In our collective imagination, the word Laser evokes sci-fi movies and high-tech secret agent devices. But, nowadays lasers are common tools found in very different environments: from dvd players in our homes to laser pointers at work, from disco to surgical theatres, laser devices have been developed for surprisingly diversified applications.
In health care, high power lasers are used daily for surgical and cosmetic interventions, but another category of medical lasers is currently on the rise - therapeutic lasers for low level laser therapy (LLLT).
An ever-growing body of evidence shows the benefits of LLLT for musculoskeletal conditions, wound healing and pain management. NHS hospitals, like St Thomas’ in London, use K-Laser for treating chronic inflammations and hypersensitivity, or post-operatively for accelerating the healing processes of damaged tissues and reduce scar formation. But also, as a non-pharmaceutical option for pain management for a variety of syndromes including arthritis, fibromyalgia and back pain.
In the private sector K-Laser Therapy is used for speeding up the recovery of athletes following sport injuries: teams like Swansea Football Club have seen the average recovery time of their injured players drop to the shortest it has ever been historically since they added the K-Laser, an advanced Class IV therapeutic laser, to their standard of care.
The Acute Podiatry clinic, and the Tissue Viability team at St Thomas’ Hospital and in the Southwark and Lambeth community services used the same device for treating pressure ulcers, diabetic wounds and bedsores, with impressive accelerated wound healing results. The clinical data produced over three years of trials was so convincing that one K-Laser was purchased straightaway, and a bid for two more units was placed short after.
A study on diabetic foot ulcers demonstrated that 80% of patients treated with K-Laser healed completely within a month, whilst none of the patients in the control group (treated with standard of care but no LLLT) was healed after three months. The Class IV laser treatment had spared the patients many months of discomfort and potential infections, and saved St Thomas’ hospital hundreds of thousands of pounds in professional care and consumables during this study alone.
Furthermore, a string of single cases with various non-healing wounds showed significant improvements: from a one-year old ulcer unresponsive to standard care that healed in 3 weeks, to a recurrent pressure ulcer that healed in 2 weeks instead of the usual average of 2 months in a diabetic elderly patient.
Several cases with recurrent diabetic pressure ulcers showed faster resolution compared to previous breakdowns. Following this body of evidence King’s College is now preparing a large scale, multi-centre study to confirm these early results.
Today St Thomas’ K-Laser Therapy clinic is one of the highest earning clinics in St Thomas’ hospital, and the top one for patient compliance (93%) - so popular that the Hand Therapy department needed to double up the clinic’s hours from three to six days a week.
Not only the consultants are prescribing the therapeutic laser for growing number of ailments, but the patients themselves are asking for it after having had a successful first course. Some travelling as far as Surrey, Kent and Essex for having their treatment at St Thomas’ in central London.
Patients in fact love the treatment, as unlike others it is not painful and induces a soothingly warm sensation. The laser is moved over the injured area and its surroundings without touching the skin, which makes it a favourite to those patients with severe pain and hypersensitivity, and particularly non-invasive for treating wounds.
BUT HOW DOES IT WORK?
The device produces a red and infra-red laser beams with specific wavelengths of light that have been found to have stimulate cellular properties in human tissues. In fact, the human body reacts to light: the skin becomes tanned, Vitamin D is produced, and Serotonin is released in our system when sun bathing. Four decades of medical research into the interaction of light and tissues allowed scientists to identify which wavelengths can have damaging effects (like UV light) and which ones have positive, stimulating effects (like infra-red light, used in therapeutic lasers).
These beneficial wavelengths of light, isolated and calibrated in specific dosages, penetrate through our tissues and are absorbed at cellular level, where light-receptors activate a cascade of photo-chemical reactions that boosts cellular metabolism, activating the healing process. Depending on the wavelengths used, that vary between devices, various reactions can be obtained: circulation can be boosted, oxygenation can be maximised, inflammation can be reduced, cell growth encouraged, and nerve activity regulated.
In short, the laser beam activates the natural reparative processes in our body, providing the much-need extra energy that the tissues require to heal themselves. Whether skin or tendons, deep muscles, cartilage or bone fractures, any tissue can be treated. A good therapeutic laser can generate the right combination of wavelengths, power and frequencies to suit the specific case, tailoring the protocol not only on the condition, but also on the individual, based on body size and general health conditions.
Depending on the performance potential of the device, we can obtain a vast array of treatments. But the effectiveness of the laser therapy is only as good as the device: if the machine is poorly built, is not powerful enough and can produce only one or two wavelengths, with set frequencies the effects of the therapy are going to be limited. Lack of government and EU regulation means laser therapy equipment needs only prove safety and not effectiveness to get a sales license.
If instead the machine is technologically advanced, is powerful and features various wavelengths, the outcomes are much better. An advanced Class IV laser can stimulate superficial and deep healing of tissues, and reduction of pain or inflammation across a wide range of human clinical ailments and disorders and can be used post-surgical to accelerate and enhance rehabilitation.
Furthermore, LLLT is a localised intervention: unlike medications it does not affect the whole body, meaning that patients with other conditions can safely receive Laser Therapy for wounds or back pain without the fear that it affects the rest of the body or conflict with medications. Nor Laser Therapy has proper side effects of its own: unless the patient is unusually photosensitive (cannot be exposed to sunlight at all), anybody can have laser treatment.
A fragile elderly patient who is already undergoing several pharmaceutical treatments can be spared excessive use of anti-inflammatories and painkillers using Laser Therapy instead.
The K-Laser session lasts from 3 to 6 ½ minutes depending on the condition, and any nurse or manual therapist can perform the treatment, if they have received proper training. The training is usually provided by the laser company and consists in a one-day course with online training modules. A physician will monitor the patient as usual but doesn’t need to be present during the session.