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Laser Physics and Frequently Asked Questions (FAQ's): FAQ's Laser Physics 101 Photobioactivation Contraindications What are Healing Laser Frequencies? Indications listed in the World Litterature of Laser Therapy   Not All Lasers Are Created Equal See A Comparison Chart - Click Here

Welcome to the FAQ's page.
This is where you will find the answers to frequently asked questions
about lasers, low level laser therapy and biostimulation.

Below are ten important questions about Lasers and the answers:
Please click on the question to see the answer below or continue scrolling down.

1. What does LASER stand for?

2. How does laser light differ from "normal" light?

3. Are low level lasers SAFE?

4. How do low level lasers work?

5. Where can low level laser therapy be used?

6. Have low level lasers been scientifically studied and proven?

7. How much do low level lasers cost?

8. Does a higher price always mean a better low level laser?

9. What features should I look for in a quality low level laser?

10. What low level laser(s) meet all these requirements?

BONUS QUESTION: What are Healing Laser Frequencies?

1. What does LASER stand for?

LASER stands for Light Amplification by Stimulated Emission by Radiation.

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2. How does laser light differ from "normal" light?

Light emitted from a laser diode is monochromatic (having only one wavelength), parrallel and coherent (having waves with similar direction, amplitude, and phase). These qualities make laser light much more valuable for therapeutic benefits.

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3. Are low level lasers SAFE?

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4. How do low level lasers work?

Pain results from trauma, inflamation and/or cellular disruption, malfunction, or less than optimal cellular function. Healing and pain relief come with cellular normalization. Photons enable cells to perform optimally by stimulating them to initiate bio-chemical reactions, which produce enzymes and ATP (usable energy). Use of low level lasers enhances cellular function and it can also encourage the formation of collagen and cartilage in damaged joints and the repair of tendons and ligaments.

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5. Where can low level laser therapy be used?

Low level laser therapy may be used any place there is acute or chronic pain or inflammation, and, low level laser therapy may be effective on any disease or disorder. Users have reported successes when using low level laser therapy on: Arthritis, Carpal Tunnel Syndrome, Tennis Elbow, Whiplash, Headaches, Back and Shoulder Pain, TMD/TMJ, Burns, Cuts, Sprains, Colds and Cold Sores, Sinusitis, and even Age Spots!

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6. Have low level lasers been scientifically studied and proven?

Low level lasers have been used world-wide for nearly 40 years.
Over 3500 studies have shown that low level lasers:
(1) REDUCE PAIN by stimulating cells to produce their own endorphins, a natural pain killer,
(2) PROMOTE FASTER HEALING by stimulating cells to increase the production of two major healing enzymes by as much as 75%,
(3) REDUCE INFLAMMATION by as much as 75%,
(4) INCREASE BONE REPAIR SPEED by stimulating fibroblastic and osteoblastic proliferation,
(5) RELAX MUSCLES and muscle spasms,
(6) DECREASE SWELLING by stimulating lymphatic drainage,
(7) ENHANCE THE IMMUNE SYSTEM by increasing the number of "killer" cells by 400-900%, and most importantly,
(8) RE-ENERGIZE CELL MEMBRANES to allow transport of essential nutrients across cell walls (nutrients will not cross an injured or sick cell wall, thus slowing healing) allowing a healthy new cell to grow.

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7. How much do low level lasers cost?

We have seen low level lasers advertised for anywhere from $200 up to $20,000 each. Not all lasers are created equal. Cheap lasers usually incorporate only LED diodes, rather than true laser diodes. High quality laser diodes combined with LED diodes create QUALITY laser healing tools.

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8. Does a higher price always mean a better low level laser?

Not always. A VERY LOW price usually means that the product contains only cheap LED's, and no true lasers - and while "LED only" products may provide some benefit, they are not as good as a product with both LED's and true lasers. It is also not necessary to pay VERY HIGH PRICES (over $5,000) for an individual low level laser unit. Call our laser experts to explore your options. Phone toll free 1-888-824-7558.

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9. What features should I look for in a quality low level laser?

(1) A unit with both true Laser and LED diodes.
(2) Lasers that are designed to both Harmonize and Resonate with the body's natural energy.
(3) The unit should be able to consistently control power output (more is not necessarilly better) via a Computer-Controlled, Rechargeable Power System.
(4) The laser should be able to produce Multiple Energy Levels and Multiple Wave Lengths.
(5) All laser diodes should be Polarized so as to energize the greatest number of cells.
(6) The laser energy should be Pulsed to encompass all frequencies in the brain.
(7) Programmability - the unit should be able to be reprogrammed as successful new frequencies are discovered.
(8) The unit should be Small and Convenient to use.
(9) Finally, the unit should be Reasonably Priced - meaning a suggested retail price between $1800 and $4000 (depending on features).

