Clinical use of low level laser therapy
INTRODUCTION
Low level laser therapy (LLLT) is gaining increasing acceptance in conventional veterinary practice (as a therapy for tissue trauma, wounds, granuloma, myositis, tendinitis etc). Cold (soft) lasers are available as robust, portable instruments. They are operated by batteries or by mains electricity.
LLLT also is used instead of needles in veterinary acupuncture (AP) to stimulate the acupuncture points (APs) and Trigger Points (TPs) in animals but there are few published studies to date. Commercial interests claim excellent results in a wide variety of clinical conditions. Russian and German workers have used LLLT at the human APs for many years. Since 1984, there are many papers on the method in humans (Rogers 1991g).
The history, theoretical uses and physics of laser are discussed in detail in Pontinen's textbook (1995).
Though laser light is emitted in a continuous wave (cw) beam, it can be interrupted (modulated) at variable frequencies and intervals by mechanical or electronic means. Interruption of the light beam at fixed intervals is called pulsing. Pulsed lasers, especially those interrupted 2000-10000 times/second (Hz), penetrate deeper in tissue than unpulsed lasers.
LLLT has some advantages over needling or point injection in AP or TP therapy:
* It is aseptic, non-invasive, painless and, if used properly, has no reported side-effects. The probe is held within 0-5 cm from the skin and the light is aimed at the point.
* It is ideal for use on painful (AhShi) points or in nervous/difficult animals. Children and cats tolerate LLLT very well.
* It may be used safely on dangerous points in large animals (such as points below the carpus and tarsus of cattle and horses).
* It is ideal for treatment of superficial APs, such as those on the ear.
LLLT usually is given on 2-8 occasions, at intervals of 1-3 days in acute cases and 3-7 days in chronic cases. At each session, the laser is applied for 20-120 seconds/point over or around the rim of the lesion and to each of the APs or TPs selected for the case.
Total treatment time/session depends on mean output power (MOP) and the depth of point. High output lasers (MOP >30 mW) and superficial points need less irradiation time than low output lasers (MOP 1-10 mW) and deeper points. With 30-50 mW MOP lasers, dose time is 10-60 seconds/point, but with 3-5 mW MOP lasers, the required dose time/point is 10 times longer.
The LASUWA laser claims a MOP of 30 mW. It has a strong metallic probe, with the glass shield of the diodes set back about 0.5 cm from its tip. In horses, the probe can be applied with heavy pressure over muscular areas, thereby gaining 1-3 cm extra penetration into the tissues, their TPs and APs, as well as achieving a massage effect at the tender areas.
From September 1989 to September 1991, I used LASUWA LLLT experimentally in clinical conditions in horses, dogs and people. This article summarises my experiences during that time.
CONDITIONS TREATED AND METHODS USED
The main types of conditions treated were: (a) equine, human and canine muscle pain and lameness; (b) human and canine "disc disease"; (c) equine flexor tendon injuries; (d) equine and human periostitis; (e) skin lesions; (f) miscellaneous human conditions; (g) haematoma.
From September 1989 and April 1990, most cases were treated by LLLT alone. The laser was applied over or near the affected area, to TPs and key APs for the affected area. If systemic signs were present, the relevant APs were treated also (for example in a case of chicken-pox, LLLT was applied to points GV14, LI04,11; ST36 (for their effect on fever and the immune system), as well as to the pruritic lesions. In a few cases, AP needles were inserted in TPs also, especially if the TPs were deep, as in heavily muscled areas. In a small number of cases, other therapies (electro-AP, local medication, Dermisol or ointments) were combined with LLLT.