Cold Laser Therapy

Cold laser therapy, aka low-level laser therapy (LLLT) is a type of laser therapy that patients often find helpful for pain reduction. While the biological effects of LLLT are still being explored, current evidence shows that it improves the ability of mitochondria, the cellular powerhouses, to produce ATP, the energy form used by cells.

LLLT uses “low-level lasers,” or low-power lasers” as opposed to high-power lasers. Cold lasers do not actually feel cold; rather, the term “cold” is used to distinguish low-power lasers from high-power or “hot lasers,” which are used in laser surgery to cut tissue.

Cold laser therapy is most often used for musculoskeletal pain relief, to accelerate the repair of injured tissue, and to decrease inflammation.

It is commonly offered by chiropractors, physical therapists, and other medical professionals to help with a wide range of conditions, from arthritis to difficult-to-heal wounds.

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How Cold Laser Therapy Works

While the ways that cold laser therapy works are still being researched, it is currently understood to increase the ability of your cells to produce adenosine triphosphate (ATP), or usable energy. Laser light energy in the form of photons stimulates photochemical effects in the electron transport chain (ETC) of mitochondria, causing them to produce more energy in the form of ATP. Downstream effects continue to be studied.

Among other benefits, research shows that cold laser therapy can enhance neuroprotection after brain injury; improve the organization of collagen during the wound healing process, resulting in greater tensile strength of the tissue; accelerate recovery time; and relieve chronic pain.

Specific wavelengths used in cold laser therapy have unique effects. The cold laser therapy wavelengths or colors that are used include:

  • Red laser therapy (Usually around 635 nm)- helps tissue repair, has bodywide effects; red laser stimulates complex IV of the electron transport chain (ETC).
  • Violet laser therapy (405 nm) – antimicrobial effects, prevents cell death; violet laser stimulates complex I and complex II of the ETC.
  • Green laser therapy (520 nm) – especially helps with chronic musculoskeletal conditions and encourages stem cell differentiation; green laser stimulates complex III of the ETC.
  • Infrared laser therapy (Invisible near-infrared light that is usually 800 nm or higher)- thermal; infrared laser stimulates complex IV of the ETC.
Cold laser therapy stimulates the electron transport chain in mitochondria, increasing ATP production.
Cold laser therapy works by stimulating the mitochondria to produce more ATP, among other chemical effects. Different laser wavelengths (colors) influence different steps of the mitochondrial electron transport chain.
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Low level laser therapy (LLLT) can be used as a first-line approach for pain relief, because it is a safe and effective approach to reduce pain, with no known side effects.

It can also be used to:

  • optimize recovery– helps recover faster and better
  • decrease inflammation– using LLLT over inflamed tissue can help decrease pain, swelling, and inflammation. This is especially significant because inflammation drives degeneration—whether the involved tissue is a joint, the gut, or the brain! The sooner inflammation is quelled, the better the outcome.
  • precondition– healthy tissue recovers better than unhealthy tissue. Laser preconditioning can be helpful before surgeries and sports.

Examples of uses:

  • to relieve neck and shoulder pain
  • for vagus nerve stimulation (VNS)
  • to support brain health, especially after concussion
  • to shorten recovery time from injury or surgery
  • to precondition before events such as surgery or sports. Energizing mitochondria with laser therapy before a challenge—which will require cellular energy—is like filling your gas tank up before a long drive.

Pros and Cons of Cold Laser Therapy

• Non-invasive procedure
• nonpharmacological pain control
• Fast pain relief
• No recovery time is needed
• Improved joint range-of-motion
• Improved blood flow to the targeted area

• Usually not covered by insurance
• Not suitable for every condition
• Results vary

Your Cold Laser Therapy Session

Ideally, the laser light beam is pointed directly on the skin on the targeted area, such as the neck, back, or knee. We can either laser through clothing, or you can change into a patient gown for your session.

Depending on which laser device we use, you may be asked to wear special goggles during your session.

Laser sessions last 5 minutes per body area, and you can do up to 20 minutes of laser at a time.

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Frequently asked questions

Cold laser therapy works by triggering chemical changes in the tissue being lasered. Low-level laser therapy (LLLT) increases the production of ATP, or cellular energy, by your mitochondria. This increase in cellular energy helps your cells carry out tasks such as manufacturing proteins for tissue repair after injury. LLLT also increases local blood flow to the targeted area, and supports angiogenesis, which is the production of new blood vessels.

Cold laser therapy does not specifically “treat” any condition, but there are FDA market clearances for LLLT devices for neck and shoulder pain, chronic low back pain, postoperative pain, plantar fasciitis, onychomycosis, acne, and body contouring.

Low-level laser therapy (LLLT) research shows that it can help people get positive results when it is applied to conditions such as joint pain or brain health.

Yes, cold laser therapy has been shown to help decrease inflammation. It decreases levels of inflammatory chemicals and activates genes for cell survival. Research shows it can also reduce swelling of injured tissues.

Cold laser therapy can also be used for vagus nerve stimulation (VNS) to activate anti-inflammatory pathways.

For most people, it is best to do cold laser therapy at most once per day. In special cases, it may be appropriate to do multiple, brief sessions in one day.

Cold laser therapy sessions are 5 mins per location (body area), for a total of 5-20 mins, depending on how many body areas are covered.

Cold laser refers to lasers that work by stimulating photochemical effects in cells, while hot lasers work by cutting tissue.

Cold laser is the type of laser that a healthcare professional such as a chiropractor or physical therapist uses, while hot lasers are used by surgeons.

Laser therapy and cold laser therapy are terms used interchangeably. Other names that mean the same thing are low-intensity laser therapy (LILT), low-power laser therapy (LPLT), and low-level light therapy (LLLT).

Photobiomodulation therapy (PBM therapy or PBMT) refers to light therapy in a broad sense, including not only laser therapy but also light-emitting diode (LED) therapy, such as red light therapy.

Cold laser therapy can be used for knee pain because it is a non-invasive procedure that can reduce pain quickly, without needing recovery time.

It also helps to improve joint range-of-motion, reduce inflammation and swelling, and increase local blood flow. Additionally, cold laser therapy can be used in conjunction with chiropractic and other treatments.

Cold laser therapy can help knee pain by decreasing inflammation, thereby reducing pain and degeneration. It can also help increase range-of-motion. There is no downtime needed after cold laser therapy, and sessions can be clustered as desired, up to four per week, to accelerate recovery time.

Cold laser therapy is usually not covered by insurance, and results can vary from patient to patient.

Cold laser therapy has been shown to increase ATP production by mitochondria. Different effects are achievable, depending upon the wavelength (color) of the laser, the tissues being lasered, and other variables. For example, red laser over an injured area can shorten recovery time and reduce scarring. Violet laser is used as a treatment for acne. Green and red lasers are used for fat loss, or body contouring.

The main disadvantage of low-level laser therapy is that it is often not covered by health insurance. Additionally, its effectiveness for pain management may vary depending on individuals, and their conditions.

No, cold laser therapy is not painful. On the contrary, most patients find it helps relieve pain during their sessions.

Cold laser therapy has been shown to be safe and effective for a number of uses, such as for acute and chronic pain relief, fat loss, and acne treatment. Different cold laser therapy devices have different applications, so it is important to clarify your goals and follow a management plan using a suitable laser type to achieve the results that you are looking for.

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