NIR Class 4 Laser Therapy
NIR class 4 laser therapy speeds healing and reduces pain /swelling / inflammation
NIR class 4 laser therapy speeds healing and reduces pain
/inflammation
LASER is an acronym for Light Amplification by Stimulated Emission of Radiation
What is NIR class 4 laser therapy?
A red/near infrared
(NIR)frequency of light (~700-1000
nanometers) is
applied via a class 4 laser to
problem areas of the body at an appropriate dosage and power level.
SImilar to Low Level Laser Therapy (LLLT, aka cold laser therapy), this therapy
is also referred to as photobiomodulation , whereby laser energy is absorbed by
specific chromophores in the body:
Melanin in skin
Cytochrome C oxidase (to promote cellular energy production);
Hemoglobin (to enhance oxygen delivery to cells)
Water (to improve circulation)
The overall functional effects are:
Improved cellular function;
Increased cell
growth;
Repair/production of enzymes, proteins, immunoglobulins and DNA/RNA.
In
contrast to LLLT, the higher wattage utilized in class 4 laser therapy also produces a
mild photothermal
effect, which aids vasodilation, muscle relaxation and nerve conduction. Note
that an excessive photothermal effect can damage tissue.
Infrared Class 4 laser therapy produces biomodulating reactions that
can very effectively:
Reduce pain
Reduce inflammation
Enhance tissue healing (in hard and soft tissues, incl. muscles, ligaments,
bones)
By definition a class 4 laser must be able to deliver power of at
least ½ a watt (i.e. 500 milliwatts). Unfortunately this category does
not distinguish between the different power levels required for cosmetic /
hair-removal use, healing, surgical lasers or even military lasers (capable of shooting
down a satellite!).
The Class 4 laser is more powerful than low level
laser (or light) therapy (LLLT) devices.
This
extra power enables class 4 lasers to penetrate deeper into the body to reach muscles, and areas such as spine and
hip . In contrast to high powered lasers, LLLT does not produce a healing photothermal effect. The typical power level employed in class 4 lasers used for healing
is around 5-8 watts, compared to 5 milliwatts - 1/2 watt for LLLT class 3a and
3b lasers.Most common class 4 therapy uses a gallium-aluminum-arsenide (GaAlA)
semiconductor diode to produce an infrared laser beam.
A diode may produce
either a continuous wave or pulsed frequencies of 2-10,000 Hz. Infrared
beams are carried by a fiber optic cable and naturally diffuse (not focussed) to a 10-12° angle to produce beam diameter sizes of 10-25mm
(this produces a spot treatment area of 0.8 - 5cm2 ). Power densities
are typically in the 0.4 - 3 W/cm2 range. Primary inteactions with
tissue reach a depth of ~4 centimeters; secondary and tertiary photon effects on
tissue and body systems are seen at greater depths. Pulsed frequencies typically
have a 50% duty cycle (meaning
the pulse is active half the time between pulses).
Infrared class 4 lasers were FDA-approved in 2005 as medical therapy
devices (class 3 lasers were FDA-approved in 2002):
However, the FDA consider them only as an infrared
heating lamp. The FDA does not recognize the
bio-stimulatory effects of the laser; interestingly,
Europe has been researching and recognizing
the benefits of using lasers for therapy for over 3 decades;Infrared class 4 lasers
are prescription medical devices available for sale and use only to health
professionals. These are then trained by the manufacturer in
their use. The U.S. has many class 4 laser therapy providers across the country.
Treatment cost (~$50 -75 / treatment) is not usually
covered by insurance.
Brand
Specs. (CW=continuous wave)
Cost
K-laser (still available,
K-800. 0.1 - 8 watts
Summus lasers
P-4. 0.5-24 watts in continuous mode or 28 watts peak / av. 15
watts pulse.
