Cold laser therapy, also known as low level laser therapy, refers to the use of low-intensity laser light to reduce pain and inflammation. Cold laser therapy is a relatively new and controversial therapeutic option for the treatment of carpal tunnel syndrome, osteoarthritis, sports injuries and a variety of musculoskeletal conditions that can cause inflammatory pain. The United States Food and Drug Administration, has approved the use of certain cold lasers for specific diseases and conditions.
How Does Cold Laser Work?
Cold lasers use irradiation with minimal temperature elevation of no more than 0.5 degrees Celsius. Non-thermal photons of light emit from the laser, and pass through layers of skin and fat to a depth of 2 to 5 centimeters. The light photons interact with cells to initiate a series of events that promote healing. The laser is a small handheld device, usually the size of a flashlight. During therapy it is placed over the painful area from 30 seconds to a few minutes, depending on the size of the treatment area and the dosage supplied by the laser.
What has the FDA Approved?
The FDA approved the first cold laser for pain therapy in 2002. The 830 Laser was approved for the treatment of carpal tunnel syndrome, a serious ailment affecting the hands and wrists of millions. A variety of cold laser manufacturers exist, and each device is legally marketed for a specific use. The Q Laser System was approved for use in treating osteoarthritis of the hands, while the PL 5000 Laser was approved for use in neck and shoulder pain.
Advantages of Cold Laser Therapy
The procedure is non-invasive, meaning that it does not require any surgical incisions. Also it generally does not react with medications and is sometimes promoted as a way to decrease medication intake. The procedure can be performed during regular office visits and is not painful.
Disadvantages of Cold Laser Therapy
The clinical effectiveness of cold laser therapy has been questioned by some medical practitioners. Many patients do not appear to get satisfactory pain relief from cold laser therapy.
In research by G.E. Djavid published in the “Australian Journal of Physiotherapy”, cold laser therapy combined with exercise was more beneficial than exercise alone in treatment of chronic low back pain. Another disadvantage is that most insurance companies will not pay for cold laser therapy and more than one treatment is needed.
Does It Work?
Controversy still exists over the use of cold laser therapy for treatments of certain conditions. Some clinical trial results seem to support the use of cold laser therapy in hand, shoulder and neck pain.
In research studies using cold laser therapy for carpal tunnel pain by E. Wong G Lee and Baylor University, therapy rapidly alleviated pain, tingling and tenderness, while improving functional hand-wrist performance at a success rate of 77 percent. Also, improvement with cold laser therapy has been reported for fibromyalgia, osteoarthritis and elbow pain. Cold laser therapy research has shown promising results for treating post-mastectomy lymphedema and dental surgery inflammation, but has failed to improve tissues in rheumatoid arthritis or sensorineural hearing loss exhibiting tinnitus.
As the clinical results for cold laser is still unclear, more studies are required to determine its role in clinical practice.
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