In the last few years it appears that the number of clinics offering “Laser Therapy” for pain relief, arthritis, hair loss (or to remove hair) and a bevy of other health benefits. Billboard ads, radio spots, even flyers in alternative medicine offices (Chiropractors, naturopaths etc.) seem subjectively to be increasing. It got me thinking about what laser therapy is and why it would be effective for any sort of health problem, so let’s have a closer look at the fundamentals.
To start with, the idea of using a laser for health-related reasons apparently came in 1967 when Endre Mester in Budapest, Hungary noticed that if he shaved hair off the backs of mice, the hair grew back more quickly in mice that were subsequently bombarded by laser light. That’s an interesting finding, but before I start digging into the Internet treasure trove of studies on lasers in health applications, it might behoove us to take a look at exactly what a laser is in the first place.
Lasers, it turns out (and according to Wikipedia) “is a device that emits light through a process of optical amplification based on the stimulated emission of photons.” It also turns out that the word ‘Laser’ is an acronym for Light Amplification by Stimulated Emission of Radiation. Without boring the dickens out of everyone, it’ll suffice to say that lasers are highly focused beams of light that resist diffraction; meaning that you can see a laser spot on a white wall even if it’s being beamed from a small hand-held laser from 100 feet away. This reminds me of The Amazing Meeting 7 where the JREF’s gift to attendees was a combination pen/light/laser pointer and a large portion of the 800-strong audience decided to focus the beam of their new laser pointers on Phil Plait’s shiny forehead (the famously bald Bad Astronomer). But I digress…
Because the light is so concentrated in lasers they can produce a great deal of heat and can in fact cause damage to human tissue, including burning the human retina (the sensitive nerve at the back of your eyes) and ultimately causing permanent vision loss. However, the last two decades have seen the growth of the Low Level Laser Therapy (LLLT) devices, sold by an ever-increasing group of companies. What probably prompted the proliferation of laser treatment in the alternative medical circles were a few studies that showed some minor improvement in wound healing when the wounds were exposed to LLLT. Unfortunately LLL therapy has fallen into the snake-oil sinkhole, having become a cure-all for everything from daily aches and pains to a cure for serious diseases.
Indeed, there’s good news if you suffer from nearly any complaint because according to the Ontario Laser Health and Rehabilitation center’s website some of the many treatments lasers can help include:
• Soft tissue and sports injuries
• Smoking cessation
• Repetitive stress problems
• Arthritic conditions
• Musculoskeletal problems
• Carpal Tunnel Syndrome
• Weight Loss
• And much more! (yes, they really say this).
Thank goodness that lasers can help improve so many parts of our lives, all by shining a little light somewhere, although one wonders where the laser would be aimed for weight control or fibromyalgia. If a person had pain in their rectum or colon cancer where exactly would the probe go?
The Laser Therapy Review website, which states on its front page that it’s “designed to be a comprehensive website for news and information in the field of Laser Therapy” states that LLLT has proven physiologic effects such as increasing the production and release of endorphins, cortisol, growth hormone, and ATP (Adenosine Triphosphate). It also “Increases protein synthesis, venous and lymphatic flow facilitation, increases angiogenesis, and enhances immune response.” This sort of language is typical of cure-all treatments like LLLT. Indeed, throwing big words at the general public sounds impressive and if you don’t know any better, one might think it could actually have an effect.
While not a medical expert I attended university and was a Registered Nurse working in ICU for about 10 years. Let’s take a look at one claim they make about LLLT: Angiogenesis. Now for those who don’t know angiogenesis is the creation of new blood vessels in the body, although the Laser Therapy Review defines it as “elevation of oxygen saturation”. This definition is so disingenuous one doesn’t even know where to begin, since oxygen saturation has nothing to do with the production of new blood vessels. Still, angiogenesis must be good, right? Considering that most tumor growth is make possible only by the body’s misguided ability to create new blood vessels to feed the tumor, a great deal of cancer research is aimed at stopping angiogenesis, not encouraging it as LLLT claims to do.
A quick Google of the phrase “Cancer research and angiogenesis” and got an entire page of news about how cancer researchers are fighting to stop angiogenesis in cancer patients. I am certainly not suggesting that LLLT causes cancer, I am merely pointing out that the advertisements for what LLLT does are full of what appears to me to be meaningless fluff and medical words sprinkled around without context or real meaning.
The Laser Therapy Review goes on to list the conditions LLLT can treat, and these include (and I’m not making this up):
• Temporo-mandibular Joint Dysfunction,
• Venous Stasis
• Nerve regeneration
• Rheumatoid Arthritis
• Knee dysfunction
• And the list goes on…
So what is the exact mechanism of action of these lasers and why can they do so much to help people? Since the penetration of the laser (Dr. Mark Crislip M.D, the infectious disease doctor who creates the excellent podcast “QuackCast” mentioned on a recent podcast that these lasers only penetrate a few millimeters into the tissue in the first place), the wavelengths of the laser treatments, and indeed even the type of lasers are not standard (not to mention the duration, dose, and location of treatments) it’s difficult to say what, if anything is actually going on therapeutically.
Many of the studies that the Laser Therapy Review point to in its reference section are small studies done in laboratory conditions looking at minute changes in cellular activity after being bombarded by a laser. That doesn’t mean this science isn’t important, but it does mean that it is an unproven treatment that may have some use for temporary pain relief, but it certainly is not something people should be turning to in order to treat diseases like atherosclerosis or diabetes.
The bottom line is that any time one sees a product or treatment that is a panacea cure for large numbers of disparate conditions and it’s being marketed with lots of big words the average Joe wouldn’t understand, it should spark one’s skeptical intuition. The reality of lasers is that a few studies have shown that LLLT can have some small-localized effects on wound healing (by treating the wound edges) and some pain reduction in certain situations where tendons are close to the surface of the skin. But pain is highly subjective and several recent studies show that when it comes to pain control, sham laser treatments work just as well as ‘real’ laser treatments, and even then the benefits are small and highly subjective.
As for the websites that promote LLLT, be skeptical. For example the Laser Therapy Review cleverly has a link to Health Canada (along with the Health Canada Icon) on the bottom of their web page. One can only assume that they are implying approval from the Canadian government, however clicking the link to Health Canada and searching the words Laser Therapy brings up several articles about laser hair removal (a proven treatment) and nothing else except the August 2012 recall of a Fraxel Re-Store Dual Laser system console made by Solta Medical Inc. The laser apparently burned a patient and an operator.
The bottom line is that the claims that LLLT is a new treatment that is a miracle for pain sufferers and those hobbled by chronic disease are just there to take your money. If it sounds too good to be true, it probably is.