Low Level Laser Therapy, commonly known as LLLT, is a form of phototherapy which involves the application of low power monochramatic and coherent light to injuries and lesions to stimulate healing.

LLLT is used to increase the speed, quality and tensile strength of tissue repair, resolve inflammation, and give pain relief. The technical term often used to describe this form of therapy is 'photobiostimulation'.

ADVANTAGES OVER OTHER MODES OF THERAPY?

LLLT has been found to offer superior healing and pain relieving effects compared to other electrotherapeutic modalities, especially in the early stages of acute injuries, and for chronic problems. LLLT can also be used for Acupuncture Point stimulation.

LLLT is a universal method of treating muscle, tendon, ligament, connective tissue, bone and skin tissue with one simple piece of equipment, however, the best results are achieved when it is used to complement other treatment modalities. Treatment time for the laser portion is typically between 4 and 12 minutes.

Importantly for athletes, LLLT is a non-invasive, drug-free modality that can be applied on competition day without risking disqualification by drug testing.

What is a Laser?

The laser is the latest and most advanced of our light sources. The word LASER is an acronym for Light Amplification by Stimulated Emission of Radiation. Strictly speaking, therefore, lasers are light amplifiers if the radiation produced is within the visible range, or radiation amplifiers if the radiation produced is within the infrared or the ultra-violet ranges.

The laser is a light source that generates extremely pure light. With pure light we mean light that has a single wavelength, not a whole spectrum.  Light from laser is highly ordered, well organized, while the light from ordinary light bulbs is typically un-organized. Laser light is called coherent.

There are many different types of lasers. They can be manufactured as high power and low level lasers. Laser light can be of any color, or it can be invisible. The laser beam can be made small and parallel, or divergent. Some are used for Medicine.

What is a Medical Laser?

There are many different types of medical lasers. For our purposes, two main groups stand out:

High Power Lasers: they are used to cut, coagulate and evaporate tissues. These lasers are often called surgical lasers because they can replace the scalpel of the surgeon.

Low Level Lasers: they can be used for the stimulation of cell function. They are also called bio-stimulating lasers or Low Intensity Lasers. Their biological effect is not thermal, as is the case with surgical lasers. The pure light of the lasers causes photochemical reactions in the cells. Laser light photons are absorbed by antenna pigments (chromophores) within the cells. This induces increased production of cellular energy (ATP) which leads to normalization of cell function, pain relief and healing. The effect of Low Level Laser Therapy (LLLT) is especially striking in areas of the body where cells are under stress.

Conditions that respond well to Low Level Laser Therapy (LLLT):

There are more than 50 positive Double Blind Low Level Laser Therapy (LLLT) Studies that show clear evidence that LLLT is highly effective for the following conditions:

Airaksinen O., et al.
Effects of infra-red laser irradiation at the trigger points. Scand J of Acu & El Therapy.
1988; 3: 56-61

Airaksinen O., et al.
Effects of laser irradiation at the treated and non-treated trigger points.
Proc. 4th Intern Symposium. Acupunc & Electrother Res. 1988; 13 (4): 238-239.

Antipa C. et al.
Clinical results of the low energy laser action on distal forearm posttraumatic nerve lesions.
Laser Therapy. 1996; 1: 36.

Antipa C. et al.
Comparative effects of various IR low engergy diodes in the treatment of the rheumatic diseases.
1997. In press (Monduzzi Editore, Bologna)

Armino L. et al.
Laser therapy in post-episiotomic neuralgie.
LASER. Journ Eur Med Laser Ass. 1988; 1(1):7.

Atsumi K. et al.
Biostimulation effect of low-power energy diode laser for pain relief.
Lasers Surg Med. 1987; 7: 77.

Barabas K. et al.
Controlled clinical and experimental examinations on rheumatoid arthritis patients and synovial membranes performed with neodym phosphate glas laser irradiation.
Proc. 7th Congr Internat Soc for Laser Surg and Med, Munich June 1987. Abstract no 216a.

Bihari I., Mester A.
The biostimulative effect of low level laser therapy of long-standing crural ulcer using Helium Neon laser, Helium Neon plus infrared lasers and non coherent light: Preliminary report of a randomized double blind comparative study.
Laser Therapy. 1989; 1(2): 97.

