Clinical use of low level laser therapy

CLINICAL RESULTS

(a) Equine, human and canine muscle pain/lameness

Most cases involved para-vertebral pain (cervical, thoracic, lumbar or sacral). Some involved pain of limb muscles (scapula, arm, forearm, thigh, gluteals, gastrocnemius).

LLLT (10-30 seconds/point) was used on the TPs and APs for the affected area and over the painful muscle(s). As many points were treated at each session, the session time was usually 10-20 minutes. Treatment was given every 1-2 days in acute cases and every 5-9 days in chronic cases. Excellent results were got in 2-4 sessions over 4-9 days in acute cases and in 1-7 sessions over 16-35 days in chronic cases.

In dogs and people, results were similar to those using simple AP, electro-AP or point injection in similar cases over the previous few years. In horses, in which TPs can be 7-12 cm deep, the clinical results were about 10% points below those attained by earlier AP methods and clinical success took 1-3 sessions more to attain than with earlier AP methods.

(b) Human and canine "disc disease"

Four acute cases of human low lumbar disc disease were treated by LLLT, often with needles, at TPs plus BL23, GB34 bilateral, plus GV03. The cases were diagnosed clinically as Grade 1 by a positive "Straight Leg Raising Test" and a history of pain radiating along the sciatic path. All had excellent results in 3-5 sessions at intervals of 1 week.

Three cases of acute canine thoracolumbar disc disease (diagnosed as Grades 1 to 3 on clinical examination) were treated by LLLT, often with needles, at TPs plus BL23, GB34 bilateral, plus GV03. All had excellent results in 2-4 sessions at intervals of 5-9 days.

As the diagnosis was made on clinical grounds only (i.e. did not involve myelography or radiography), some of these cases may have been myofascial paravertebral pain (section (a), above), rather than "disc disease".

(c) Equine flexor tendon injuries

IR LLLT was used on 10 cases: 4 were acute (recent strain, hot and painful), 2 were acute local nodules/swellings (caused by suspected brushing) and 4 were chronic (bowed tendon).

LLLT was used 3-6 times in 1-4 weeks (10-20 seconds/point) on about 8 points along each surface of the tendon (lateral, posterior and medial), concentrating especially on the bowed or swollen area. LLLT was used also on LI04,11 and Thoresen's Ting points (PC09, LU11,HT09).

Of the 6 acute cases, two passed veterinary inspection for the Newmarket yearling November sales and were sold within 5-7 days of presentation for treatment; 1 case became cool after 2 weeks but some tendon thickening was still present. Three cases failed (swelling and heat persisted). That trainer refused to comply with my advice to rest the horses for the first few weeks. He changed to another vet, who gave other treatments, which also failed.

All 4 chronic cases improved markedly, with disappearance of the "bow" and lessening of the mediolateral thickening in 2-4 weeks. These cases were rested for 6 weeks (kept in the box and given only walking or paddock exercise daily) before gradual resumption of training.

Initially, IR LLLT gave very encouraging results in tendon injury, whereas AP methods used in previous years gave very poor success in such cases. However, all 4 of the chronic bowed tendons relapsed or the horses broke down on the opposite leg and were shot or retired and 3/6 of the acute cases failed to become sound.

Today, I would confine my use of LLLT in equine tendon problems mainly to recent superficial injury, especially that caused by brushing. Before starting to treat the case, I would extract an undertaking from the trainer that the horse would not be worked for 10 months, or until I was satisfied that the tendon was well healed.

I would attempt to treat chronic tendonitis only if trainer would undertake not to work the horse for 10 months.