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10. What low level laser(s) meet all these requirements?

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Laser Physics 101

In order to clarify how low-level laser therapy affects the body, it is necessary to review basic laser physics and developmental anatomy.

Laser means Light Amplification by Stimulated Emission of Radiation and was first theorized by Einstein. In 1960 Miaman developed the first laser, a ruby laser. This was a tube laser with a metal chamber, which contained the element ruby. When an electrical current excites the enclosed element, the atoms give off photons or packets of light energy. The photons bounced off a solid mirror on one end of the tube and out holes in the mirror on the other end of the tube. This light beam is unlike regular light in that it is coherent i.e., the photons are well ordered and synchronized. Laser light is also monochromatic, meaning it is of one pure color.

Power density is a key to laser energy. Power Density (PD), or light concentration is measured in watts per centimeter squared (W/cm2). The problem with most DC battery driven lasers is that the battery bleeds off and does not maintain a standard PD, which negatively affects low-level laser therapy (LLLT) results. Recent developments in miniature computers have enabled the patenting of techniques that maintain a standard PD as well as to control energy frequency.

Wavelengths are measured in nanometers. The most beneficial wavelengths are in the visible and near infrared ranges. These ranges are very safe ranges, far away from the damaging ultraviolet, x-rays, gamma and cosmic rays. Although the longer waves such as microwaves and radio waves are usually considered safe, there are some that think they might be damaging to the very sensitive individual. All wavelengths used in low-level lasers are safely divided from these potentially damaging waves. Many people only think of lasers as cutting lasers. In order to cut with lasers, it is necessary to increase the PD from 300 to 10,000 W/cm2. Lasers do not even have a warming affect unless they are operated above 5 W/cm2. Low-level lasers commonly use laser diodes that range in power from 5mW to 500mW. These are safe power ranges that will never heat or damage tissue and are thus, commonly referred to as cold lasers.

Low-level lasers today are manufactured using semi-conductors, which are computer-like chips grown from various pure elements or combinations thereof. Combining the elements of InGaAlP makes visible light in the range of 630 to 685 nm; combining GaAlAs produces light in the range of 780 to 870 nm; and, combining GaAs produces infrared laser diodes in the 900nm range.

The visible light ranges, while quite beneficial, are limited by its shallow penetration of 1 to 3 mm. The invisible or infrared light range penetrates much deeper. Research documents infrared penetrations from 10 to 15 mm, but clinical results indicate that the infrared beam penetrates 8 to 10 cm. Excellent results have been achieved using the patented (Low Level Lasers, Inc.) concept of "piggy backing" the beneficial effects of the visible upon the penetrating ability of the invisible.

Low level lasers are used everywhere in our society, such as bar code check out, laser printers, compact disc players and for many medical procedures. In fact, without lasers, our society and economy as we see it today would collapse.

World-wide studies have shown that laser energy is accumulative as well as cascading and
reduces pain and inflammation via:

1. Bio-stimulation and photo-stimulation.

2. Endogenous opiate production

3. Slowing sensory nerve production.

4. Restoring cellular resonant energy.

5. Stimulating the Na/K pump mechanism in the cell membrane.

6. Inhibiting bradykinin & leukotriene production.

Osmosis, a scientific fact taught in all grade and high school science classes, states that no nutrient can transfer across the depolarized membrane of an injured cell. One of the most important functions of low level laser therapy is to re-polarize sick and injured cellular membranes. This allows for essential nutrients to transfer from the blood into the cell. Research has shown that low level laser therapy can increase cellular ATP (body fuel) by as much as 150%.

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Photobioactivation    -    Light is energy of life

Photobioactivation is a term applied to a light stimulus that initiates and/or accelerates a physiological response. Other stimuli used in medicine, for example, are temperature, ultrasound, electrical power, electromagnetic fields, etc.

Wound healing (formation of granulation tissue, epithelization, improved trophic condition)

Anti-inflammatory effect (enhancement of immune response)

Analgesia

Improvement of regenerative processes

These effects can be observed in dermatology, neurology, surgery, rheumatology, traumatology, orthopedics, gynecology, urology, dental medicine and veterinary medicine etc.