Boerner E. et al.
Double-blind study on the efficacy of the laser therapy.
SPIE Proc. 1996. Vol. 2929: 75-79.

Bihari I., Mester A.
The biostimulative effect of low level laser therapy of long-standing crural ulcer using Helium Neon laser, Helium Neon plus infrared lasers and non coherent light: Preliminary report of a randomized double blind comparative study.
Laser Therapy. 1989; 1(2): 97.

Carillo J. et al.
A randomized double-blind clinical trial on the effectiveness of helium-neon laser in the prevention of pain, swelling and trismus after removal of impacted third molars.
Int Dent Journ. 1990; 40: 31.

Ceccherelli F.
Diode laser in cervical myofascial pain. A double-blind study versus placebo.
The Clin J Pain. 1989; 4: 301-304.

Cheng R.
Combined treatments of electrotherapy plus soft laser therapy has synergistic effect in pain relief and disease healing. Surgical and Medical Lasers.
1990; 3 (3): 135 (abstract).

Cieslar G. et al.
Effect of low-power laser radiation in the treatment of the motional system overloading syndromes.
SPIE Proc. Vol 3198. 1997, pp. 76-82.

Cowen D. et al.
Low energy helium neon laser in the prevention of oral mucositis in patients undergoing bone marrow transplant: results of a double blind randomized trial.
Int J Radiat Oncol Biol Phys. 1997; 38 (4): 697-703.

de Bie R. A.
Effect of laser therapy on ankle sprains
Ned. T. Fysiotherapie. 1988; 95: 108-112. (in Dutch)

Eckerdal A., Lehmann Bastian H.
Can low reactive-level laser therapy be used in the treatment of neurogenic facial pain? A double-blind, placebo controlled investigation of patients with trigeminal neuralgia.
Laser Therapy. 1996; 8: 247-252.

Emmanoulidis O. et al.
CW IR low-power laser application significantly accelerates chronic pain relief rehabilitation of professional athletes. A double blind study.
Lasers Surg Med. 1986; 6: 173.

England S. et al.
Low power laser therapy of shoulder tendinitis.
Scand J Rheumatology. 1989; 18: 427.

Flöter T., Refisch H. P.
Pain treatment with laser. A double blind study. Proc. of the 4th Internat Symposium.
Acupunct & Electro-Therap Res. 1988; 13(4): 236-237. Also: Schmerzbehandlung mit Laser. Eine Dopppelblinde Studie. Top Medizin. 1990; 4(4): 52-56.

Fructuoso F. J. G., Moset J. M.
Estudio randomizado doble ciego sobre los efectos bioestimulantes del lßser en la irradiacion de glandula paratida en pacientes afectos de syndrome de Sjoegren. (Double blind study on the biostimulatory effects of laser irradiation on the parotid gland in patients affected by Sjoegrens syndrome).
Investigacion y Clinica Laser. 1987; 4 (1): 18-25.

Gelskey S. C. et al.
The effectiveness of the Nd:YAG laser in the treatment of dentinal hypersensitivity.
J Can Dent Assoc. 1993; 59 (4): 337-386.

Gerschman J. A. et al.
Low Level Laser in dentin hypersensitivity.
Australian Dent J. 1994;39:6.

Goldman J. A. et al.
Laser therapy of rheumatoid arthritis.
Lasers Surg Med. 1980; 1: 93-102.

Gudmundsen J. et al.
Laserbehandling av epicondylitis humeri og rotatorcuff-syndrom. Dobbelt blindstudie - 200 pasienter. (Laser treatment of epicondylitis humeri and rotator cuff syndrome. Double blind study - 200 patients. In Norwegian)
Norsk tidsskrift for idrettsmedisin. 1987; 2: 6.

Gertner C.
Analgesy by low power laser (LPL): a controlled double blind study in ankylosing spondarthritis (SPA).
Lasers Surg Med. 1989; Suppl 1:55.

Gärtte S. et al.
Doppelblindstudie zur Ueberpruefung der Wirksamkeit und Vertraeglichkeit einer niederenergetischen Lasertherapie bei Patienten mit aktiver Gonarthrose.
Jaros Orthopaedie. 1995. 12: 3034.

