Light Amplification by Stimulated

Emission of Radiation (LASER)

Jorell Victor S. Angeles, PTRP
 • 1960s after Albert Einstein’s early
theories of light emission, Theodore
Maiman produced first ruby laser
• Ali Javan, helium neon gas laser
History of • 1970s, Mester noticed its use for chronic
Laser wounds
• 2002 LLLT has been FDA approved and
was widely used
 • light production that has
specific and unique
properties that
differentiate laser light
from other light sources,
notably a concentrated
beam of light energy

Physical Properties of
Lasers
THE SPECTRUM OF LIGHT
 Monochromaticity

Physical
Coherence: temporal
Properties of
Lasers and spatial

Collimation
Physiologic Effects of Laser
Certain
wavelengths
are absorbed
Tissue Repair
differently
because of
specialized
bodily cells
Inflammation
reacting to
the
wavelength. Pain Reduction
Clinical Application of Lasers
• Low Level Laser
Therapy (LLLT)
• =<500mW
• High Intensity Laser
Therapy (HILT)
• >500mW
 Joules per treatment point

Joules per treatment session if multiple tx points

Total Joules per course of treatment

Dosimetry of Total ENERGY:

Lasers CONTINUOUS:
• Watts x time of irradiation x number of diodes going out of
the environment
PULSED:
• WATTS X PULSE FREQUENCY X PULSE DURATION X
DURATION
WHICH HAS THE BETTER
OUTCOME?
PULSED OR CONTINUOUS?
Techniques of • Direct skin contact
• Use a grid for larger areas
Laser • May be off skin but keep within 1 cm, move in
Application: a wavy manner
LLLT
Techniques of • Evidence in research show higher dosages
used than the limits prescribed by FDA. Up to
Laser 15W were used.
• Must be moved like an ultrasound head to
Application: avoid burns.
HILT
Indications of • Both LLLT and HILT are indicated for pain
and inflammation for musculoskeletal
Laser disorders.
EFFECTIVE
INEFFECTIVE
INEFFECTIVE
 Da Silva et al reported that use of a 70-mW, 780-
nm infrared laser with dosages of 52.5 J/cm2 and
105 J/cm2 resulted in significant improvement in
pain relief, mandibular protrusion, and lateral
movement

However a systematic review disproved its

TMJ effectivity.

CONFLICTING EVIDENCE.
 905-nm, 12-mW laser to painful areas
with dosages of 2 J/cm2 per point,
totaling 12 J/session, 5 times per week
for 3 weeks

Spine (Low Cervical: 830-nm, 300-mW laser with

dosages of 9 J/point, 2 times per week
Back) for 7 weeks

2 J/cm2 and 9 J/point consistently

provide better outcomes compared
with higher dosages of 40 J/cm2.
 890-nm laser, 2 to 4 J/cm2, 5 times a
week for 2 weeks

Shoulder 810-mW GaAlAs laser with a dosage of

Pain/ 1.8 J/cm2 2 times per week for 4 weeks
and then once a week for 3 weeks
Dysfunction
1.6 to 7 J/cm2 with similar treatment
protocols of 2 to 5 times per week for 2
to 8 weeks
Precautions
Contraindications
Contraindications
LASER APPLICATION
References:
• Michlovitz, Susan L., Modalities for Therapeutic Intervention, 6th
Edition