Laser sounds like a serious type of treatment, however you don’t need to worry at all. It assists with relief of pain and stimulates healing in your own tissue. And most of the time you won’t even feel anything. This article will explain to you exactly what you can expect from laser treatment.

When you think of laser, you might think of laser hair removal or laser eye surgery or maybe you’ve seen someone shine a laser pointer on a screen. But have you ever heard of laser being used as a treatment by physiotherapists? There are two types of laser, high powered lasers which are used in industry and engineering settings. Physiotherapist, use a laser that is called “Low Level Laser Therapy”. These type of lasers are called cold lasers because they do not burn. There are over 4000 studies proving the effectiveness of lasers used for tissue repair.

What exactly is Laser?

The term Laser is the acronym for: Light Amplification by Stimulated Emission of Radiation. Laser light is monochromatic, collimated, and coherent. A laser is a device that produces such a light. Now, that’s a mouthful. Let’s simplify these concepts. Light consists of waves, the same as sound waves. The light waves coming from a laser, has very specific qualities. It needs to be light waves of exactly the same colour, frequency and wavelength. And the waves move precisely parallel to each other. This creates a very concentrated, precise beam of light. Light coming from a laser, is created by specific process within the laser device to cause the controlled emission of radiation.

It has been extensively researched and investigated by western medicine and scientifically proven in numerous studies. True Acupuncture techniques used by reflexologists are not the same as the medically approved “Dry Needling”. The technique requires the insertion of fine stainless steel needles through the skin to the underlying deep structures such as muscles, fascia, ligament, etc.

These points are determined by the physiotherapist after thorough assessment of the underlying tissue. Acupuncture or Dry Needling are very effective in stimulating the body to heal itself and to relieve acute or chronic pain.

Dry needling is a very safe modality if done by a trained physiotherapist

In medical acupuncture, your practitioner will make a diagnosis using the same techniques as those of conventional medicine. Needles are inserted at certain points identified by the practitioner during his screening and assessment of your body. Acupuncture needles stimulate nerve endings and alter the way your brain functions, it also activates an immune response localized to the insertion point which accelerates the healing of the tissue.

  • Needles inserted at different position/ points
  • Diagnosis based on clinical examination and test
  • Aim to restore normal movement (biomechanical structure)
  • Uses it WITH OTHER types of treatment

Why we use laser

Low level laser therapy (LLLT) is used by physiotherapists to treat various musculoskeletal conditions. It is a non-invasive light source treatment that emits no sound or vibration and very little to no heat. LLLT is believed to affect the function of connective tissue cells (fibroblasts), accelerate connective tissue repair and act to decrease inflammation. Although the skin is the organ that is naturally exposed to light more than any other organ, it still responds well to laser and infrared wavelengths.

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Healing Effects of Laser
  • Ease pain
  • Reduce inflammation
  • Decrease swelling
  • Increase blood flow
  • Increase cellular metabolism
  • Improve blood supply to injured tissue
  • Break down scar tissue and adhesions
  • Increase tissue flexibility
  • Decrease muscle spasm
  • Increase cell regeneration
  • Stimulate muscle contraction

“One of the most powerful machines to accelerate tissue healing”

Carli van Dyk - Physiotherapist and medical professional at Well Health Pro
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The Technique

Physiotherapist use laser therapy as part of their treatment, in conjunction with other treatment techniques. Laser treatment tend to last anywhere between 2 and 10 minutes, depending on the size and depth of the structure being treated.

Physiotherapist are qualified to determine if Laser treatment will benefit you. It is mostly used on structures like ligaments, tendons and joints that is made up of much more collagen. It can be applied to all kinds of musculoskeletal injuries to help reduce pain, inflammation and encourage cell reproduction. Physiotherapist are qualified to provide treatment with a Low level Laser

Different types of application

Lasers with an output power of less than 0.5 Watts are classified as LLLT (low level laser therapy), whereas lasers with an output power of more than 0.5 Watts are classified as HPLT (high power laser therapy).

  • HPLT creates heat on the surface of the skin due to their higher power density and these lasers are used in the laser medicine field to cut or destroy tissue (e.g., eye surgery)
  • LLLT is often referred to as “cold lasers” since they do not create a heating sensation during treatment. This is the type of laser therapy that is used by physiotherapists.

