Low Level Laser Therapy

Written By Rebecca Nardi

A Non-Invasive Treatment for Pain, Inflammation, Scar Tissue and Lymphedema

By: Doctor of Physical Therapy, Dr. Becky Nardi


Low Level Laser Therapy, LLLT,  is not a new treatment modality. It has been used since the 1960’s for the treatment of pain, inflammation and to promote healing. 


What is relatively new is the growing body of research supporting its effectiveness achieving results for the treatment of a variety of musculoskeletal conditions and post-breast cancer lymphedema. 
LLLT uses light at specific wavelengths, 660nm-905nm, to promote cellular healing and tissue remodeling in the body.

The energy impacts cells in the treated area to: 

  • Increase cellular activity that reduces inflammation 

  • Increase collagen and energy (ATP) production

  • Stimulates immune system functionImprove lymphatic movement

  • Soften adhesions and scar tissue

The procedure is completely painless and non-thermal, meaning it does not produce heat.

Research supports the effectiveness of treatment with LLLT for a variety of conditions including but not limited to: 

  • Tendonitis, Bursitis

  • Sprains, & Strains

  • Neck and Back Pain

  • Arthritis

  • Carpal Tunnel

  • Lymphedema

  • Radiation FibrosisScar Tissue

Research suggests LLLT can provide pain relief equal to or better than NSAIDs, with fewer side effects!  Optimal pain relief is achieved when LLLT is used in combination with other modalities such as manual therapy and therapeutic exercise. When combined with an  individualised physical therapy treatment plan, it is an effective modality to accelerate recovery from injury. 

Lymphedema

Multiple randomized controlled trials have demonstrated Low Level Laser Therapy to be an effective treatment of lymphedema. Currently, the RianCorp LTU-904 laser is the ONLY FDA approved laser for the treatment of lymphedema. Making it the Low Level Laser of choice for my practice! 

Surgical removal of axillary lymph nodes is common in breast cancer treatment resulting in reduced lymphatic drainage to the arm and breast. Cancer treatments such as radiation can cause a tightening of the treated tissue and in some cases radiation fibrosis can form.  LLLT can restore lymphatic flow through the axilla in persons who have undergone lymph node removal by stimulating the body to create new lymphatic pathways.


Multiple studies have demonstrated that treatment in LLLT significantly reduces limb volume in people with post-cancer-related lymphedema. It is more effective at reducing volume than pneumatic compression or traditional compression garments alone. When LLLT is combined with Manual Lymphatic Drainage techniques and Physical Therapy Therapeutic Exercise, studies demonstrate optimal limb volume reduction is achieved. 


Studies demonstrate LLLT benefits for lymphatic flow are sustained up to 36 months!  In one randomized controlled trial patients reported 100% of patients reported softer tissue and 90% reported reduced limb volume at one year post treatment! 


I am excited to offer low level laser therapy using the ONLY FDA approved laser for the treatment of lymphedema as a treatment modality in my practice.


I carefully consider the effectiveness of each treatment I incorporate into a comprehensive treatment plan with my patients. Research has clearly determined low level laser therapy to reduce inflammation, improve the mobility of scar tissue and fibrosis, reduce pain, improve lymphatic flow.  When this modality is combined with other treatments such as manual therapy and therapeutic exercise effectiveness is enhanced and optimal results are achieved. 

References


1. Ahmed Omar MT, Abd-El-Gayed Ebid A, El Morsy AM. Treatment of post-mastectomy lymphedema with laser therapy: double blind placebo control randomized study. J Surg Res. 2011 Jan;165(1):82-90. doi: 10.1016/j.jss.2010.03.050. Epub 2010 Apr 18. PMID: 20538293

2.. Anderson S.N, Piller N.B, Gannon b, Carati C.J., Angel A.P, Randomised, Double Blinded, Placebo Controlled, Crossover Trial Determining the Effect of Treating Post-Mastectomy Lymphodema with LTU-904H Laser Therapy

3. Avci P, Gupta A, Sadasivam M, Vecchio D, Pam Z, Pam N, Hamblin MR. Low-level laser (light) therapy (LLLT) in skin: stimulating, healing, restoring. Semin Cutan Med Surg. 2013 Mar;32(1):41-52. PMID: 24049929; PMCID: PMC4126803.

4. Carati CJ, Anderson SN, Gannon BJ, Piller NB. Treatment of postmastectomy lymphedema with low-level laser therapy: a double blind, placebo-controlled trial. Cancer. 2003 Sep 15;98(6):1114-22. doi: 10.1002/cncr.11641. Erratum in: Cancer. 2003 Dec 15;98(12):2742. PMID: 12973834.

5. Cotler HB, Chow RT, Hamblin MR, Carroll J. The Use of Low Level Laser Therapy (LLLT) For Musculoskeletal Pain. MOJ Orthop Rheumatol. 2015;2(5):00068. doi: 10.15406/mojor.2015.02.00068. Epub 2015 Jun 9. PMID: 26858986; PMCID: PMC4743666.

6. Farhan F, Samei M, Abdshah A, Kazemian A, Shahriarian S, Amouzegar-Hashemi F, Farzin M, Ghalehtaki R, Jafari F, Cuccia F. Investigation of the effect of Low-Level Laser Therapy on arm lymphedema in breast cancer patients: A noninvasive treatment for an intractable morbidity. Health Sci Rep. 2023 May 17;6(5):e1261. doi: 10.1002/hsr2.1261. PMID: 37205934; PMCID: PMC10189865.

7. Gur A, Sarac AJ, Cevik R, Altindag O, Sarac S. Efficacy of 904 nm gallium arsenide low level laser therapy in the management of chronic myofascial pain in the neck: a double-blind and randomize-controlled trial. Lasers Surg Med. 2004;35(3):229-35. doi: 10.1002/lsm.20082. PMID: 15389743.

8. KloseTraining.com Low Level Laser for Lymphedema An Overview of the Research 

9. Okita S, Sasaki R, Kondo Y, Sakamoto J, Honda Y, Okita M. Effects of low-level laser therapy on inflammatory symptoms in an arthritis rat model. J Phys Ther Sci. 2023 Jan;35(1):55-59. doi: 10.1589/jpts.35.55. Epub 2023 Jan 1. PMID: 36628144; PMCID: PMC9822828.

10. Selcuk Yilmaz S, Ayhan FF. The Randomized Controlled Study of Low-Level Laser Therapy, Kinesio-Taping and Manual Lymphatic Drainage in Patients With Stage II Breast Cancer-Related Lymphedema. Eur J Breast Health. 2023 Jan 1;19(1):34-44. doi: 10.4274/ejbh.galenos.2022.2022-6-4. PMID: 36605467; PMCID: PMC9806938.

11. Tehrani MR, Nazary-Moghadam S, Zeinalzadeh A, Moradi A, Mehrad-Majd H, Sahebalam M. Efficacy of low-level laser therapy on pain, disability, pressure pain threshold, and range of motion in patients with myofascial neck pain syndrome: a systematic review and meta-analysis of randomized controlled trials. Sci. 2022 Dec;37(9):3333-3341. doi: 10.1007/s10103-022-03626-9. Epub 2022 Aug 13. PMID: 35962884

Rebecca Nardi
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