Low level laser therapy
In the low-level laser therapy is an alternative medicine and veterinary treatment, the laser light - is performed - so monochromatic and coherent light. The goal of treatment is to reduce pain, to promote wound healing, and combat infection. The effectiveness is not scientifically proven.
The low-level laser therapy is known by different names. In addition to the outdated name soft laser therapy, the terms cold light laser therapy, Laserbiostimulation and Laserbiomodulation be used further still. The name of Low Level Laser is actually misleading, because the therapy can be performed with high power lasers. Thus the name Laser Photo Therapy ( engl. Laser Photo Therapy ) is used by scientists in this area, but this name has not yet been set (also in the scientific literature ) everywhere.
First medical applications of laser technology, there were already a few years after the invention of the laser in 1960. Way Endre Mester examined already in 1963 at the Semmelweis University in Budapest, the influence of laser radiation on tissue, particularly in view of a possible carcinogenic effect of laser radiation. To this end, he irradiated mice to skin, which were made previously accessible by shaving the hair. The results of his experiments, he interpreted to the effect that the investigated laser had no carcinogenic effect, but also that the hair of the mice in the treatment group regenerated significantly faster than in the control group. In further studies, he claims to have found an improved epithelialization of poorly healing wounds. Mester published his results in 1967 in several publications. These studies are now seen by some authors as the starting point and the first proof of LLLT, a scientifically reception or even experimental verification of its results is not available so far.
Mechanism of action
Triggered by the laser light into living cells photochemical processes are the subject of numerous scientific and pseudo-scientific speculation Zeicher and far from clear. Among the protagonists of this therapy is of central importance to the influence of light is assumed to mitochondria. These organelles are responsible for the cell to provide energy in the form of adenosine triphosphate ( ATP) shall be substantially. This happens in located on the inner membrane of the respiratory chain, which eventually synthesize ATP via several redox reactions of adenosine diphosphate ( ADP) and Phophor through the process of phosphorylation.
Karu and other authors describe a mechanism to the antenna pigments of the respiratory chain attaches directly by absorption and through various processes such as the stimulation of flavin dehydrogenase and cytochrome oxidase to a direct activation of the respiratory chain and the way of stimulation of porphyrins by the formation of oxygen with subsequent oxidation of NADH and related activation of the respiratory chain should eventually lead to an increased ATP synthesis.
Stimulated by the incident laser light and controlled by the enzyme ATP synthase ATP synthesis thereby lead to an increase of the cell energy in the form of ATP up to 400 %. The ATP will thereby released from the mitochondria into the surrounding cytoplasm, is by increasing ATP supply of the cell and thereby actively a number of cellular processes at. An important operation is in the process activating the sodium-potassium ion pump has a significant influence on the stabilization of the membrane potential of the cell, such as important for pain stimulation and forwarding function of nerve cells ensures.
A further important consequence of the increased concentration of ATP is the activation of DNA and RNA synthesis, and thus the increase of mitosis which has a significant influence on the capacity for tissue regeneration.
The third basic effect is to exercise the laser light on tissue, is a antiendzündlicher effect. This is due to different mechanisms, the arterial and venous microcirculation should be encouraged, which amplifies transporting leukocytes and macrophages into the affected tissue. In addition, the phagocytosis of leukocytes and macrophages am encouraged. In addition, the formation of antibodies to be stimulated and be reduced by decreased secretion of granules from mast cells of the inflammatory stimulus.
In addition to these three main mechanisms of action, there will be a number of other supposedly proven effects. So be interesting to note that there may be damage to the cell membrane and inhibition of Bakterinenzyme by the formation of oxygen free radicals in a strong inhibition of bacteria.
The recommendations for use are based primarily on superficial inflammation of the skin and mucous membrane as well as wear and tear, inflammation of the organs of motion and joints, as well as allergies (eg house dust, animal dander, hay fever).
A standardized form of application for therapy does not exist. Just as the device performance vary the application parameters of therapist to therapist. Soft laser devices are, inter alia, to in practices of medical practitioners, orthopedists (mainly sports physicians ) and ENT physicians.
Soft laser treatment is considered to be free of side effects and painless. The laser beam penetrate the lower layers of the skin and will assist according to its user as salutary " biostimulation " on the metabolism in the connective tissue. This leads to the regeneration of hair cells, stimulation of the immune system, acceleration of cell division and activation of specific defense molecules. Scientific evidence for this missing.
There are irradiated surface depending on the training of the therapist either aching parts of the body, or it can be targeted acupuncture points treated (laser acupuncture). A rarely offered variant is the laser irradiation of blood (Blood Acupuncture ), intended to act via a catheter into a vein in the blood at the green light.
The therapeutic value of soft laser is different, mainly considered critically in the literature. The effectiveness is not scientifically proven.
A systematic review for use in neck pain comes to the conclusion that the short and medium exists an analgesic effect.
Especially for the application of low-level laser tinnitus are several randomized controlled trials, but each with a low number of patients. While some of them show positive results, others may not demonstrate efficacy of low-level laser therapy for tinnitus. A corresponding study for medium - power laser (450 mW, 830 nm) from the year 2013 could not detect any effect of treatment above the placebo effect.
The German Society of Dental Oral and Maxillofacial Surgery is used in the evaluation of laser biostimulation to the conclusion that the means employed are comparable in view of their low power density laser pointers. Due to numerous double - blind studies it must be concluded with high certainty from the fact that the Laserbiostimulation have no substantial effect and that therapeutic effects on the placebo effect based.
There are three types of lasers:
- Hard - lasers with between 30 and 180 watts ( used in surgery )
- MID laser with emission intensity in the two -digit milliwatt range
- Soft laser with very soft emission in the low milliwatt range
For use in physiotherapy area usually come the so-called MID laser. The intensity of radiation is about 70 milliwatts. Applied with a point electrode, which can be placed on a pain point or is out in a manner strokes over the affected area.