Lasers with wavelengths between 660 nm and 905 nm have the ability to penetrate skin, and soft/hard tissues. This light has a good effect on pain, inflammation and tissue repair. Administering LLLT below this dose range has been shown to not be effective.

Anatomical Changes you’ll notice

When the laser is placed against skin, the light penetrates it and travels several centimetres. It gets absorbed by the mitochondria in each cell (this is the part of the cell that creates energy). The energy fuels many positive physiological responses resulting in restoration of normal cell function but at enhanced rate.

The effect is photochemical not thermal, meaning it doesn’t have a heating effect in your tissues (thus, the name cold laser). The light triggers biochemical changes within your cells and can be compared to the process of photosynthesis in plants, where sunlight is absorbed by plant cells and it triggers a chemical reaction within the plant.

Changes on a cellular level:

Low level laser therapy (LLLT) is used by physiotherapists to treat various musculoskeletal conditions. It is a non-invasive light source treatment that emits no sound or vibration and very little to no heat. LLLT is believed to affect the function of connective tissue cells (fibroblasts), accelerate connective tissue repair and act to decrease inflammation. Although the skin is the organ that is naturally exposed to light more than any other organ, it still responds well to laser and infrared wavelengths.

Similar to the photosynthesis of plants, the effects of LLLT are brought about by photochemical processes in the cells’ mitochondria. Low level laser light reduces oxidative stress in the tissue while increasing ATP synthesis.

The primary effects of the biological stimulation takes place at the cellular level. Here the monochromatic red and infrared beams are absorbed by components of the respiratory chain, which enhances the electrochemical potential of protons, ATP, RNA, and protein synthesis, oxygen consumption, the membrane potential, and the synthesis of NADH.

Laser therapy feels like:

Laser light therapy can sometimes cause a slight stinging feeling, but in most cases, it causes no pain and no heat. You might feel only the pressure of the applicator on your skin as it doesn’t vibrate or make a sound. Your physiotherapist might apply it to one spot only, or a few spots.

How long does Laser treatment take?

Treatment times per point are usually between 30 seconds to a minute. As little as one point may be treated or as many as 10 to 15 points in larger areas.

However, laser light therapy will only be a part of your treatment session. Often, your physiotherapist will combine it with soft tissue techniques, massage or stretching to have a bigger and more prolonged effect.

How many times should I get laser therapy?

You could feel the effect of the laser therapy after the first session, however it works best if it can be administered repeatedly for a few weeks. It can be used in each treatment session.

Your physiotherapist will discuss a treatment plan with you, we’ll give you an idea of how long it will take for your condition to improve and how often treatment is needed. Some cases we’ll need 6-8 sessions. Mostly we see you twice during your first week, and once a week for the next two weeks and then once every second week in the next month.

What can I do at home to ensure laser therapy is effective?

Unfortunately, the effect of low light laser therapy might be temporary if the real cause of the problem isn’t addressed. Your physiotherapist will look at the bigger picture and discuss the possible causes of your pain with you. With physiotherapy treatment, it is important to comply to the whole treatment plan, including rehabilitation and conditioning. This is the best way to get long-lasting pain relief.

There are a few things you can do at home:

  • Stretch the surrounding tissue
  • Apply heat / ice to help with pain (your physio will advise you which one to use)
  • Do your prescribed home exercises
Nina Myburg Physiotherapist and medical professional at Well Health Pro
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Cost of laser therapy

There are certain medical aid rates for laser therapy as a treatment, but they are always used as part of a complete treatment consultation. So, you will never be paying for only laser.

This treatment in isolation will not fix your problem. It’s the complete treatment package that shows the real improvement.

Medical Aid Code – 006

The laser treatment code 006 is used when laser therapy is used during treatment, it can take place at the same time while other techniques are being applied and rarely in isolation. Most good medical aids offer re-imbursement for laser therapy.

Does it make a difference to have an experienced physiotherapist apply laser therapy?

The experience and skill of your physio makes all the difference to identify and apply the technique accurately and with precision. This is not something you can do or copy form YouTube. You might risk making it even worse if you don’t consider how the different structures are interacting with each other.

Our physiotherapists have years of clinical experience and in depth knowledge of your body’s anatomy. They understand different painful conditions and injuries and will know exactly what manual therapy techniques are suitable to help you heal quicker.