Photochemical effect
The laser energy is absorbed by metabolically active pigments of the mitochondria in various cutaneous and subcutaneous layers: here involved are the two enzymes of the oxidation chain, Cytochrome a/a3 and Flavoprotein with absorption maxims of wavelengths applied.

Depending on the stimulated type of cells, the following cell physiological reactions are observed:

Regenerative effect

Enhanced fibroblast formation and collagen synthesis with improved tissue strength values

Neovascularization of lymphatic and blood vessels as well as vasodilatation, improve microcirculation and lymphatic drainage (resorption of oedema)

Larger quantity of granulation tissue and accelerated epithelization

Increased activity of osteoblasts promote the formation of callus

Regulation of muscle tissue including myocardium

Enhancement of peripheral nerve re-growth

Prevention of central nerve degeneration and regeneration of peripheral axons after injury

Analgesic effect

Measurable changes in the potential of nerve cell membranes lead to its hyperpolarization as a good analgesic mechanism

Improved release reaction of ß-endorphines

Changes in transmitter concentration at the synapsis

Accumulation of 5-OH-indoleacetate (serotonin metabolite)

Relaxation of muscle induced by the neuromuscular unit (ATP increase)

Effect on the immune system (immune modulation)

Activation of proliferation of immune cells including macrophages

Immune suppressive effect by reduced antigen perception of the T-lymphocytes (increased acceptance of a transplant)

Optical window of the skin

The skin is a non-homogenous tissue and yet shows in its spectral analysis an optical window with an optimal transmission capability of light between >600 nm (visible red) and <1300 nm (infrared). Wavelengths (colors) outside of this optical window are mostly being absorbed before they reach deeper layers.

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Indications listed in the
World Literature of Laser Therapy

Laser Therapy is a regulative medical treatment modality, which is used most in medical specialties including Dermatology, Traumatology, Sports Medicine, Orthopedics, Dental Medicine, Urology, Gynecology, General Medicine, Veterinary Medicine, Physical Therapy, Natural Medicine etc.

Anti - Inflammatory

Enhances proliferation of immune cells (enhancement of immune response, increase of NK cell activity etc.)

Enhances lymphatic activity (drainage)

Improves microcirculation (vasodilation)

Reduces swelling (oedema & haematoma resorption)

Reduces mucositis after irradiation & chemotherapy

Postoperative wound healing- Herpes simplex & zoster

Decubitus, elephantiasis

Ulcus cruris, diabetic foot

Postoperative lymphoedema

Experimental

Mucositis

Analgetic (pain reduction)

Induces B-endorphin release

Increases ATP production

Increases the measurable potential on nerve cell membranes

Relaxation of muscle tension and increase of pressure pain threshold

Reduction of trigger activity (f.e. myofacial pain and fibromyalgia)

Acupuncture point activation

Tendinitis, osteoarthritis, synovitis

Soft tissue injuries

Fractures, overstrained injuries (Carpal Tunnel Syndrome, tennis elbow etc.)

Frozen shoulder, tension neck, tension headache, lumbago

Needle replacement

Regenerative

Stimulates the rate of mitosis in repair mechanisms (bone, epithel and muscle tissue)

Enhances peripheral nerve regeneration after injury

Reduces degenerative process on central nervous system

Enhances survival of brain cells after transcient ischemia

Reduces or eliminates scar tissue formation

Increases collagen synthesis (fibroblast proliferation, tensile strength and elasticity increase)

Wound healing, bone repair

Facial paresis

Stroke rehabilitation

Wound healing

Wound healing, post injury

Wound management

Post operative etc.

Contraindications and precautions:
There are no absolute contraindications for (LT) laser therapy. However, it is always better to be cautious when treating patients in high-risk categories. Laser therapy should be given with special caution in the following cases:

Patients with pacemakers Pacemakers are electronic devices and well protected inside a cover and insensitive to light. All therapy lasers are approved medical devices and have an EMC approval (Electro Magnetic Compatibility) therefore should not interact with pacemakers.

Patients with a history of cardiac arhythmias or unexplained chest pain Laser therapy applied to mid-thoracic area (Th4-7) para spinally may induce transient coronary spasm and/or arrhythmias in rare occasions.

Patients who are pregnant Laser therapy should not be applied directly over the fetus. The same applies to the so-called forbidden acupuncture points (e.g. Hegu (LI4), Sanyinjiao (SP6), and points in lumbosacral region) to avoid uterine contractions. However, nausea and vomiting (hyperemesis gravidarum) may be treated through Neiguan (PC6) point.

