High Intensity Laser (HIL) technology is based on the well-known principle of low level laser therapy (LLLT). High power and choice of the right wavelength allow for deep tissue penetration. HIL offers powerful and non-addictive form of pain management. Through a natural process of energy transfer (biostimulation and photomechanical effect) it speeds up healing and regeneration. HIL is particularly effective in treatment of sport injuries, e.g. muscle strain or joint distortion, and back pain caused by e.g. herniated disc or disorders in the cervical region causing neck pain.
Laser (acronym for Light Amplification by Stimulated Emission of Radiation) can be used as a therapeutic device which produces monochromatic (one specific wavelength), coherent (constant phase) and polarized (directional) light.
The source of laser beam in therapeutic high power lasers is typically a semiconductor diode capable of producing light of one specific wavelength (e.g. 1064nm).
The light generated by the diodes is then directed into an optical fiber, end of which is connected to the laser applicator. The beam is further processed by a series of lenses which ensure the right direction and diameter of the beam and consequently the spot.
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Therapeutic lasers are defined by their power and wavelength. Wavelength is important as the ideal effects on human tissue are of light in the “therapeutic window” (approx. 650 – 1100 nm). 1064nm wavelength of the High Intensity Laser ensures a good ratio between penetration and absorption in the tissue. The amount of power a laser can safely deliver can reduce therapy time by more than a half.
Based on the power and wavelength lasers are divided into several classes. Therapeutic lasers are typically of class 3B, low level laser therapy (LLLT) with power less than 500 mW, and class 4, High Intensity Laser with power 500 mW and more.
The High Intensity Laser can be used in two modes – pulsed and continuous. Pulsed mode represents turning the laser on and off with a very high frequency and is used as an analgesic treatment. Continuous irradiation is a mode in which the laser remains turned on the whole time of the therapy and is used to promote biostimulation, healing and recovery.
Although therapeutic High Intensity Laser is generally safe to use and promotes reparative processes, it can still damage the eye and so protective eyewear is obligatory throughout the therapy. With increasing power of the High Intensity Laser, caution is in place as to its thermic effects which on one hand provide very pleasant therapy, but on the other, if not monitored and used by a trained operator, can damage the tissue.
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High Intensity Laser is typically used in two modes – pulsed and continuous. Each mode affects the tissue differently and triggers different medical effects. Overall medical effects are biostimulation, pain relief, anti-inflammatory effect, superficial thermic effect and muscle relaxation.
Based on the gate control mechanism of pain, mechanical stimulation of free nerve endings leads to their inhibition and hence analgesic treatment
High Intensity Laser therapy actually heals the tissue while providing a powerful and non-addictive form of pain relief.
Energy delivered to the cells by the High Intensity Laser speeds up cell metabolism and causes faster resorption of proinflammatory mediators.
ATP allows for faster synthesis of RNA and DNA and leads to faster recovery, healing and edema reduction in the treated area.
Thermic effect causes vasodilation and in consequence increased blood perfusion.
As increased perfusion passes more blood through the treated area, the muscles relax.
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Low level laser therapy (LLLT) is a therapy with maximum laser beam output power of equal to or less than 500mW whereas High Intensity Laser (HIL) typically have output power in order of watts.
In short, it can be said that with low level laser therapy one need a significantly more time to deliver the desired healing amount of energy (dosage) to the tissue than HILs. HILs are capable to deliver the same amount of energy as LLLTs in much shorter time. Therefore same areas can be treated in much less time with HIL than with LLLT and at the same time one can treat larger areas using HIL where LLLT would require up to several hours or irradiation.
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Light is an electromagnetic wave. Such wave has peak. Distance between two consequent peaks is called wavelength.
In therapy by High Intensity Laser, wavelength is important as different wavelengths have different absorption and scatter ratios in the tissue. 1064 nm wavelength has the ideal absorption to scatter ratio. Laser light of 1064 nm is scattered less in the skin and absorbed more in deeper lying tissues and is therefore able to penetrate up to 10 cm deep into the tissue where High Intensity Laser promotes its positive effects.
Dosage is the amount of power delivered to a unit of area in time. The unit of dosage used in High Intensity Laser therapy is J/cm2.
High Intensity Laser is a class 4 laser, which has an output power of more than 500mW. Class 4 lasers may cause severe, permanent damage to the eye. Such lasers can be operated strictly by trained professionals only and safety goggles must be worn by both the patient and the therapist at any time throughout laser operation/therapy.
Laser power output directly affects a laser’s ability to perform a process. The power of a laser is measured in Watts (and often reported in terms of nW, mW, W, etc.). This is referring to the optical power output of the laser beam, which is the continuous power output of continuous wave (CW) lasers, or the average power of a pulsed or modulated laser.
High Intensity Laser beam can be generated using various types of media. Most High Intensity Lasers use diodes (also called semiconductor lasers) to produce the laser beam of desired wavelength. Diode lasers are very compact, do not require large amounts of energy to produce laser light (unlike gas e.g. CO2 lasers) and present minimal danger as to electro-technical setting but are still dangerous to the eye. Different diodes can produce beams of different wavelengths, e.g. 1064 nm.
