Low Level Laser Therapy (Cold Laser) for Knee Pain

Posted by Feroz Osman-Latib on

 Low Level Laser Therapy for Knee Injury

More than 2500 studies have now been completed on the use of Low Level Laser Therapy and its use is gaining momentum in various medical settings. In the treatment of pain and injury LLLT is already widely used to provide analgesia, in addition LLLT has been shown to accelerate the healing of injured tissues by promoting wound healing and tissue reapir. LLLT also exerts a positive effect on fibroblast proliferation and collagen synthesis. Up to now no human studies have been conducted on meniscal injuries although LLLT is often used for knee pain whether due to injury or degenerative disorders. A recent study published in the December 2012 issue of Lasers in Medical Science concluded that the application of LLLT for medial meniscal tears was more effective than placebo and resulted in long term pain reduction and recovery benefits for those treated. Researchers at the National Track & Field Centre, Sports Injury Clinic in Thessaloniki, Greece selected patients with symptomatic meniscal pathology. A double blind RCT was conducted with the treatment group receiving one dose of approximately 100 Joules using a 904nm wavelength laser on the medial surface of the knee over the anatomical medial meniscus. Treatment with LLLT was associated with a significant decrease of symptoms compared to the placebo group and the researchers concluded that LLLT should be considered in patients with meniscal tears who do not wish to undergo surgery.

Clinical application:

Although this particular study used a unit with a wavelength of 904nm, we have found that wavelengths of 660nm to 904nm are all effective for soft tissue injury and analgesia. We recommend a cluster probe with a combination of 660nm and 780nm laser diodes such as our AL-151 unit, a single cluster probe in either 660nm or 780nm can also be used such as the 5 lead laser shower unit or even a portable unit such as the Klas unit. Note that LED units are not recommended as they do not have the ability to penetrate to the depth of the meniscus and surrounding soft tissue.

If using the AL unit, a frequency setting of 700Hz is recommended as this is known empirically to have an added anti-inflammatory effect, otherwise continuous mode should be used.

Dosage: The aim should be to deliver a total starting dosage of 100 Joules to each affected meniscus at least once a day. The dosage and therefore time can be increased by 50% at each subsequent session until maximum pain relief is achieved post therapy. Once inflammation is under control reduce by 30% at each session. The time required to deliver this dosage will differ with each unit depending on the power and the number of diodes used in the treatment. The table below can be used as an example and is based on our laser units

Unit

Power

Required Dosage

Time=(Dosage/Power)

Application

HB/AM series

750mw

1000mw

100J

100J

2m12s

1m40s

Apply the probe/leads for 2m21s

Apply for 1m40s over the affected area/points

Portable

50mw

90mw

100J

100J

33 Minutes

18m

6 tender points for 5:30s each

6 tender points for 3:00s each

Klas DX

-

100J

-

This unit is an intelligent dosage unit, simply enter 100J into the system and it will automatically calculate time required


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