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Laser therapy, also known as Low-Level Laser Therapy (LLLT) or photobiomodulation, has gained significant attention in physiotherapy for its non-invasive approach to treating various musculoskeletal conditions. This technique utilizes specific wavelengths of light to penetrate tissues, promoting cellular regeneration and reducing inflammation and pain. This article delves into the mechanisms behind laser therapy and explores its clinical applications in physiotherapy [1].

Mechanisms of laser therapy

Laser therapy operates on the principle of photobiomodulation, where light energy is absorbed by cellular photoreceptors, triggering a series of biochemical reactions. The primary mechanisms include:

Absorption of light energy: Laser devices emit light at specific wavelengths, typically in the red or near-infrared spectrum. These wavelengths are absorbed by chromophores, such as cytochrome c oxidase in the mitochondria, leading to increased production of adenosine triphosphate (ATP).

Enhanced cellular metabolism: The increase in ATP production boosts cellular metabolism, facilitating faster repair and regeneration of damaged tissues. This is particularly beneficial for muscle cells, tendons, ligaments, and other soft tissues [2].

Reduction of inflammation: Laser therapy modulates inflammatory pathways by decreasing the levels of pro-inflammatory cytokines and increasing anti-inflammatory cytokines. This helps in reducing swelling and pain associated with acute and chronic injuries.

Pain modulation: The therapy stimulates the release of endorphins and enkephalins, natural pain-relieving chemicals in the body. It also inhibits pain transmission at the neuronal level, providing relief from discomfort.

Improved blood flow: Laser therapy promotes vasodilation and enhances microcirculation, improving the delivery of oxygen and nutrients to the affected area and removing metabolic waste products more efficiently.

Clinical applications in physiotherapy

Laser therapy has a broad range of applications in physiotherapy, addressing various conditions and enhancing the overall treatment outcomes. Some notable applications include:

Musculoskeletal injuries

Sprains and strains: Laser therapy accelerates the healing of ligament and muscle injuries by reducing inflammation and promoting tissue repair.

Tendinitis and bursitis: It effectively reduces pain and inflammation in tendons and bursae, facilitating quicker recovery and improved function [3].

Arthritis: Laser therapy provides significant relief for patients with osteoarthritis and rheumatoid arthritis by reducing joint pain and stiffness and enhancing mobility.

Back and neck pain: Chronic conditions such as herniated discs, sciatica, and cervical spondylosis can be managed effectively with laser therapy, alleviating pain and improving the range of motion.

Wound healing: The therapy promotes faster healing of chronic wounds, ulcers, and post-surgical incisions by stimulating tissue repair and reducing infection risks.

Sports injuries: Athletes benefit from laser therapy for conditions like tendinopathies, muscle tears, and joint injuries, experiencing reduced downtime and faster return to activity.

Neuropathic pain: Conditions such as carpal tunnel syndrome, diabetic neuropathy, and post-herpetic neuralgia respond well to laser therapy, with patients reporting decreased pain and improved function [4].

Advantages and Considerations

Advantages

Non-invasive: Laser therapy is a non-surgical option with minimal side effects, making it a safe choice for many patients.

Quick and painless: Treatments are relatively quick, often lasting only a few minutes per session, and are generally painless [5].

Complementary: It can be used alongside other physiotherapy modalities to enhance overall treatment efficacy.

Considerations

Individual response: The effectiveness of laser therapy can vary based on the individual's condition, age, and overall health.

Dosage and protocols: Proper training and adherence to established protocols are essential for achieving optimal results and avoiding potential adverse effects [6].

Conclusion

Laser therapy in physiotherapy offers a promising and versatile approach to managing various musculoskeletal and neuropathic conditions. Its ability to reduce pain, inflammation, and promote tissue repair makes it an invaluable tool in modern physiotherapy practice. As research continues to advance, laser therapy's applications and effectiveness are likely to expand, providing even greater benefits to patients and practitioners alike.

Acknowledgment

None

Conflict of Interest

None

References

1. Thiese M, Hegmann KT, Kapellusch J, Merryweather A, Bao S, et al. (2016) . J Occup Environ Med 58: 588-593.

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2. Aben A, De Wilde L, Hollevoet N, Henriquez C, Vandeweerdt M, et al. (2018) . J Shoulder Elb Surg 27: 387-392.

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3. Hsiao CK, Tsai YJ, Lu CW, Hsiung JC, Hsiao HY, et al. (2022) . BMC Musculoskelet Disord 23: 131.

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4. Tarpada S, Morris M, Lian J, Rashidi S (2018) . J Orthop 15: 107-110.

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5. Wiggins AJ, Cancienne JM, Camp CL, Degen RM, Altchek DW, et al. (2018) . HSS J 14233-237.

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6. Curti S, Mattioli S, Bonfiglioli R, Farioli A, Violante FS (2021) . J Occup Health 63.

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