Treatment with High Intensity Laser is safe. However, there are safety precautions that need to be followed in order to ensure safety. High Intensity Laser light can be dangerous to the eyes (even closed eyes), therefore both the patient and the therapist must wear safety goggles provided by the device supplier. As High Intensity Laser operates in high powers the therapist is to continuously ask the patient about their sensations during the treatment and possibly adjust the power according to the patient’s feeling.
One of the great benefits of the High Intensity Laser is that it’s absolutely painless. The therapist delivers the therapy moving the applicator along the skin surface in either scanning or spiral motion either in contact with the skin surface or they can hold the applicator right above the treated area and conduct the same motion in non-contact manner.
There is very low chance of High Intensity Laser burning the patient as the therapy is always dynamic and the applicator is continuously moved along the skin surface. When used in pulsed mode (analgesia), there is little or no heat sensation. In continuous mode (biostimulation), the treatment programs are pre-set to be safe. To secure safety High Intensity Laser power starts at low values and can be increased if desirable. Therapists and doctors operating the High Intensity Laser are well trained professionals.
Number of treatments varies based on the indication, its severity and how the patient’s body reacts to the treatment. Number of treatments can therefore be anywhere between 3 and 15, more in very severe cases. Contact your therapist/doctor to see how many treatments you might need.
The typical number of treatments per week is between 2 to 5. The therapist sets the number of treatments so that the therapy is the most effective and suitable to the patient’s time options.
There are no side-effects to the treatment. There is a possibility of slight redness of the treated area right after the treatment which disappears within several hours after the treatment. As with most physical therapies the patient might feel a temporary worsening of their condition which also disappears within several hours after the treatment.
No, the treatment is in contrary to pain medication non-addictive.
No, there is no limit to the number of treatments as the therapy is non-addictive. It is up to the therapist to determine whether the patient needs more treatments or conclude that in the given patient’s case the therapy is not effective and suggest other therapy options.
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s injuries are no more a pathology specific to top athletes. As larger part of population is interested in living a healthy lifestyle, the number of sport injuries increases every year. Sport pathologies include muscle strains, sprains, ruptures and tears all over the body. A study reports excellent results in symptomatological regression with disappearance or reduction of any functional deficit in 294 people treated with High Intensity Laser.
Trigger point, sensitive spot in the muscle, is a very common indication in patients. As simple as they may seem, they can be the direct cause of pain, complicate injuries or mimic practically any pain but the trigger point one. The High Intensity Laser is a fast, lasting and painless solution. The photomechanical effect of the High Intensity Laser relieves pain and the thermic effect causes relaxation of thetrigger points.
A sprained shoulder is caused by a force on the arm which stretches the shoulder ligaments. The result can be overstretching or tearing of the shoulder ligaments or capsule. The biostimulation characteristic of the High Intensity Laser is responsible for fast healing. High Intensity Laser stimulates the tissue to faster oxygen exchange in the mitochondria and consequently increased production of ATP – the body’s source of energy. When the High Intensity Laser treatment is applied, full motion of the shoulder is restored significantly faster than with conservative treatment.
Ankle sprain – one of the most common injuries. Whether one sprained their ankle due to a sudden jolt, twisted it or overstretched it, the consequences are pain and swelling. The common treatment options include rest, icepacks and post-treatment exercise in order to increase strength and mobility. High Intensity Laser treatment shortens the rest phase, relieves pain and prevents the edema to reach chronic phase. High Intensity Laser treats inflammation by decreasing the concentration of proinflammatory mediators in the area.
Majority of people presenting with low-back pain have problems with discs in the painful area. Conservative treatment options include behavioral therapies, lumbar support and physical therapy which are financially challenging. High Intensity Laser offers fast pain relief and solution to herniated disc and even in severe cases (receiving 40 treatments) is significantly cheaper than conservative therapeutic solutions. Therapy by High Intensity Laser has proven effective, time-saving and cost-effective.
Cervical pain is one of very common types of pain that can be caused by various disorders not necessarily in the cervical region, but e.g. radiating from the shoulder. High Intensity Laser features deep penetration which can get through the skin all the way to the source of pain whether it’s vertebrae, deep lying trigger point or ligament. It relieves pain through blocking free nerve endings, increasing blood perfusion of the treated area and speeding up metabolism. All effects of High Intensity Laser combined, lead to immediate pain relief and faster healing.
Low back pain (LBP) is one of the most common types of pain among today’s population. It is related to disability and work absence, accounting for high economic costs in Western world the more when acute phase becomes chronic. Non-invasive, painless and easily administered High Intensity Laser treatment can be provided for a wide range of conditions causing LBP. At the same time it is a safe, proven and effective therapy that actually helps.
