How Does Cold Laser Work For Arthritis?
Arthritis affects almost 70 million Americans. The most common forms of arthritis are osteoarthritis, a
degenerative disease in which the cartilage wears away, and rheumatoid arthritis, which is an
autoimmune inflammatory condition. Also, there are other conditions that fall under the "umbrella" of
arthritis including bursitis, tendonitis, low back and neck pain, carpal tunnel syndrome, and so on.
The common symptom of most forms of arthritis is pain. Pain develops as a result of multiple factors
including inflammation with stimulation of neural peripheral pain sensors due to either biochemical
factors such as cytokines or to mechanical factors- joint deformity. Arthritis pain may be accompanied
byother problems including loss of range of motion and disability. Cold laser
While medicines, injections, and surgery all have their place and are valuable, there is still a need for
potentially useful adjunctive modalities that might speed up recovery and reduce pain faster.
Low level therapeutic laser, better known as phototherapy, is a relatively new form of treatment. Its
premise is that certain wavelengths of light have effects on living tissue. This effect is termed
Phototherapy has been shown in experimental settings to stimulate cell growth, increase cell
metabolism, improve cell regeneration, induce an anti-inflammatory response, reduce edema, reduce
fibrous tissue formation, reduce levels of substance P, stimulate production of nitric oxide, decrease the
formation of bradykinin, histamine, and acetylcholine, and stimulate the production of endorphins.
These effects are felt to be what reduce pain.
Most cold lasers in use today use a combination of light emitting diodes and infrared emitting diodes.
The beneficial effects of cold laser were first noted in wound healing in rats (Mester E, Spy T, Sander
N, Tito J. Effect of laser ray on wound healing. Am J Surg 1971; 122: 523-535).
Subequently, laser was found to be beneficial in a number of animal models and is till being studied as
a possible tool for cartilage regeneration and healing (Lin Y, Chai CY, Yang RC. Effects of helium-neon
laser on levels of stress protein and arthritic histopathology in experimental osteoarthritis. Am J Phys
Med Rehab. 2004; 83: 758-765).
Data regarding the usefulness of cold laser on different conditions seen in a rheumatology office
Rheumatoid arthritis and osteoarthritis (Brosseau L, Welch V, Wells G, Tugwell P, de Bie R, Harman K,
Shea B, Morin M. Low level laser therapy for osteoarthritis and rheumatoid arthritis: a meta-analysis. J
Rheum. 2000; 27: 1961-9);
Elbow tendonitis (Simunovic Z, Trobonjaca T, Trobonjaca Z. Treatment of medial and lateral
epicondylitis- tennis and golfer's elbow- with low level laser therapy: a multicenter double-blind,
placebo-controlled clinical study on 324 patients. J Clin Laser Medicine Surg. 1998; 16: 145-51);
Fibromyalgia trigger points (Simunovic Z. Low level laser therapy with trigger points technique: a
clinical study on 243 patients. J Clin Laser Medicine Surg. 1996; 14: 163-167);
Neck arthritis (Ozdemir F, Birtane M, Kokino S. The clinical efficacy of low-power laser therapy on
pain and function in cervical osteoarthritis. Clin Rheumatology. 2001; 20: 181-184);
Carpal tunnel syndrome (Naeser MA, Hahn KA, Lieberman BE, Branco KF. Carpal tunnel syndrome
pain treated with low-level laser and micro amperes transcutaneous electric nerve stimulation: a
controlled study. Archives Phys Med Rehab. 2002; 83: 978-988);
Shoulder tendonitis (England S, Ferrell AJ, Coppock JS, Struthers G, Bacon PA. Low power laser
therapy of shoulder tendonitis. Scand J Rheum. 1989; 18: 427-431);
Low back pain disorders (Tasaki E, et al. Application of low power laser therapy for relief of low back
pain. Ninth Congress of the International Society of Laser Surgery and Medicine. Anaheim, CA. USA.
November 2-6, 1991; Tuner J, Hode L. The Laser Therapy handbook. Prima Books. 2004. Sweden, p.
Adequate clinical assessment is vital to determining whether a patient is a good candidate for laser
therapy. Also, laser is a complementary therapy; it should be used in conjunction with other therapies
as well. Concurrent medications, etc. should not be forgotten. Cold laser therapy
Phototherapy is FDA approved for a number of applications and has been deemed safe. It also requires
relatively little time to perform. Established protocols and tissue dosages have been established that
make clinical application relatively easy.
The number of sessions required varies according to disorder, length of time the disorder has been
present, and the severity of the disorder.
Contraindications include pregnancy (use of the laser over the pregnant uterus), thyroid exposure, over
a pediatric epiphysis, transplant patients, directly on a an active cancer, on an are where there has been
a recent (within 24 hours) steroid injection, or on the chest of a patient with a pacemaker.
While cold laser is considered by some to be unproven, it appears so far to be a safe, effective mode of
therapy for many rheumatologic disorders and is worth trying before subjecting a patient to more
invasive and dangerous procedures.