Patients with labile epilepsy As pulsing light (especially with 5-10 Hz frequency) can induce epileptic attacks laser therapy using visible low frequency pulsed emission should be avoided when treating these patients. Note! Remember to use eye protective goggles!

Endocrine glands According to Spanish studies thyroid gland seems to be sensitive to light. Therefore laser therapy over the thyroid gland should be avoided unless there is a need for activation of thyroid function.

Patients with tumors Laser therapy has not induced or accelerated tumor growth in any of the reported in vivo studies. However, laser therapy should not be directed over the tumor tissue as the precise reactions of existing tumors to laser therapy is unknown.

Patients with prostheses Although laser therapy does not increase the temperature of deeper tissues (muscles, cartilage, bone) or that of materials used in prostheses markedly, some very sensitive patients may react to laser therapy over the prosthesis by temporary increase of pain.

Risk of eye injury As the cornea and lens focus radiation onto the retina, the power density may increase to more than 100,000 times higher than the primary energy density on the skin or cornea. The cornea, aqueous humour, lens and vitreous humour are more conductive of radiation with a wavelength of 450-900 nm. The risk of retinal injury is reduced if laser therapy is given in a bright light when the pupil size is at the minimum. IR lasers are more dangerous than those emitting at visual wavelengths, as the invisible beam does not provoke an eye-blink reflex.

To date, no retinal injuries have been reported during or after laser therapy. Due to the individual characteristics of each laser beam (parallel, focalized or divergent) and in order to avoid any future discussions of possible eye injuries it is recommended that patients always wear goggles. On the contrary, laser therapy may be applied through the lids and eyeball to alleviate inflammatory reaction after high power laser irradiation to correct retinal detachment or even retinal lesions from accidental direct laser beam exposures.

Patients with solar eczema or hypersensitivity to sunlight may react to laser therapy when high photon densities are used. Avoid photosensitizers when laser therapy is given over the newly abrased skin, especially in the face.

Note! Discoloration due to pigment reaction is possible. Radiation over dark skin or tattoos may cause thermal reactions.

Hematological interactions There is no evidence that LT could induce either thrombosis or prolonged bleeding time. Instead LT is indicated for its anti-inflammatory and pain relieving effect in acute injuries from fresh wounds and bruises to joint injuries and fractures. Increase of microcirculation and lymphatic flow prevent stasis and reduce existing oedema, and form basis for fast recovery.

Note! When adequate LT provides only a short lasting relief of pain and dysfunction and this response is not getting better with repeated treatments the underlying disturbances in homeostasis (e.g. systemic disease, infection, tumours) or interactions with medication should be taken into account.

There is clinical evidence that cholesterol lowering drugs like fibrates and statins (e.g. serivastatin) may induce muscle pain and fatigue in about 1-2 percent of patients, in rare cases increase of S-CK and rhabdomyolysis leading to myoglobinaemia, myoglobinuria, kidney failure and death. More common is poor response to adequate pain therapy with any form of peripheral stimulation including LT. Increased muscle pain and fatigue 1-2 months from beginning of statin medication is a clear sign of this side effect. The normal response to LT may take some 2-4 weeks after cessation of medication. Statins provide valuable protection against cardiovascular accidents and should be terminated gradually and not stopped abruptly. Other drugs that may interact with statins are macrolides (e.g. erythromysin), cyclosporins, konazoles, nicotinic acid and fibrates.

Pekka J. Pöntinen, MD, PhD, FICAE, FASLMS
Assoc. Prof. Tampere University
Tampere, Finland

Today, LASERS play a very important role in industry, medicine and research.
Lasers are applied in measuring distances, laser imaging, cutting materials and identifying materials. In communications, LASER enables faster data transmission. Three characteristics make the LASER a unique form of light: monochromaticity, coherence/polarization and capability of parallelism. LASER stands for: Light Amplification by Stimulated Emission of Radiation.

1. Monochromaticity
A term, which describes electromagnetic radiation (light) of only one precise wavelength (or color).

Low level LASER devices applied in Laser therapy, however, are non thermal light sources emitting always the same light color without significantly changing the skin temperature.

2. Coherence/Polarization
Coherence means that all the light waves are of the same phase. Coherence guarantees an orderly photon emission and an optimized photon density. This is a LASER specific property. Laser light has some sort and degree of polarization.

3. Parallelism
Laser light can be emitted into one direction in a parallel way. In the present, most Therapy-Lasers are emitting a slightly divergent beam for safety purposes.

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