Degenerative knee arthritis is another indication successfully treated by the High Intensity Laser. It has been reported that High Intensity Laser treatment decreases pain in patients by up to 63%, reduces inflammation and rapidly induces the deep tissue photochemical and photothermic effects that increase blood flow, vascular permeability and cell metabolism.
Muscle strain and pain related to it can refer to strain, pull or even tear of the muscle or its attaching tendons. The High Intensity Laser treats the muscle through a thermic effect and at the same time by triggering photomechanical processes on the cellular level, which cause synthesis of extracellular agents, endothelial cells and regeneration of the muscle and connective tissue cells. The High Intensity Laser shortens the rest phase and returns the patient to their daily routine or sports earlier than when applying conservative methods.
Analgesic effect of the High Intensity Laser is promoted mainly when using the pulsed mode. The High Intensity Laser can deliver very short pulses at a very high repetition rate. With this setting it has the ability to create actual pressure. The pressure waves are carried through the tissue where they stimulate free nerve endings. Based on the gate control mechanism of pain, mechanical stimulation of free nerve endings leads to their inhibition and hence pain relief. Analgesic effect of the High Intensity Laser is instantaneous and long-lasting.
Mechanical waves created by the High Intensity Laser stimulate local microcirculation and support lymph drainage of the pathological area. Combining biostimulation and photomechanical stimulation, the High Intensity Laser therapy actually heals the tissue while providing a powerful and non-addictive form of pain management.
The energy delivered to the cells by the High Intensity Laser speeds up cell metabolism and causes faster resorption of proinflammatory mediators. Decreased concentration of proinflammatory mediators restores capillary permeability and results in complete elimination of inflammation and faster return to one’s daily activities.
The term biostimulation means stimulating the organism on the cellular level to enhance healing and recovery. Oxygen is processed in cells by mitochondria. Here oxygen is processed by a cascade of respiratory enzymes and delivered to ATP synthase which synthesizes the organism’s source of energy – ATP. Faster exchange of oxygen and metabolites due to laser irradiation causes more oxygen atoms to reach mitochondria. Mitochondria are further stimulated to synthesize ATP faster. ATP allows for faster synthesis of RNA and DNA and leads to faster recovery, healing and edema reduction in the treated area.
The thermic effect of the High Intensity Laser therapy is caused by the absorption of the 1064 nm laser beam in the superficial structures which consequently causes a temperature increase in the tissue. Warming the superficial structures is responsible for decrease of scatter and absorption coefficients for the 1064 nm wavelength and allows for even deeper penetration by the 1064 nm light. Thermic effect also causes vasodilatation. As a result, blood perfusion increases, larger amounts of oxygen are delivered to the tissue and more metabolites are resorbed.
The energy transferred by continuous High Intensity Laser emission to the tissue causes superficial hyperthermy and consequently vasodilatation in the treated area. As increased perfusion passes more blood through the treated area, the muscles relax. In painful muscle-related indications such as trigger points, muscle strain etc., the patient feels immediate relief of pain caused by the muscle tension, and immediately increased range of motion.
The therapy should always be preceded by a clinical examination. Always check for contraindications and explain the procedure to the patient. Determine the most painful spot(s) and position the patient. The position should allow for a clear access to the treated area and be comfortable for the patient at the same time.
Then calculate size of the area that you want to irradiate. The bigger the area, the longer the session will take, provided that other parameters (power and dosage) remain the same.
The therapy is performed in two phases – analgesic and biostimulation. The analgesic phase is used to decrease pain. Biostimulation is used to support the healing and regeneration of the area.
If necessary adjust the parameters.
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Both the patient and the therapist must be wearing protective eyewear suitable for the BTL High Intensity Laser. No substitutes of the eyewear are to be used. The safety goggles are specifically design to filter laser light of a specific wavelength. When using different than provided eyewear, both the therapist’s and patient’s sight might be impaired.
Press start key on the touchscreen display to start the therapy.
The analgesic mode shouldn’t have any noticeable thermic effect on the patient. Here, laser beam is emitted in pulsed mode, which allows the tissue to cool down even with higher intensities. This part of the procedure is focused on pain relief. Start the application procedure in about 5-7 cm distance from the most painful spot and then slowly approach to the central zone using continuous spiral movement. After reaching the spot of maximum pain, stay in the position for 2-3 seconds. This is the only time in the whole High Intensity Laser procedure where the applicator is not moving. Eventually, repeat the procedure from the start on the outer edge of the spiral. In subacute and chronic conditions continue the therapy in biostimulation mode.
The biostimulation mode uses continuous emission of laser light and the treated area covers both the pathology and its close surroundings. The applicator is moved continuously in scanning manner, respecting the direction of the muscle fibers, so that the whole area is irradiated evenly. In the course of the treatment the patient should feel pleasant warming of the skin. Speed of the movement should be adjusted according to the patient’s sensation in such way to provide an optimal thermic effect. Movement too slow could lead to unpleasant heating, while too quick won’t allow enough energy to transform into heat.