High Power Laser Therapy
This article comes from the Endolaser HP Therapy Book (art.nr. 1636960)
Click here to download the Endolaser HP Therapy Book
Lasers in physical medicine
The development of increasingly specialised medical laser systems in the past four decades has given rise to an increasing narrowing of the individual methods to ranges of indications within a rational system. Appropriate therapeutic objectives were allocated to the laser systems as well as the operating conditions. Physical medicine also uses certain laser methods whose effects undoubtedly demonstrate success in the established range of indications.
The design of the “Endolaser HP”, a special high-power laser for physical medicine, is based on this scientific development.
Laser radiation develops through the stimulation and amplification of light (LIGHT AMPLIFICATION by STIMULATED EMISSION of RADIATION) in special resonators.
In contrast to regular light, the features of laser radiation are defined with the following terms:
- Beam intensity
- Monochromasia
- Collimation
- Coherence
The effects of laser
General effects
Like regular light, laser light is subject to the laws of optics. Therefore, laser light is to some extent reflected on the surface of the tissue; on the other hand, it penetrates into the tissue, is scattered and absorbed there, and thus enters into interaction with the tissue. A small part of the laser light also passes through the tissue and exits at the opposite side.
In physical medicine, the portion of the laser light which is scattered and absorbed in the tissue is therapeutically relevant. The site and amount of the laser energy which remains in the tissue and is converted into other forms of energy are crucial for the effect.
The biological effects of the laser light are described as biostimulation and thermal effects.
Interactions
In the tissue, the laser light encounters molecules with certain colours and colour properties. In the near infrared range (780-1400 nm) it is primarily absorbed by melanin, myoglobin and haemoglobin. In doing so, there is a thermal reaction due to the conversion of light energy into heat, that is, there is a heating of the tissue.
The heat which develops also spreads to adjacent areas of tissue via conduction (thermal conduction).
Note: Other effects, such as ionisation or the breaking of molecular bonds, do not occur with lasers in the near infrared range in the energy spectrum of the Endolaser HP laser.
The heating of the skin limits the total energy since thermal damage occurs at an excessively high dosage. The total energy administered can be increased through cooling at least in white skin since there is less blood due to the vasoconstriction because of the cold and thus also less haemoglobin in the skin.
Thus less laser energy is absorbed; the laser light penetrates deeper into the tissue.
Biostimulation
At the same time, a part of the laser energy is converted into chemical reaction energy, as a result of which molecules are directly excited through the transmission of electrons and indirectly through the formation of oxygen radicals.
These primarily include coloured molecules of the respiratory chain, such as flavoproteins and cytochromes.
This results in an increase in energy metabolism activity which is known as “biostimulation”.
Wavelengths
The wavelengths of the Endolaser HP of 810 nm, 980 nm and 1064 nm, are within the absorption minimum of melanin and haemoglobin. In this way, the maximum penetration ability of the laser light is achieved. Melanin is contained in the epidermis which forms a very thin layer. For this reason, the laser energy can penetrate this layer very easily.
The wavelength 1064 nm favours penetration of the radiation into the tissue. The scatter of the laser radiation decreases as the wavelength increases. Since the penetration depth is limited not only by absorption but rather also by scatter, a higher depth of penetration is expected for radiation of the wavelength 1064 nm.
More to know (consult the therapy book)
The use of laser in general, and high power laser specifically, is further related to:
- Frequency, superposition, and interaction with the tissue
- Depth of penetration
- Thermal effect
- Mechanisms of laser therapy (Analgesic mechanism, Reflexive effects, Regeneration of tissue)
- Emission mode (continuous, intermittent)
- Application techniques (static, dynamic, combined)
- Determining the thermal threshold
Treatment recommendations
Myopathy, tendinopathy
Humeroscapular periarthritis (”frozen shoulder”)
Infraspinatus muscle and insertional tendinopathy
Supraspinatus muscle and insertional tendinopathy
Biceps longus tendon
Insertional tendinopathy of the adductors
Radial epicondylopathy
Ulnar epicondylopathy
Patellar tendonitis
Tendinopathy of the greater trochanter
Achillodynia
Plantar fasciitis
Insertional tendinopathy of the pes anserinus
Low back pain
Painful muscle tension
Sciatica
Facet syndrome
Osteoarthritis
Osteoarthritis of the knee
Osteoarthritis of the base of the thumb
Spondylarthrosis, cervical
Spondylarthrosis, cervical
Traumatological diseases
Ankle sprain
Pulled muscle, torn muscle
Impingement syndromes
Carpal tunnel syndrome
Morton’s neuralgia
Skin diseases
Acne vulgaris
Herpes simplex
Plantar warts
Anogenital warts
Impaired wound healing
Venous ulcer
Decubitus ulcers
Please download and consult the Endolaser HP Therapy booklet for in depth knowledge and explanation of the above.