Haker E. et al.
Is low-energy laser treatment effective in lateral epicondylalgia? J of Pain and Symptom Management.
1991; 6(4): 241.

Hashimoto K.
Clinical applications of various lasers in oral surgery.
Lasers in dentistry. Eds. Yamamoto Y et al. 1989; p. 63-70. Elsevier Science Publishing B.V, Amsterdam

Hashimoto T. et al.
Efficacy of laser irradiation on the area near the stellate ganglion is dose-dependent: a double-blind crossover placebo-controlled study.
Laser Therapy. 1997; 1(9): 7-11.

Hopkins G. O. et al.
Double blind cross over study of laser versus placebo in the treatment of tennis elbow. Proc International. Congress on Lasers, "Laser Bologna".
1985: 210. Monduzzi Editore S.p.A., Bologna.

Hoteya K. et al.
Effects of a 1 W GaAlAs diode laser in the field of orthopedics. In: Meeting Report: The first Congress of the International Association for Laser and Sports Medicine.
Tokyo, 1997. Laser Therapy 1997; 9 (4): 185.

Kaiser C. et al.
Estudio en doble ciego randomizado sobre la eficacia del He-Ne en el tratamiento de la sinuitis maxilar aguda: en pacientes con exacerbacion de una infeccion sinusal cronica. (Double blind randomized study on the effect of HeNe in the treatment of acute maxillary sinusitis: in patients with exacerbation of a chronic maxillary sinusitis).
Boleton CDL. 1986; 9: 15.

Kamikawa K. et al.
Double blind experiences with mid-Lasers in Japan. 1985. Proc Int Congr on Lasers, "Laser Bologna".
1985: 165-169. Monduzzi Editore S.p.A., Bologna.

Kemmotsu M. D. et al.
LLLT for pain attenuation - the current experience in the pain clinic. In: Progress in Laser Therapy.
Eds Oshiro T, Calderhead R G. 1991: 197-200. John Wiley & Sons, Chichester, Engl. ISBN 0-471-93154-3.

Khullar S. M. et al.
Low level laser treatment improves longstanding sensory aberrations in the inferior alveolar nerve following surgical trauma.
J Oral Maxillofac Surg. 1996; 54: 2-7.

Khullar S. M. et al.
Effect of low-level laser treatment on neurosensory deficits subsequent to sagittal split ramus osteotomy.
Oral Surgery Oral Medicine Oral Pathology. 1966; 82 (2): 132-8.

Kim J. W., Lee J. O.
Double blind cross-over clinical study of 830 nm diode laser and 5 years clinical experience of biostimulation in plastic & aesthetic surgery in Asians.
Lasers Surg Med. 1998; Suppl. 10: 59.

Kinoshita F. et al.
Clinical evaluation of low-energy, semi-conductor laser therapy in oral surgery - a double blind study.
Josai Shika Daigaku Kiyo. 1986; 15 (3): 735-742. (in Japanese)

Laakso E. L. et al.
Pain scores and side effects in response to low level laser therapy (LLLT) for myofascial trigger points.
Laser Therapy. 1997; 2 (9): 67-72.

Lonauer G.
Controlled double blind study on the efficacy of He-Ne-laser beams versus He-Ne- plus Infrared-laser beams in the therapy of activated osteoarthritis of finger joints.
Clin Experim Rheuma. 1987; 5 (suppl 2) : 39

Longo L. et al.
Treatment with 904 nm and 10600 nm laser of acute lumbago - double blind control.
LASER. Journ Eur Med Laser Ass. 1988; 1(3):16.

Lucas C. et al.
Low level laser therapy bij decubitus statium III.
Rapport Hoegschool van Amsterdam. 1994.

Loegdberg-Andersson M. et al.
Low level laser therapy (LLLT) of tendinitis and myofascial pains - a randomized, double-blind, controlled study.
Laser Therapy. 1997; 2 (9): 79-86.

Mach E. S. et al.
Helium-Neon (Red Light) Therapy of Arthritis.
Rheumatologia, 1983; 3: 36.

Meier J. .L, Kerkour K.
Traitement laser de la tendinite.
Med. et Hyg. 1989; 46: 907-911.