Eltech Klaser
12-15 watts
~$20-28k
EVOlaser
9 - 20 watts
~$10-15k
Pilot Laser
9 watts
~$8k
Apollo Laser
.5 - 5 watt
$5k and up
Conditions helped by NIR Class 4 laser therapy
The high-power of the class 4 laser
enables it to penetrate deep enough into the body to reach muscles, and areas such
as spine and hip
Some examples of health problems healed by class 4 laser treatments:
Fibromyalgia
Peripheral Neuropathy; neuromuscular
disease / damage
Plantar fasciitis
Acute muscle, ligament and tendon
injuries. E.g. strains, sprains, tears, rotator cuff and shoulder
injuries
Repetitive-use injuries,
E.g. carpal tunnel syndrome
Arthritis (benefits joint capsule, synovial
lining and fluid, and cartilage), hip dysplasia (Degenerative Joint Disease)
Chronic frozen shoulder, shoulder tendonitis
Reversal of muscle atrophy
Ulcerations, open wounds (abscesses)
Trauma / fractures
Acute / chronic neck and back pain
Some respiratory, urinary and GI conditions
How to obtain class 4 laser treatment
Effects of NIR Class 4 laser therapy
Generally promoted functions:
Increased circulation
Immune stimulation / Immunoregulation / Immunomodulation
increased lymphatic drainage
Muscle relaxation
Improved vascular activity / vasodilation
• Type 1 collagen production (yields better tendon
and ligament strength and elasticity
Accelerated cell reproduction / tissue
repair and growth / faster wound healing
• Neurologic repair / axonal regeneration / improved
nerve function
Increased metabolic activity
Analgesia
Anti-inflammatory: reducing swelling,
edema
Decreased fibrosis
Acupuncture or trigger point stimulation
Enhanced range of motion, function, flexibility
and mobility
Specific infrared frequencies perform different tasks:
In addition to power level, the laser wavelength determines
penetration depth (note that wavelength is inversely proportion to
its frequency)
650
nm - Accelerates Surface Healing. Absorbed well by melanin
in the skin. By inhibiting bacteria and promoting cell growth, it heals wounds and
regulates scar tissueAn optimal window
around 790 nm penetrates the deepest - Ideal for pain management.
In this window, laser photons are least absorbed by melanin,
hemoglobin and water, and therefore penetrate the deepest.810 nm - Increases
cellular energy production. Allows cells'mitochondrial
cytochrome oxidase enzymes to absorb photons to promote ATP cellular energy production; particularly targets damaged cells;915 nm - Enhances
oxygen delivery. Stimulates
hemoglobin molecule to deliver oxygen to treatment site to be used for energy production .
915 nm is hemoglobin's peak absorption wavelength.970 nm - Stimulates
tissue microcirculation
Effects of laser photon beam
Primary effects
Energy from 400-1100nm wavelength photons are specifically
absorbed by chromophores in the skin (including melanin, blood and water).
Chromophores convert light energy to kinetic energy in mitochondria and cell membranes
of cells (E.g. fibroblasts) located up to ~4cm depth into the body. Scattered
photons from a Class 4 infrared laser produce an egg-shaped treatment area in tissue.
The ability of infrared lasers to target chromophores is utilized in cosmetic therapies
such as hair removal, skin resurfacing, and treating age spots, rosacea, and vascular
lesions / broken blood vessels.
Secondary effects
Primary reactions precipitate a cascade of metabolic
changes resulting in physiological changes to cells. E.g.
changing membrane permeability, release of calcium from mitochondria to change cell's
intrarcellular levels. This in turn stimulates cell metabolism and regulates signaling
pathways needed for wound repair, such as cell migration, RNA/DNA synthesis, cell
mitosis, protein secretion, and cell proliferation.
Tertiary effects
Secondary events induce distant effects.
Affected /energized cells communicate with each other and non-irradiated
cells via increased levels of cytokines and/or growth factors. This leads to an
increased immune response to control inflammatory healing (activates
T-cells, macrophages, several mast cells, and increases endorphin synthesis / decreases
bradykinin to control pain )
References
Practical pain management
Dr. Mercola
(www.mercola.com) interview with Dr. Phil
Harrington,a chiropractic physician
who was involved in the development of the K-laser
