Low-Level Laser Therapy - Essay Example

Physical Agents: Low-level Laser vs. ultrasound therapy in wound management. Due Low-level laser therapy versus ultrasound therapy Introduction Electrotherapies are useful in the treatment of conditions of injuries and pain. It involves the use of electric current to cause therapeutic effects on tissues in the body. Low Level Laser Therapy, commonly referred to as LLLT, is a type of phototherapy that uses monochromatic, thermal, polarized and coherent non-ionizing radiations on lesions and injuries to stimulate healing and relief chronic pain. Low-level laser therapy effects can be described as photobiomodulation. This refers to the effects of increased quality, speed and tensile strength of tissue repair, resolved inflammation and pain relief it causes in the body. Ultrasound therapy uses sound waves to cause stimulation of tissues under the skin surface. The sound waves have a high frequency (between 800,000Hz to 2,000,000Hz) which causes movement in cellular molecules. It promotes blood circulation, prevents swelling and edema, and reliefs chronic pains. An ultrasound sound works with a gel spread on the skin as it transmits the sound waves from the ultrasound head. LLLT is different from ultrasound: it does not require a gel, and is used directly on the skin without a gel application. An ultrasound has limitations on its effectiveness and a range of applications compared to LLLT. An ultrasound should not be used on acute injuries, plates, pins or bony prominences. Physiotherapists prefer the LLLT over the ultrasound when it comes to its use on the above mentioned areas, which the LLLT performs effectively. Wound Management Ultrasound therapy works on closed wounds only. It has both thermal and non-thermal properties, which makes it therapeutically beneficial. It generates warmth at high intensities, and it is thus useful in muscoskeletal conditions, such as spasms and changes the model of wound healing phase, to improve the outcome of wound healing or the scar. LLLT employs low-level lasers to alter the process of healing at the level of the cell, even on an open wound. It reduces inflammation by lowering the quantity of enzymes and chemicals in the cell linked to inflammation and pain. It also increases the speed of wound healing by increasing cell division and cell proliferation. LLLT versus Ultrasound therapy in treatment of pressure ulcers Through various researches, it is possible to compare the effects of laser and ultrasound on wound healing. Pressure sores are common in patients who have spinal cord injuries due to the immobilizing effect of the condition. The effect of therapeutic ultrasound on pressure ulcers treatment with ultrasound on pressure ulcers have not shown significant benefits in healing of the ulcer in most study cases, however, harmful or beneficial effects of the modality on pressure ulcers cannot be ruled out based on the few trials that have been carried out. LLLT on pressure ulcers from various diagnosis showed that pulsed monochromatic light, increased the rate of healing and shortened the time for healing (Barnett, Herdzina, & Schock, 2007). Physiological effects of the modality Ultrasound therapy and low-level laser therapy have beneficial effects on the management of wounds. They facilitate the healing process and accelerate the process, as well. They have effects which are beneficial to healing of tendons. LLLT is perfect and vitally instrumental in the management of post-operative wounds. The modality alleviates chronic and acute pain caused by the wound, normally in superficial tissues and joints. Irradiation of affected areas alleviates swelling, pain and inflammation in bursae and sheaths, tendons, ligaments and superficial muscles. Ultrasound is effective in controlling pain and resolution of periostitis and osteitis in superficial areas such as ringbone and splints. Laser radiations also bring about biomodulation. Contraindications: it is not advisable to irradiate cancerous tissue. Some authors are advising against the use of laser on closed swellings, characterized by acute infections as this may cause the local infection to spread (Schneider & Harley, 1999). Wound healing stages that are most appropriate for the incorporation of the modality Therapeutic ultrasound is most appropriately used at the inflammatory phase and the proliferative phase. At the inflammatory phase, ultrasound therapy causes mast cells to release histamine, degranulate and other chemical mediators. This release attracts