Mester A.
Biostimulative effect in wound healing by continous wave 820 nm laser diode. Double-blind randomized cross-over study.
Lasers in Med Science, abstract issue July 1988, No 289.

Miyagi K.
Double-blind comparative study of the effect of low-energy laser irradiation to rheumatoid arthritis.
Current awareness of Excerpts Medica. Amsterdam. Elsevier Science Publishers BV. 1989; 25: 315.

Mokhtar B. et al.
A double blind placebo controlled investigation of the hypoalgesic effects of low intensity laser irradiation of the cervical roots using experimental ischaemic pain. Proc.
Second Meeting of the International Laser Therapy Assn., ôLondon Laserö, Sept 1992, p 61.

Mokhtar B. et al.
The possible significance of pulse repetition rate in lasermediated analgesia: A double blind placebo controlled investigation using experimental ischaemic pain. Proc.
Second Meeting of the International Laser Therapy Assn, ôLondon Laserö Sept 1992. p 62

Molina J. J. et al.
La laserterapia como coadyuvante en el tratamiento de la A.R. (Artritis Reumatoidea).
Boletin C.D.L., Barcelona. 1987; 14: 4-8.

Moore K. et al.
LLLT treatment of post herpetic neuralgia.
Laser Therapy. 1988; 1: 7.

Moore K. et al
The effect of infra-red diode laser irradiation on the duration and severity of postoperative pain. A double-blind trial.
Laser Therapy. 1992; 4: 145.

Mousques T.
etude en double aveugle des effets du traitment unilateral au laser helium-neon lors de chirurgies parodontales bilaterales simultanes.
Quest Odonto-Stomatol. 1986; 11: 245.

Mousques T.
Etude en double aveugle des effets du helium-neon en chirurgie parodontale.
Quest Odonto-Stomatol 1986; 11: 223.

Neuman I. et al.
Low energy phototherapy in allergic rhinitis and nasal polyposis.
Laser Therapy. 1996. 1: 37.

Nivbrant Bo et al.
Therapeutic laser treatment in gonarthrosis.
Acta Orthop Scand. 1989; 60: 231.

Ortutay J et al.
Psoriatic Arthritis Treatment with low power laser irradiation. A double blind clinical study.
Lasermedizin - Laser in Med Surg. 1998; 13 (3-4): 140.

Oyamada Y. et al.
A double blind study of low power He-Ne laser theraphy in rheumatioid arthritis.
Optoelectronics in Medicine. 1987; p 747-750. Springer Verlag, Berlin (abstract). Complete study in Boleton de CDL. 1988; 17: 8-12.

Palmgren N. et al.
Low-Power Laser Therapy in Rheumatoid Arthritis.
Lasers in Medical Science. 1989; 4: 193.

Palmgren N. et al.
Low Level Laser Therapy of infected abdominal wounds after surgery.
Lasers Surg Med. 1991; Suppl 3:11.

Palmieri B.
A double blind stratified cross over study of amateur tennis players suffering from tennis elbow using infrared laser therapy.
Medical Laser Report. 1984; 1: 3-14

Rochkind S. et al.
Double-blind Randomized Study Using Neurotube and Laser Therapy in the Treatment of Complete Sciatic Nerve Injury of Rats.
Proc. 2nd Congr World Assoc. for Laser Therapy, Kansas City, 1998.

Roumeliotis D. et al.
820nm 15mW 4J/cm2, laser diode application in sports injuries. A double blind study.
Proc. Fifth Annual Congress British Medical Laser Association. 1987.

Saeki N. et al.
Double blind test for biostimulation effects on pain releif by diode laser.
1989. Laser Surgery; 1066: 93-100.

Sasaki K. et al.
A double-blind controlled study on free amino acid analysis in CO2 laser burn wounds in the mouse model following doses of low incident infrared (830 nm) diode laser energy.
Proc. 2nd Meeting of the Internat Laser Therapy Assn., London, 1992, p.4.

Sasaki K. et al.
A preliminary double blind controlled study on free amino acid analysis in burn wounds in the mouse following 830 nm diode laser therapy.
Laser Therapy. 1997; 2 (9): 59-65.

