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    How Cold Laser Therapy (PBM) Works 

    ​​Who would have thought that a beam of light could reduce pain and promote healing on almost every part of the body without any side effects? It sounds like science fiction!

    Cold laser therapy, or photo biomodulation (PBM) is a cutting edge, scientifically proven option for treating a range of conditions.

    An Introduction to Cold Laser Therapy

    Cold laser therapy is also known as:

    • Low-level laser therapy (LLLT)
    • Low-power laser therapy (LPLT)
    • Soft laser bio stimulation
    • Photo biomodulation therapy (PBMT)

    Cold laser therapy or photo biomodulation (PBM) can provide relief in just minutes to a wide spectrum of conditions, from sprains, tennis elbow and bruising to carpal tunnel, chronic back, neck and shoulder pains and even conditions such as arthritis and fibromyalgia.

    Increased blood flow, decreased scar tissue, decreased inflammation and increased cellular growth.

    Cold laser therapy is simply a beam of light that stimulates the powerhouse of your cells at the site of injury, it provides energy to the cells to speed up healing.

    Treatment times are usually short, about 10-20 minutes and because it just uses light, treatment doesn’t hurt at all, there are no side effects and often provides relief in the first session and underlying issues effectively treated with 3 to 6 sessions.

    For chronic conditions, these effects can be long-lasting for sometimes months and even years as a result of improved tissue healing.

    How does Cold Laser therapy (PBM) compare to other treatments?

    ​Effective pain management is critical for quality of life for sufferers of both acute and chronic pain and inflammation.
    Day-to-day life can be a battle when you’ve got pain or inflammation, which can affect all aspects of your life including sleep, mental wellbeing, work and relationships in addition to restricting the ability to undertake physical activities which are so important for maintaining emotional and physical well-being.

    However many of the treatment options for pain management can be ineffective, invasive or have significant side effects.

    Low level laser therapy (PBM) has been scientifically proven to significantly reduce inflammation and promote tissue repair and has been used in pain management for years

    This painless and non-invasive therapy works at a cellular level to relieve pain. The significant advantages of PBM over other pain management options are that it is non-invasive, may provide long-lasting relief and importantly has no known side effects.

    How does Cold Laser therapy work (PBM) and how long does it last?

    Cold laser therapy (PBM) uses a red or infrared continuous laser (typically 600 to 1000 nm wavelength) for pain reduction and healing stimulation.

    Light is applied to an injury or a painful site for 30–60 seconds a few times a week for several weeks.

    Approximately 3-6 treatments are required to reduce inflammation and promote blood circulation which assists revitalization of cells and promotes healing.

    The result is a reduction of inflammation, pain relief and accelerated tissue regeneration.

    With over 10 years of research in this field we can safely say that cold laser therapy (PBM) has no bad side effects. 

    Cold laser therapy is ‘cold’ because the effect is photochemical, not thermal. The use of lower doses of light is more effective than much higher doses - hence the term low level laser therapy.

    Cells communicate with each other using light. An easy way to think about how it works it as the effect of light in photosynthesis in plants.
    Photosynthesis occurs because when light is absorbed by the photoreceptors in plant cells the energy from the light triggers a biochemical reaction in the cell.

    When cells are injured and diseased, the type of light emitted is altered. Laser therapy uses a 'healthy' light wavelength to re-program injured or diseased cells.
    This results in repairing the damaged cells to help fast-track recovery. These low doses of light have demonstrated the ability to heal skin, nerves, tendons, cartilage and bones.

    Cold laser therapy acts as an anesthetic agent and the most immediate effect is pain relief which can occur within a few minutes of application. This fast-acting pain relief occurs as a result of blocking pain nerves and a reduction of muscle spasms by causing the contracted muscle to release or relax.

    Within hours and days of treatment, there is a reduction in inflammation and swelling and the long term effects from improved tissue healing occur within a week or two and can last for months or sometimes years.

    What conditions can Cold Laser therapy (PBM) be used to treat?

    Cold laser therapy can be used to effectively treat many types of acute and chronic pain and inflammation. Because it acts at a cellular level, the spectrum of conditions that can be treated is incredibly diverse.

    Studies have shown that it can be effective for:

    • Neck pain
    • Back pain
    • Lymphoedema
    • Women’s health/pelvic pain
    • Sports injuries
    • Migraines/headaches
    • Tendonitis
    • Frozen shoulder
    • Sciatica
    • Knee pain
    • Carpal tunnel
    • Inflammation (e.g. from rheumatoid arthritis or autoimmune diseases)
    • Fibromyalgia
    • Arthritis / Joint Pain
    • Bursitis
    • Fibromyalgia
    • Temporo-Mandibular Joint Disorder
    • Knee Pain
    • Finger & Toe Joint Pain
    • Muscle Pain / Spasms
    • Shoulder / Rotator Cuff
    • Tendonitis
    • Whiplash
    • Back Pain / Neck Pain
    • Carpal Tunnel Syndrome
    • Heel Spurs / Plantar Fasciitis
    • Migraine Headaches
    • Nerve Pain / Radiculopathy Sciatica
    • Sprain / Strain
    • Tennis Elbow
    • Trigeminal Neuralgia
    • Psoriasis

    There are currently clinical trials testing the effectiveness of photo biomodulation on diseases like Parkinson’s Disease, traumatic brain injury, spinal cord injury and Alzheimer’s disease, with patients reporting significant improvement in symptoms after treatment.