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Marlene Koen - Physiotherapist and medical professional at Well Health Pro
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Conditions that respond well to Laser treatment

  • Rheumatoid arthritis

  • Temporomandibular joint pain

  • Shoulder impingement syndromes

  • Hip or shoulder bursitis

  • Lower back disc pain

  • Sciatica

  • Tendonitis

  • Plantar fasciitis

Contra-indications to laser therapy

  • Malignancy/cancer in the area

  • Lasers should not be pointed at someone’s eyes and if an area close to an eye needs to be treated, appropriate safety glasses should be worn.

  • Pregnant women should not get laser treatment close to the baby

  • Epileptic, photosensitive patients could have an adverse reaction to pulsed light, so take caution with laser therapy.

Other laser treatment answers:

Yes, in the wrong hands

The laser beam is not visible, yet it reflects off surfaces like your skin and tissue that may cause the beam to reflect into your eyes, and permanently damage the light sensitive receptors at the back of your eyes.

When used correctly, no but leave the laser on one spot for too long you can cause some problems.

During the treatment, you won’t feel a thing, but you may find the area more sensitive for the first 24 hours after the laser was applied.

Laser treatment is extremely safe. Technological and medical advances in recent years have significantly lowered the chances of serious side effects.

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The difference between traditional Chinese acupuncture & medical acupuncture (also known as dry needling)?

Demonstration of physiotherapy treatment called Acupuncture

Traditional Chinese Acupuncture

The difference in traditional Chinese medicine (TCM) acupuncture and medical acupuncture lies in the way that each approaches acupuncture and the philosophy behind the diagnosis and treatment.

Practitioners of TCM believe that energy known as ‘qi’ flows around your body in channels (meridians). With traditional Acupuncture, the diagnosis partly depends on an energetic diagnosis assessing the flow of qi. Equal and opposite properties called yin and yang are thought to become unbalanced, causing illness. The needles used in acupuncture aim to restore this balance.

  • Needles inserted at fixed ‘qi’ points
  • Diagnosis based on energy flow
  • Aim to restore balance (between yin & yang)
  • Uses it as the ONLY form of treatment

Traditional Chinese Acupuncture is the healing of the body, through the use of small needles inserted into the different points of the body. Acupuncturists are trained in Traditional Chinese Medicine which should not be confused with Western Medicine. The goals of acupuncture is to promote healing and to relieve pain. Acupuncturists are there to help you understand the energy your body gives off.

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Acupuncture treatment of Meridians

The body consists of 12 points called meridians. These points are the pathways through which a life force substance called Qi flows. An acupuncturist will take a medical history, inspect your body. After this, the acupuncturist is then insert small needles into the body along these meridians, at the right points depending on where the imbalance of energy is.

In conclusion: The main aim of Acupuncture administered by Acupuncturists are to restore balance in their life by changing the flow of Qi.

Western Medicine Acupuncture or Dry Needling

It has been extensively researched and investigated by western medicine and scientifically proven in numerous studies. True Acupuncture techniques used by reflexologists are not the same as the medically approved “Dry Needling”. The technique requires the insertion of fine stainless steel needles through the skin to the underlying deep structures such as muscles, fascia, ligament, etc.

These points are determined by the physiotherapist after thorough assessment of the underlying tissue. Acupuncture or Dry Needling are very effective in stimulating the body to heal itself and to relieve acute or chronic pain.

Dry needling is a very safe modality if done by a trained physiotherapist

In medical acupuncture, your practitioner will make a diagnosis using the same techniques as those of conventional medicine. Needles are inserted at certain points identified by the practitioner during his screening and assessment of your body. Acupuncture needles stimulate nerve endings and alter the way your brain functions, it also activates an immune response localized to the insertion point which accelerates the healing of the tissue.

  • Needles inserted at different position/ points
  • Diagnosis based on clinical examination and test
  • Aim to restore normal movement (biomechanical structure)
  • Uses it WITH OTHER types of treatment
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Effects of Acupuncture

  • Accelerate healing of tissue
  • Improve muscle range of motion
  • Shorten recovery time
  • Improve joint range
  • Increase blood flow to tissue
  • Loosening of muscle tightness
  • Improve muscle flexibility
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How does the Western Acupuncture affect the tissue:

When the needles are inserted into the injured tissue, the needle stimulates a chemical reaction called a Cytokine reaction. What is the Function of cytokines? Cytokines are a large group of proteins, peptides or glycoproteins that are secreted by specific cells of immune system. Cytokine cells are a category of signaling molecules that mediate and regulate immunity, inflammation and hematopoiesis. This reaction stimulates a localized inflow(influx) of inflammatory cells to site of the needle insertion:

