Laser Therapy / Photobiomodulation (PBM)

Photobiomodulation (PBM Therapy) previously known as Low Level Laser Therapy (LLLT) is the application of red and near infra-red light over injuries or lesions to improve wound and soft tissue healing, reduce inflammation and give relief for both acute and chronic pain. First developed in 1967, it is now commonly referred to as PBM.

Photobiomodulation is used to: increase the speed, quality and tensile strength of tissue repair; resolve inflammation and relieve pain (analgesia).

The red and near infrared light (600nm-1000nm) commonly used in PBM can be produced by laser or high intensity LEDs. The intensity of PBM lasers and LED's is not high like a surgical laser. There is no heating effect.

The effects of PBM are photochemical (like photosynthesis in plants). When the correct intensity and treatment times are used, red and near infrared light reduces oxidative stress and increases ATP. This improves cell metabolism and reduce inflammation. These effects can be enhanced with pulses however when analgesia is required there is a second mechanism which works best when a strong continuous beam is applied.

PBM devices are typically delivering 10mW - 500mW (0.01 -> 0.01 Watts). The power density typically ranges from 0.005W/Cm² -> 5 W/Cm².

PBM is popularly used for soft tissue injuries, joint conditions, neuropathic pain, non-healing leg and pressure ulcers.

Photobiomodulation (PBM Therapy) has a photochemical effect (like photosynthesis in plants). One of the main mechanisms of action occurs in the mitochondria (the cellular power plant inside every cell). The effect depend on the application of the correct wavelength and density of light, delivered to the target tissues for an appropriate period of time (typically between 30 - 60 seconds). Pulses can improve tissue repair and anti-inflammatory effect, analgesia is best achieved with a continuous beam.

TISSUE REPAIR AND ANTI-INFLAMMATORY EFFECTS

The primary effect occurs when light is absorbed in cytochrome c oxidase a protein within the mitochondria.

When cells get stressed (perhaps due to disease, injury or ageing) the mitochondria produces nitric oxide (NO). This competitively displaces oxygen from cytochrome c oxidase consequently reducing ATP (an essential intracellular cellular energy and extracellular signalling molecule) and causing an over production reactive oxygen species (ROS) and leading to oxidative stress. Oxidative stress is well known to lead to inflammation an cell death via the gene transcription factor NF-Kb.

PBM of the correct wavelength and density, dissociates NO allowing oxygen back in, so ATP is restored and oxidative stress reduced. Once normal mitochondrial function is restored by PBM then cell metabolism is improves, and the patient gets better more quickly.