Neutrophils and monocytes to the site of injury. These in combination with other events alleviate the acute inflammatory phase and promote the process of healing. Ultrasound therapy has a stimulatory effect on fibroblasts in collagen secretion. This boosts the tensile strength of the healing tissue. It also accelerates the wound contraction process. LLLT finds its use in the inflammatory, proliferative and remodeling phases of wound healing; the therapy reduces the duration of acute inflammation. LLLT causes the granulation to begin earlier, which is the proliferative repair phase. It increases angiogenesis and the rate of contraction of the wound (Schneider & Harley, 1999). Research on the effects of LLLT on macrophages, mast cells, keratinocytes, and fibroblasts has shown the alleviative effects on these cells toward wound healing. The healing process accelerates as a result of LLLT (Barnett, Herdzina, & Schock, 2007). History of LLLT and therapeutic ultrasound use in physical therapy Ultrasound saw its use in physical therapy in 1940s. Raimar Pohlman was able to demonstrate the therapeutic effects of ultrasonic waves in human tissues. He was the pioneer and the one who introduced ultrasonic physiotherapy to medical practice in Berlin. There were exuberant claims made in the 1940s on how the ultrasound was effective. It was almost a remedy of “cure-all”, even though it lacked scientific evidence. The conditions, which they claimed were cured by the therapy, were thyrotoxicosis, elephantiasis, hemorrhoids, arthritic pains, asthma, eczema and even angina pectoris! Cynicisms and concern for harmful tissue damage by ultrasound arose which led to diagnostic ultrasound development in the following years. Low-level laser therapy has been in medical practice for more than four decades. Albert Einstein conceived the laser theory in 1916, i.e. Light Amplification through Stimulation of Emission of Radiation (LASER). It was in 1967 that low power lasers began its use by Prof. Andre Mester, who is also recognized as the grandfather of laser therapy. The common pathologies that the modality is used for During the research, the common pathologies that employ LLT and therapeutic ultrasound are eczema, muscoskeletal pain and inflammation, muscle spasms, acne vulgaris, sprains and strains, sinus-related diseases and disorders, soft tissue injury, wound management and treatment of existing scars (Goodman & Fuller, 2009). Current Trends Currently, there is little doubt that light-emitting-diodes, LEDs, have a therapeutic role when used correctly, due to their effectiveness in generation of responses that is of biomodulatory effect in living tissues. The LLLT and therapeutic ultrasounds are gaining tremendous recommendation in the medical practice, in wound management and other pathological areas, as stated above (Wood et al., 2010). LLLT is currently considered to be the safest form of electrotherapy; it has substantial amount of published research evidence for its support, more than any other electrotherapy. Still, the research shows an unclear state of evidence which prevents the researchers to give this modality a full support. Some of them state that there is a physiological rationale to support this modality’s use in acute conditions. It therefore remains an unsettled matter which cannot conclusively be debated (Sharma & Maffulli, 2008). While many practitioners in the medical field employ the modality, the research is not enough to back it up. The future of the modality should focus on concrete research and improvement of the existent operations to make the best out this promising field. References Barnett M.J., Herdzina, R.J., & Schock A.N. (2007). The Effect of Low-level Laser Therapy, Ultrasound, and a Physical Therapy Protocol on Temporomandibular Disorder (TMD): A Pilot Study. Washington: University of Mary press. Goodman, C.C., & Fuller K.S. (2009). Pathology: Implications for the Physical Therapist. Atlanta: Elsevier Science Health Division press. Schneider, W.L., & Harley, D. (1999). Low Level Laser Therapy for Wounds. California: Alberta Heritage for Medical Research press. Sharma, P., & Maffulli, N. (2008). Tendinopathy and tendon injury: The future. Disability & Rehabilitation, 30(20-22): 1733-1745.  Wood, V. T., Pinfildi, C. E., Neves, M. A., Parizoto, N. A., Hochman, B., & Ferreira, L. M. (2010). Collagen changes and realignment induced by low-level laser therapy and low-intensity ultrasound in the calcaneal tendon. Lasers in Surgery and Medicine, 42(6): 559-565. Read More