Sato K. et al.
A double blind assessment of low power laser therapy in the treatment of postherpetic neuralgia. Surgical and Medical Lasers.
1990; 3 (3): 134 (abstract)

Saunders L.
The efficiacy of low-level laser therapy in supraspinatus tendinitis.
Clin Rehab. 1995; 9: 126-134

Schindl A. et al.
Low intensity laser irradiation improves skin circulation in patients with diabetic microangiopathy.
Lasers Surg Med. 1998; Suppl. 10: 7.

Scudds R. A. et al:
A double-blind crossover study of the effects of low-power gallium arsenide laser on the symptoms of fibrositis.
Physiotherapy Canada. 1989; 41: (suppl 3): 2.

Simunovic Z., Trobonjaca T. et al.
Treatment of medial and lateral epicondylitis - tennis and golfer elbow - with low level laser therapy: a multicenter double blind, placebo controlled clinical study on 324 patients.
J Clin Laser Med & Surg. 1998; 16 (3): 145-151.

Simunovic Z., Trobonjaca T.
Soft tissue injury during sport activities and traffic accidents - treatment with low level laser therapy. A multicenter double blind, placebo controlled clinical study on 132 patients.
Proc. IXX ASLMS Congress, Orlando, Florida, April 1999.

Snyder-Mackler L. et al.
Effect of helium-neon laser on musculoskeletal trigger points.
Physical Therapy. 1986; 66: 1087.

Snyder-Mackler L. et al.
Effect of helium-neon laser irradiation on peripheral sensory nerve latency.
Physical Therapy. 1988; 68: 223.

Snyder-Mackler L. et al.
Effect of helium-neon laser irradiation on skin resistance and pain in patients with trigger points in the neck or back
Physical Therapy. 1989; 69: 336.

Soriano F. A. et al
Acute cervical pain is relieved with gallium-arsenida (GaAs) laser irradiation. A double-blind preliminary study.
Laser Therapy. 1996; 8: 149-154.

Soriano F. A. et al.
Low level laser therapy response in patients with chronic low back pain. A double blind study.
Lasers Surg Med. 1998, Suppl. 10, p. 6.

Toya S. et al.
Report on a computer-randomized double blind clinical trial to determine the effectiveness of the GaAlAs (830 nm) diode laser for pain attenuation in selected pain.
Laser Therapy 1994; 6:143.

Taguchi T. et al.
Thermographic changes following laser irradiation for pain.
Clinical Laser Med Surg. 1991; 2(9): 143.

Tsurko V. et al.
Laser therapy of rheumatoid arthritis. A clinical and morphological study.
Terap Arkh. 1983; 97. (Russian).

Volez-Gonzalez M. et al.
Treatment of relapse in herpes simplex on labial and facial areas and of primary herpes simplex on genital areas and "area pudenda" with low power HeNe-laser or Acyclovir administered orally.
SPIE Proc. 1995; Vol. 2630: 43-50

Vasseljen O. et al.
Low level laser versus placebo in the treatment of tennis elbow. Scand
Scand J Rehab Med. 1992; 24: 37. Also in Physiotherapy. 1992; 5: 329.

Walker J.
Relief from Chronic Pain by Low Power Laser Irradiation.
Neuroscience Letters. 1983; 43: 339

Walker J.
Temporary suppression of clonus in humans by brief photostimulation
Brain Research. 1985; 340: 109.

Walsh D. et al.
The effect of low intensity laser irradiation upon conduction and skin temperature in the superficial radial nerve. Double-blind placebo controlled investigation using experimental ischaemic pain.
Proc. Second Meeting of the Internat Laser Therapy Association, London, sept. 1992.

Willner R. et al.
Low power infrared laser biostimulation of chronic osteoarthritis in hand.
Lasers Surg Med. 1985; 5: 149.

Wylie L. et al.
The hypoalgesic effects of low intensity infrared laser therapy upon mechanical pain threshold.
Lasers Surg Med. 1995; Suppl 7:9.

Yamaguchi M. et al.
Clinical study on the treatment of hypersensitive dentin by GaAlAs laser diode using the double blind test.
Aichi Gakuin Daigaku Shigakkai Shi - Aichi-Gakuin Journal of Dental Science. 1990; 28( 2): 703-707. (in Japanese)

Return to the Information Page