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[lAsER tHERAPY] laser and living tissue The science of photobiology can have enduring effects on patients who are in pain By Cathy ulrich, PT, dPT Photobiology is the study of how light interacts with living tissue. While we have long known that light interacts with the cells in our retinas and skin, we now know that it can interact in positive ways with every cell in the body. Light from lasers has specific characteristics that light from other sources does not. While surgical lasers are now commonplace in the U.S. medical community, low-level therapeutic lasers are a distinctly different tool. With power outputs of 500 milliWatts or less, therapeutic lasers (also called soft lasers or cold lasers) don’t burn or cut tissue; they don’t even heat tissue. They work in an entirely different way to promote tissue healing. With thousands of laboratory and clinical studies performed and published to date, scientists are developing a picture of how low level lasers work on tissues--and often work so well. Cold lasers were used initially for skin and wound healing, mainly because researchers believed that the light emitted from a laser didn’t penetrate below the layers of the skin. Later studies found that lasers 20 ADVANCE for Physical Therapy & Rehab Medicine actually penetrate significantly deeper than the skin--as much as 4 centimeters with infrared lasers. Effects of Light Therapy on Tissue Among the many effects that lasers produce on biological tissues, below are some of the most important for the purposes of a physical therapy practice. Increased cellular energy. Light photons produced by a laser increase the production of adenosine triphosphate (ATP)--the basic energy packet of the cell. Mitochondria--organelles in cells that synthesize ATP--contain light-sensitive molecules known as porphyrins, which absorb laser photons and raise the energy level of the molecule, causing a chain reaction resulting in increased ATP levels by as much as 170 percent in some lab studies. This marked increase in energy boosts cells to reproduce, replicate proteins and function more efficiently. Improved cell membrane polarity. Injured or congested cells develop membranes that lose their efficiency to absorb nutrients and eliminate wastes. And cell membrane function affects every process of the cell, from energy production to enzyme reactions to protein synthesis. Laser light encourages the polarity of cell membranes to return to normal, creating an environment for the cells to function at an optimum level. Increased immune response. Studies show that low-level laser light increases the activity of lymphocytes as well as the proliferation of these cells. This increased immune response stimulates a localized low-grade inflammation, which starts the body on a path of healing. Inflammation is the body’s way of cleaning out dead or damaged tissue to make room for new, healthy cells. Some studies have shown that herpes simplex blisters (better known as cold sores) heal in about half the time when treated with a low-level laser. Tissue healing. While it makes sense that increased ATP production from therapeutic laser treatment helps cells reproduce, studies have proven that therapeutic lasers stimulate cell mitosis as well as fibroblast activity. Fibroblasts--the cells that make collagen and connective tissue--reproduce rapidly and get to work to make more collagen, strengthening and repairing injured areas. Tissue healing is enhanced with the presence of laser light. Blood circulation. Thermographic studies show that low-level lasers increase tissue temperature--not from the laser light, but from an increase in blood flow--as much as four degrees. Many of my clients report feeling warmth from the laser and I explain to them that this sensation is not heat from the laser (since there is no heat), but from the increase in circulation. Pain reduction. Both lab and clinical studies have documented the effects of therapeutic lasers on pain. In vitro studies show increased serotonin, beta-endorphins and acetylcholine levels, all of which are known to reduce pain. At the same time, laser light reduces bradykinins, chemical substances known to stimulate pain nerve endings. Clinical studies have repeatedly shown marked reduction in pain with the application of therapeutic lasers. Muscle relaxation. Clinical observations (including my own) show a marked reduction of muscle spasm with laser application. I’ve seen trigger points practically melt. Aside from their energy function, ATP molecules perform the vital role of releasing the actin and myosin protein bond in muscle so that the muscle can return to a relaxed state. When muscles are chronically contracted, they develop compromised circulation and an inability to produce enough ATP to relax. So increased ATP and improved circulation gained from the laser act together to restore balance in chronically contracted muscles. JEFFREy lEESER/JASoN STEiGlEmAN
Page 1 and 2: Our digital editions give you two u
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Page 5 and 6: contents ADVANCE FoR PHYsICAl tHERA
Page 7 and 8: [MORe ARTiCleS] 9 Management Focus:
Page 9 and 10: [EDiToR’S ViEw] 8National Rehabil
Page 11 and 12: [MANAgEMENt FoCus] sticky notes wit
Page 13 and 14: [CoVER stoRY] ruNNiNg righT how To
Page 15 and 16: [CoVER stoRY] that patients adhere
Page 17 and 18: [Foot DRoP] Positive steps Understa
Page 19: [Foot DRoP] for strengthening or us
Page 23 and 24: [lAsER tHERAPY] Therapeutic Laser S
Page 25 and 26: [BACK PAIN] Pain Epidemic Physical
Page 27 and 28: [INFECtIoN CoNtRol] soft-surface Co
Page 29 and 30: [AquAtIC tHERAPY] Confidence gain W
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Page 33 and 34: [CoVER stoRY] running continued fro
Page 35 and 36: [CE DIRECTORY] • • Summer Webin
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Page 39 and 40: [CE DIRECTORY] Attention Therapists
Page 41 and 42: [CE DIRECTORY] AUG. 12, 2012 NEWPOR
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Page 49 and 50: EMPLOYMENT OPPORTUNITIES New York,
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