| Arthritis affects almost 70 million Americans. The | | | | Elbow tendonitis (Simunovic Z, Trobonjaca T, |
| most common forms of arthritis are osteoarthritis, a | | | | Trobonjaca Z. Treatment of medial and lateral |
| degenerative disease in which the cartilage wears | | | | epicondylitis- tennis and golfer's elbow- with low level |
| away, and rheumatoid arthritis, which is an | | | | laser therapy: a multicenter double-blind, |
| autoimmune inflammatory condition. Also, there are | | | | placebo-controlled clinical study on 324 patients. J Clin |
| other conditions that fall under the "umbrella" of | | | | Laser Medicine Surg. 1998; 16: 145-51); |
| arthritis including bursitis, tendonitis, low back and | | | | Fibromyalgia trigger points (Simunovic Z. Low level |
| neck pain, carpal tunnel syndrome, and so on. | | | | laser therapy with trigger points technique: a clinical |
| The common symptom of most forms of arthritis is | | | | study on 243 patients. J Clin Laser Medicine Surg. |
| pain. Pain develops as a result of multiple factors | | | | 1996; 14: 163-167); |
| including inflammation with stimulation of neural | | | | Neck arthritis (Ozdemir F, Birtane M, Kokino S. The |
| peripheral pain sensors due to either biochemical | | | | clinical efficacy of low-power laser therapy on pain |
| factors such as cytokines or to mechanical factors- | | | | and function in cervical osteoarthritis. Clin |
| joint deformity. Arthritis pain may be accompanied | | | | Rheumatology. 2001; 20: 181-184); |
| byother problems including loss of range of motion | | | | Carpal tunnel syndrome (Naeser MA, Hahn KA, |
| and disability. | | | | Lieberman BE, Branco KF. Carpal tunnel syndrome pain |
| While medicines, injections, and surgery all have their | | | | treated with low-level laser and micro amperes |
| place and are valuable, there is still a need for | | | | transcutaneous electric nerve stimulation: a controlled |
| potentially useful adjunctive modalities that might | | | | study. Archives Phys Med Rehab. 2002; 83: 978-988); |
| speed up recovery and reduce pain faster. | | | | Shoulder tendonitis (England S, Ferrell AJ, Coppock JS, |
| Low level therapeutic laser, better known as | | | | Struthers G, Bacon PA. Low power laser therapy of |
| phototherapy, is a relatively new form of treatment. | | | | shoulder tendonitis. Scand J Rheum. 1989; 18: |
| Its premise is that certain wavelengths of light have | | | | 427-431); |
| effects on living tissue. This effect is termed | | | | Low back pain disorders (Tasaki E, et al. Application |
| "photobiomodulation." | | | | of low power laser therapy for relief of low back |
| Phototherapy has been shown in experimental | | | | pain. Ninth Congress of the International Society of |
| settings to stimulate cell growth, increase cell | | | | Laser Surgery and Medicine. Anaheim, CA. USA. |
| metabolism, improve cell regeneration, induce an | | | | November 2-6, 1991; Tuner J, Hode L. The Laser |
| anti-inflammatory response, reduce edema, reduce | | | | Therapy handbook. Prima Books. 2004. Sweden, p. |
| fibrous tissue formation, reduce levels of substance | | | | 81). |
| P, stimulate production of nitric oxide, decrease the | | | | Adequate clinical assessment is vital to determining |
| formation of bradykinin, histamine, and acetylcholine, | | | | whether a patient is a good candidate for laser |
| and stimulate the production of endorphins. These | | | | therapy. Also, laser is a complementary therapy; it |
| effects are felt to be what reduce pain. | | | | should be used in conjunction with other therapies as |
| Most cold lasers in use today use a combination of | | | | well. Concurrent medications, etc. should not be |
| light emitting diodes and infrared emitting diodes. | | | | forgotten. |
| The beneficial effects of cold laser were first noted | | | | Phototherapy is FDA approved for a number of |
| in wound healing in rats (Mester E, Spy T, Sander N, | | | | applications and has been deemed safe. It also |
| Tito J. Effect of laser ray on wound healing. Am J | | | | requires relatively little time to perform. Established |
| Surg 1971; 122: 523-535). | | | | protocols and tissue dosages have been established |
| Subequently, laser was found to be beneficial in a | | | | that make clinical application relatively easy. |
| number of animal models and is till being studied as a | | | | The number of sessions required varies according to |
| possible tool for cartilage regeneration and healing (Lin | | | | disorder, length of time the disorder has been |
| Y, Chai CY, Yang RC. Effects of helium-neon laser on | | | | present, and the severity of the disorder. |
| levels of stress protein and arthritic histopathology in | | | | Contraindications include pregnancy (use of the laser |
| experimental osteoarthritis. Am J Phys Med Rehab. | | | | over the pregnant uterus), thyroid exposure, over a |
| 2004; 83: 758-765). | | | | pediatric epiphysis, transplant patients, directly on a |
| Data regarding the usefulness of cold laser on | | | | an active cancer, on an are where there has been a |
| different conditions seen in a rheumatology office | | | | recent (within 24 hours) steroid injection, or on the |
| include: | | | | chest of a patient with a pacemaker. |
| Rheumatoid arthritis and osteoarthritis (Brosseau L, | | | | While cold laser is considered by some to be |
| Welch V, Wells G, Tugwell P, de Bie R, Harman K, | | | | unproven, it appears so far to be a safe, effective |
| Shea B, Morin M. Low level laser therapy for | | | | mode of therapy for many rheumatologic disorders |
| osteoarthritis and rheumatoid arthritis: a meta-analysis. | | | | and is worth trying before subjecting a patient to |
| J Rheum. 2000; 27: 1961-9); | | | | more invasive and dangerous procedures. |