Laser therapy:

light amplification of stimulated emission of radiation is a light beam from the electromagnatic spectrum.

Background:

low level laser therapy has been investigated and used clinicically for over thirty years,mostly in eastern europe and asia.
How To Work:It works on a principle of inducing a biological response through energy transfer,in that the photonic energy delivered into the tissue by the laser,it causes the modulation of biological process within that tissue.
lasers produce nonioninizing electromagnetic radiation that is extremely monochromatic,polarized and coherent.
It penetrates in human tissue upto 8-15mm.
Types of Lasers:
Classification 1:
1.High power lasers: These are also known as hot lasers and are used for surgical cutting.
2.Low power lasers:Also known as cold lasers.Mostly used in treatment of tendons and ligaments injuries,arthritis,edema,scar inhibition,ulcer,soft tissue injuries and burns.
Classification 2:
according to some liteature ,there are three types of lasers:
1.Power laser: Used for destructive or surgical processes.
2.Soft laser:Used for the treatment of skin conditions.
3.Mild laser:Used in physiotherapy.
TYPES OF LASER:
The different types of LASERs are:
Helium Neon
Ruby
Gallium
Aluminum
Carbon
Diode
Out of these Helium Neon LASER, which has got the wavelength of 632.8 nm, is commonly used in Physiotherapy

Treatment Protocols:
1.Direct contact over skin which is known as gridding technique.
2.Distance contact 5cm distance from skin known as scanning technique.
3.Laser is applied over the grid area in an oscillating manner known as Wanding technique.
TREATMENT TECHNIQUES:
NON CONTACT METHOD
30 cm distance between skin and output
Gridding Technique
Divide treatment areas into grids of square centimeters
Scanning Technique
No contact between laser tip in skin; tip is held 5-10 mm from wound
Point Application (Acupuncture point)
Dosage and Frequency:A pulsed mode with fixed power output is used with frequency of 550-700Hz,peak power of 5W having intensity of about 0.3mW.Therapeutic LASER can be applied for 2 to 30 seconds
Few manufacturers even suggest the application of LASER  up to 10 to 12 minutes
Thus it is wise to calculate the dosages or follow the  guidelines of manufacturer to get satisfactory results.Alternatively can apply a dose of 1 to 12 J/cm2 by using the formula:
Energy Density=
Therapeutic LASER is pulsed or continuous mode can be applied
Everyday or on alternate days
Three to ten weeks
PHYSIOLOGICAL AND THERAPEUTIC EFFECTS
Low-intensity-level Laser(LILL) Penetrate the skin with no heating effect, no damage to skin & no side effects.
It increases wounds and ulcers healing may be due to increased phagocytosis, facilitation of collagen synthesis, increased wound closure.
Improved blood circulation & vasodilatation
Increases blood supply

Stimulates immune system
Optimizes the immune responses of blood
Alter nerve conduction velocity
Stimulates nerve function
Accelerated Tissue Repair and Cell Growth
Photons of light from lasers penetrate deeply into tissue and accelerate cellular reproduction and growth. The laser light increases the energy available to the cell so that the cell can take on nutrients faster and get rid of waste products.
Anti-Inflammation
Laser therapy has an anti-edemic effect as it causes vasodilation, but also because it activates the lymphatic drainage system (drains swollen areas). As a result, there is a reduction in swelling caused by inflammation.
Anti-Analgesic
Laser therapy has a high beneficial effect on nerve cells which block pain transmitted by these cells to the brain and which decreases nerve sensitivity. Also, due to less inflammation, there is less edema and less pain.
Improved Vascular Activity
Laser light will significantly increase the formation of new capillaries in damaged tissue that speeds up the healing process, closes wounds quickly and reduces scar tissue.
Increased Metabolic Activity
it creates higher outputs of specific enzymes, greater oxygen and food particle loads for blood cells.
Trigger Points and Acupuncture Points
it stimulates muscle trigger points and acupuncture points on a non-invasive basis providing musculoskeletal pain relief.

INDICATIONS:
Soft tissue injuries (nerve, muscles, ligaments, tendons, bursa)
e.g: Sprain, strain, bursitis, tendinitis, tenosynovitis, carpal tunnel syndrome, tennis elbow, etc
Fractures
Musculoskeletal problems
e.g: Osteoarthritis, Rheumatoid Arthritis, backache, etc
Neuralgia—pain (both acute and chronic)
Sports injuries
Wounds & Ulcers
Acupuncture/Trigger points
CONTRAINDICATIONS:
Application over eyes
Cancerous growths
Pregnancy – over & around uterus
Over cardiac region & Vagus nerve
Growth plates in children
Over & around thyroid gland & endocrine glands
Patients who have been pre-treated with one or more photosensitizers
Hemorrhage
Unreliable patients
DANGERS AND PRECAUTIONS:
EYE DAMAGE:
Pass through the lens of eyes causing burns
Prevented by protective goggles
Avoid application to eyes
Advise the patient not to stare directly
Room should be dark and no reflecting material including  the room color
Appropriate warning symbols outside the room
PHOTOSENSITIVITY :
Test dosage