectiveness,[63] with more emphasis to be placed on lasers compared to LEDs.[64] Ultraviolet and infrared light are more effective for alopecia areata, while red light and infrared light is more effective for androgenetic alopecia.[65]

Medical reviews suggest that LLLT is as effective or potentially more than other non invasive and traditional therapies like minoxidil and finasteride but further studies such as RCTs, long term follow up studies, and larger double blinded trials need to be conducted to confirm the initial findings.[66][67][68]

Brain injuries

LLLT has been studied for traumatic brain injury (TBI) and stroke among other conditions.[11] When applied to the head it is known as transcranial photobiomodulation or transcranial low level light therapy.

Cancer treatment side effects

LLLT has been studied as a way to reduce pain and swelling in breast-cancer related lymphedema.[69][20] The 2015 systematic review & meta-analysis by Smoot, Chiavola-Larson, et al found: “Moderate-strength evidence supports LLLT in the management of [breast cancer related lymphoedema], with […] reductions in volume and pain immediately after conclusion of LLLT treatments. Greater reductions in volume [of lymph nodes or surrounding tissues] were found with the use of LLLT than in treatments without it.”[70]

Stem cells

An ongoing area of research is the application of LLLT for increasing cell proliferation, including

stem cells.[71]

Wound healing

Low level laser therapy has been studied as a potential treatment for chronic wounds, and higher-power lasers have sometimes been successfully used to close acute wounds as an alternative to stitching.[72] However, as of 2012 and due to inconsistent results and the low quality of extant research, reviews in the scientific literature have not supported its widespread application.[72][73]

See also

References

  1. PMID 27973730
    .
  2. ^
    PMID 27752476
    .
  3. ^
    ISBN 978-1-5106-1416-1
    , retrieved 2021-02-11
  4. ^ a b "Photobiomodulation". www.aslms.org. Retrieved 2019-09-02.
  5. ISBN 978-0-429-19384-2
    . Retrieved 2023-09-04.
  6. ^ Jiang Y, Zhuoting Z, Xingping T, Xiangbin K, Zhong H, Zhang J, Xiong R, Yuan Y, Zeng J (2021-12-01). "Effect of Repeated Low-Level Red-Light Therapy for Myopia Control in Children". American Academy of Ophthalmology.
  7. ^
    S2CID 40986179
    .
  8. ^
    PMID 25198431
    .
  9. ^
    PMID 18510742
    .
  10. ^
    PMID 12775206
    .
  11. ^
    PMID 22045511
    .
  12. S2CID 227103
    .
  13. PMID 31286228
    .
  14. ^
    PMID 31662383
    .
  15. ^
    PMID 26667480.{{cite journal}}: CS1 maint: DOI inactive as of February 2024 (link
    )
  16. ^
    S2CID 16336402
    .
  17. ^
    S2CID 10634480
    .
  18. ^
    S2CID 16452438
    .
  19. ^
    S2CID 5544626
    .
  20. ^
    PMID 19764898
    .
  21. ^ "Doggone Joints: Laser Therapy for Pet Arthritis". ABC News. 2011-02-23. Retrieved 2016-07-19.
  22. ^ Robinson, Narda G. (2013), "Complementary and Alternative Veterinary Medicine: Laser Therapy", The Merck Veterinary Manual, 11th edition.
  23. ^ McKenzie, Brennen (2016), "The Laser Craze: What Is the Evidence for Low-level Laser Therapy?" Archived 2018-01-10 at the Wayback Machine [SA222]; Western Veterinary Conference, Proceedings of the WVC 88th Annual Conference, Mandalay Bay Convention Center, Resort and Casino, Las Vegas, NV, March 6–10, 2016.
  24. ^ McKenzie, Brennen (2016), "WVC 2016: The Laser Craze", The SkeptVet.
  25. ISBN 978-3-0340-1276-8
    .
  26. ^ "The Nobel Prize in Physiology or Medicine 1903". Nobelprize.org. Nobel Media AB. 2016-11-01. Archived from the original on 2016-10-22. Retrieved 2016-11-01.
  27. ^ "Engines of our Ingenuity No. 1769: NIELS FINSEN". Retrieved 2014-04-05.
  28. ^ a b c Perera J (19 March 1987). "The 'healing laser' comes into the limelight'". New Scientist.
  29. ^ "Celebrating the 100th birthday of Professor Endre Mester". Laser World. Swedish Laser-Medical Society. April 18, 2004. Archived from the original on March 3, 2016.
  30. ^ "What Is Red Light Therapy?". WebMD. Retrieved 2021-02-11.
  31. ^ American Cancer Society. Cold Laser Therapy Page archived April 24, 2015
  32. PMID 21039081
    .
  33. ^ "District Court Grants Permanent Injunction Against Device Maker". Policy & Medicine. 5 May 2018. Retrieved 2021-02-11.
  34. ^ Hein A (2018-04-24). "'QLaser' TV infomercial doc gets 12 years in prison for selling scam device". Fox News. Retrieved 2021-02-11.
  35. ^ "A Skeptical Look at Low Level Laser Therapy | Quackwatch". 26 April 2018. Retrieved 2020-02-28.
  36. ^ Blue Cross and Blue Shield of Kansas City (Blue KC). "Low-Level Laser Therapy" (PDF). Policy No. 2.01.56. Retrieved 2 February 2019. (Policy reviewed each June; if link is dead try replacing "06-18" with a more recent year.)
  37. ^ "Infrared therapy". Aetna clinical policy bulletin 0363, reviewed June 17, 2020. Aetna has additional information in its "Clinical Policy Bulletin on Cold Laser and High-Power Laser Therapies".
  38. ^ "Decision memo for infrared therapy devices" (CAG00291N). Center for Medicare & Medicaid Services, Oct 24, 2006.
  39. ^ "Cigna Medical Coverage Policy- Therapy Services Low-Level Laser and High-Power Laser Therapy" (PDF). Cigna Medical Coverage Policy. Retrieved 2021-02-11.
  40. S2CID 21912028
    .
  41. PMID 23626925
    .
  42. PMID 18425909
    .
  43. PMID 20640863
    .
  44. S2CID 7057247
    . his systematic review provides inconclusive evidence because of significant between-study heterogeneity and potential risk of bias.
  45. PMID 36171024
    .
  46. PMID 36171024
    .
  47. PMID 37683021
    .
  48. PMID 37683021
    .
  49. PMID 37683021
    .
  50. PMID 25491183
    .
  51. PMID 25450903
    .
  52. S2CID 32666794
    .
  53. PMID 18980508
    .
  54. S2CID 25494366
    .
  55. S2CID 25416518
    .
  56. PMID 25800534
    .
  57. S2CID 22627779
    .
  58. PMID 22398224
    . Since then, a number of studies have suggested the use of lasers as an effective way to treat alopecia, particularly androgenetic alopecia and alopecia areata, but there is still a paucity of independent, peer-reviewed blinded clinical trials.
  59. PMID 23970445
    .
  60. S2CID 13565213
    .
  61. S2CID 22028662
    .
  62. S2CID 23783876
    .
  63. S2CID 59524423
    .
  64. S2CID 208185306
    .
  65. S2CID 248526019
    .
  66. S2CID 215405183
    .
  67. S2CID 23783876
    .
  68. PMID 34980962
    .
  69. S2CID 27555240
    .
  70. S2CID 27555240
    .
  71. PMID 27475781
    .
  72. ^
    ISBN 978-0-85729-281-0
    .
  73. S2CID 129167
    .
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