All the Intel on Cold Laser Therapy, Which Can Speed Recovery and Relieve Pain

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You know what's cool? Cold laser therapy, a new treatment that’s gaining popularity within the fitness and health space as a form of recovery. Post-workout, it can help to treat chronic pain and inflammation, plus promote tissue growth and wound healing, says Ben Lee, MD, a plastic surgeon at Wave Plastic Surgery in California. “It involves applying low-intensity laser energy to injured tissue," he explains. "And unlike ‘hot’ lasers, cold laser therapy does not rely on application of heat, which can burn the skin."

During cold laser therapy, different wavelengths and outputs of low-level light are applied directly to the skin (or the affected area), which the body tissue absorbs. The treatment is also called a low-level laser or photobiomodulation therapy, and usually uses a laser within the range of 1 to 500 mW. “The light is the red or near infrared spectrum, but infrared can penetrate the human skin better than red wavelengths, so that’s what you may see in clinics more often,” says board-certified sports clinical specialist, Leada Malek, DPT, CSCS. “In response, the damaged cells will then create some sort of physiological reaction geared towards regrowth and rejuvenation as a means for mitigating pain."

Experts In This Article
  • Ben Lee, MD, Ben Lee, MD, is a plastic surgeon at Wave Plastic Surgery in California.
  • Brian Meenan, DC, Brian Meenan, DC, is the founder of Premier Chiropractic in Pittsburgh.
  • Leada Malek, PT, DPT, CSCS, SCS, board-certified sports specialist and physical therapist based in San Francisco

The weird part is, we still lack a lot of information on what makes cold laser therapy so successful. “It is not known definitively how it works, but it is believed that cold laser treatments improves circulation to the treated tissues,” says Dr. Lee.

One possible mechanism behind cold laser therapy and its benefits is linked to an increase in protein synthesis and a chain of events that ultimately leads to an increase in cellular metabolism, mitochondria (aka your cells' battery packs) functionality, and improvements in wound healing to fight inflammation.

“There is also the possibility that light from cold laser therapy interacts directly with the treated tissues to enhance the release of growth factors and inhibit inflammatory mediators,” Lee explains.

Below are 7 benefits of cold laser therapy to know about

1. It's non-invasive

The laser device does not injure the skin, but rather, penetrates into the deeper tissues. “It therefore offers an alternative to surgery for a variety of conditions such as arthritis of the knee,” says Dr. Lee.

2. It does not involve the use of pharmaceutical drugs

“Some people are intolerant of medications such as non-steroidal, anti-inflammatory agents (NSAIDS), or they have medical conditions that prevent them from taking certain medications,” says Dr. Lee.

3. It is usually not painful

A barrier for many patients in seeking therapy is the fear of pain, and in most cases treatments involving lasers often involve some level of discomfort. In most cases, cold laser therapy doesn't hurt. “The laser does not feel like anything, nor does it burn the skin, hence the ‘cold’ laser terminology, as opposed to heat therapy,” says Dr. Malek.

4. There are no known side effects

Unlike other modalities, there have been no reported major complications from cold laser therapy. “There is the possibility that a patient may not see the degree of response they were hoping for,” says Dr. Lee, but that’s on a more superficial level.

5. It can treat arthritis and joint pain

In people with neck pain, it reduced pain after treatment and for up to 22 weeks afterwards. What’s more, a study that examined older people with knee osteoarthritis showed that the combination of cold laser therapy and exercise resulted in more joint pain relief than purely exercise alone.

6. Cold laser therapy can accelerate healing

“When the light is absorbed from our body on a cellular level, collagen formation is sped up and laid down more efficiently—what this means is, you can heal faster and with less scar tissue then if you just let your injury go,” says Brian Meenan, DC, founder of Premier Chiropractic in Pittsburgh. It also increases the amount of a molecule called adenosine triphosphate (or ATP), which is the main energy source in our cells. “These two things allow you to heal faster when undergoing cold laser therapy,” Dr. Meenan says.

7. It also decreases inflammation

Similarly to how over-ther-counter pain medications work, the chemicals that induce pain into an area of the body are decreased with cold laser therapy. “These chemicals are simply reduced when they interact with the light from the laser,” says Dr. Meenan, which leads to less inflammation, more pain relief, and even increased blood flow. “Our blood brings in all the nutrients needed for injuries to heal, and research suggests that cold laser therapy increases blood flow to an area by making new blood vessels and increasing the blood flow traveling through the vessels,” he adds.

Who is cold laser therapy best for?

“The typical candidate for cold laser therapy is a patient who is seeking a non-invasive, painless method of improving their chronic pain or wound healing problems,” says Dr. Lee. Candidates should ideally have mild symptoms and be fairly early in their treatment.

Note: This is not a therapy for those who are battling more serious health conditions such as cancer. “Those who have cancer should always consult with their oncologist before using light therapy—although more and more research is continuing to come out regarding light therapy and different cancers, but for right now, I recommend staying away,” says Dr. Meenan. The same goes for pregnant women.

Cold laser therapy is also a good option for people experiencing severe acute pain or ongoing chronic pain. “It could and should be used in combination with other rehabilitation techniques such as stretches and exercises that may have been given to you by your chiropractor or physical therapist,” says Dr. Meenan. “In my office, I like to use it on patients who have tried everything and cannot seem to get relief, especially in areas of tendon pain such as tennis elbow, golfer's elbow, and patellar tendonitis, as those patients respond very well to light therapy,” he adds.

Something else cold laser therapy can do is help ease joint stiffness and pain, if done routinely for prevention and management of flare-ups.

What are the drawbacks of cold laser therapy?

To be fair, it’s pretty pricy. “Cost can be an issue, as multiple treatments are required (sometimes 20-30),” says Dr. Lee, so it’s not just a one-and-done kind of treatment with a single, high balance. “This can become fairly expensive due to the sheer number of treatments, and insurance may not cover the cost, either,” he adds.

For cases that involve the musculoskeletal  system (as in your muscles, bones, tendons, ligaments, and connective tissue) in particular, insurance may not cover it. “That is because while there are some promising studies and reviews that support [cold laser therapy] for certain conditions, there are not as many ‘well-designed research studies’ that back it, so you may have to pay for the service,” says Dr. Malek.

Also, there's the possibility that the treatments may not be as effective as desired, as is the risk with any kind of therapy, or it may take a while to start seeing and feeling significant results. “Most of the research has examined several weeks of use before publishing their findings,” adds Dr. Malek.

How often should do cold laser therapy?

“Because of how laser therapy works, it should be done two to three times a week, and you can go up to five times a week, but not many people have time for that,” says Dr. Meenan. It can take anywhere from one to eight visits to notice a difference in pain relief though, so keep that timeframe and subsequent cost in mind when determining if cold laser therapy is the right choice for you.

Before starting any new treatment protocol, first ask your doctor what they think is best and follow their advice. “Many people do not try the laser for enough sessions or they space the sessions out too far apart and that could diminish the benefits of the laser,” adds Dr. Meenan. If you’re willing to invest in the cost, then make sure you’re doing it properly to maximize the effectiveness.

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