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Acupuncture treatment

Cytokines effects:

  1. Granulocytes are white blood cells that have small granules or particles. These granules contain numerous proteins that are responsible for helping the immune system fight off infection (viruses, bacteria). Neutrophils, eosinophils, and basophils are three types of granulocytes.
  2. Neutrophils are white blood cells that play some very important roles in our innate immune system. They circulate around our body in the bloodstream, and when they sense signals that an infection is present, they are the first cells to migrate to the site of the infection to begin killing the invading microbes.
  3. Basophils appear in many specific kinds of inflammatory reactions, particularly those that cause allergic symptoms. Basophils contain anticoagulants, which prevents blood from clotting too quickly. They also contain the vasodilator histamine, which promotes blood flow to tissues.
  4. Macrophages are versatile cells that play many roles. As scavengers, they rid the body of worn-out cells and other debris. Along with dendritic cells, they are foremost among the cells that present antigens, a crucial role in initiating an immune response. As secretory cells, monocytes and macrophages are vital to the regulation of immune responses and the development of inflammation; they produce a wide array of powerful chemical substances (monokines) including enzymes, complement proteins, and regulatory factors such as interleukin-1.
  5. Lymphocytes function: T cells and B cells are the major cellular components of the adaptive immune response. T cells are involved in cell-mediated immunity, whereas B cells are primarily responsible for humoral immunity (relating to antibodies).

These chemical and hormonal reaction caused by the needles result in a cascade of immune system responses. All these cells rush to the area where the needles were inserted. Each of these cells have their own function to help with the healing of injured tissue.

What does it feel like?

It feels like someone is pinching your skin. Definitely not like an injection. People experience acupuncture needling differently. Most patients feel only minimal pain as the needles are inserted, some feel no pain at all. Once the needles are in place, there is no pain felt. Acupuncture needles are very thin and solid and are made from stainless steel. The point is smooth (not hollow with cutting edges like a hypodermic needle) and insertion through the skin. Its not as painful as injections or blood sampling.

The risk of bruising and skin irritation is less than when using a hollow needle.
Physiotherapist always have to use sterile disposable needles, there is no risk of infection from the treatments.

Depending on the structure and the depth that the therapist must ‘needle’, it can be uncomfortable. The needles are inserted through the skin to the deeper layers. They insert them in the body, by finding the right pressure & trigger points. When inserted into the body, the depth of the needles may vary, depending on which structure is targeted by the Physiotherapist.

When the acupuncture needles are inserted, they are left in place for between 15 and 40 minutes and often the physiotherapist will manipulate the needles so that you will feel a dull ache or numb sensation around their site of insertion. This sensation is called “De Qi” or “obtaining energy” and traditionally it is thought that “De Qi” may be an important part of the treatment process as this suggests that the nervous system is being correctly stimulated.

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Acupuncture therapy

How long does this treatment take?

Treatments tend to last anywhere between 5 to 15 minutes, depending on the size and depth of the structure being treated.

In your professional experience: Dry Needling is a very effective treatment and can make a significant change in the rate of recovery. Little discomfort now can be very rewarding later.
We often use it as an extra modality to accelerate and promote healing.

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Side-effects of Acupuncture treatment/ Dry needling

These are mild, short-lived temporary effects of this successful treatment :

  • Discomfort when the needle is inserted
  • Drowsiness
  • Feeling faint
  • Bruising or bleeding at the site of the needle
  • Numbness over the affected area
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Physio Pretoria treatment

  • Acute injury treatment
  • Ultrasound
  • Medications
  • Soft tissue massage
  • Electrotherapy treatment
  • Laser (Low Level Laser therapy)
  • Acupuncture & Dry Needling
  • Heat packs (Thermal therapy)
  • Kinesiology Tape
  • Rigid Strapping or taping
  • Neurodynamics (Nerve tissue mobilizations)
  • Dynamic Strapping
  • Strengthening exercises
  • Guided loading protocol
  • Stretches (Static, dynamic and ballistic)
  • Moon boot
  • Brace
  • Compression Bandage or
  • Sleeve
  • Supportive strapping and taping
  • Biomechanical Analysis
  • Gait Analysis
  • TENS