    ​While the list of what can be treated seems almost endless, the key is to match the correct treatment with the targeted condition.

    The right location-specific dosage and treatment procedure must be adhered to for it to be effective. This is why cold laser therapy should only be administered by a trained, qualified practitioner.

    There are four main target areas for cold laser therapy:
    1. On an injury site to promote healing and reduce inflammation.
    2. On lymph nodes to reduce swelling and inflammation.
    3. On Nerves to relieve pain.
    4. On trigger points to reduce tenderness and relax contracted muscle.

    Using different treatment times, wavelengths of light and combining laser therapy with physiotherapy for specific injuries can further improve the effectiveness of the treatment.

    The way it works and the length of time that it remains effective also varies depending on the condition.

    Is Cold Laser therapy scientifically proven to be effective?

    There have been 30 years of research into cold laser therapy and other forms of photo biomodulation, which includes many significant clinical trials and reviews of the effectiveness for a range of conditions:

    Effectiveness and results for Osteoarthritis and rheumatoid arthritis

    Cold laser therapy (photo biomodulation) is recommended for short term relief of pain and morning stiffness for arthritis. In clinical trials using cold laser therapy treating hands for rheumatoid arthritis patients reported reduced pain by 70% and reduced morning stiffness by almost 30 min and increased flexibility in the treated hand compared with the untreated hand or placebo treatment.

    Effectiveness and results for chronic knee back and TMJ pain

    Cold laser therapy (photo biomodulation) is extremely effective in reducing pain and improving the range of motion for chronic joint conditions.

    In a review of 10 clinical trials investigating the effectiveness of cold laser therapy in the treatment of knee, back and jaw (TMJ) pain in 90% of the trials the patients reported a significant reduction in pain this reduction remained significant for three weeks and there was in some instances up to six months following treatment.

    Effectiveness and results for Fibromyalgia

    In a comprehensive review of 9 clinical trials with 325 patients, patients reported significant improvement in their fibromyalgia impact questionnaire (FIQ) score, reduction in pain severity, the number of tender points, fatigue, stiffness, depression, and anxiety after cold laser therapy.

    Effectiveness and results for tendon injuries

    Chronic tendon injuries (tendinopathy) can take weeks, months or even years to recover with limited treatment options.

    Cold laser therapy is particularly effective in treating conditions such as Achilles tendon and “Tennis Elbow”. In a review of trials with 80 patients suffering Achilles tendonitis, researchers found cold laser therapy resulted in a significant improvement of pain, range of motion and motor function with lasting relief of symptoms (refer below).

    Cold laser therapy combined with exercise is even more effective than either treatment alone. A similar review of shoulder tendinopathy found that the current dosage and treatment regime was critical in providing relief and rapid improvement and could be effective alone or in conjunction with physiotherapy.

    Effectiveness and results for Headaches/Migraines

    In a recent study investigating the effectiveness of cold laser therapy for the treatment of chronic migraines, they found that patients treated with cold laser therapy over 5 weeks reported a significant reduction in headache days, reductions in medication use and decreased the intensity of pain. Sleep disturbance was also reduced.

    Effectiveness and results for Lymphoedema

    Lymphoedema (swelling due to accumulation of lymph fluids in an area of the body) has no cure and there are limited therapeutic options to treat it. Cold laser therapy is very effective in treating volume of the affected area, breaking down scar tissue, and increasing the range of motion. In some studies, improvements were reported 12 months after treatment.

    Effectiveness and results for women’s health/pelvic pain conditions

    ​Menstrual cramps are caused by powerful chemicals called prostaglandins and arachidonic acid that induce uterine muscle contractions.

    Cold laser therapy can reduce period pain by reducing inflammation and relaxing muscle contractions, it has also been shown to decrease scar tissue and adhesions association with pelvic pain.

    One study examined the effects of cold laser therapy and women's health on trigger points combined with exercise on period pain found 76 % of the women receiving three treatments per month reported complete relief after three months. In another study, cold laser therapy treatment five days before the start of menstruation reduced period pain by 83% in the first month.

    It has also been reported to be effective in the treatment of endometriosis. 

    How safe is cold laser therapy?

    Cold laser therapy is extremely safe when administered by a trained practitioner. All physiotherapists at Artarmon Physiotherapy are fully trained and qualified to administer laser treatment.

    The technique is called “cold” laser therapy because the low levels of light aren’t enough to heat your body’s tissue. The level of light is low when compared to other forms of laser therapy, such as those used to destroy tumors and coagulate tissue.

    Surgical and aesthetic lasers heat the tissue being treated. True to its name, cold laser therapy does not.

    There are no recorded side effects of cold laser therapy. Safety glasses should be worn by everyone present to protect the eyes from the laser’s red or infrared light, as a laser could cause damage to the eye (just like looking straight into a beam of light from the sun).

    However, there are a number of precautions and conditions where it is recommended to speak to your practitioner about before having treatment:

    • Cancer - not recommended over the site of any cancerous tissue, unless the therapy is for palliative care or to reduce chemotherapy side effects.
    • Pregnancy- while there is no evidence to suggest that cold laser therapy during pregnancy is harmful, it is recommended that treatment should not be done directly over the developing fetus.
    •  Epilepsy - low frequency pulsed visible light (<30Hz) might trigger a seizure in photosensitive, epileptic patients.

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