Low-level laser therapy is one of the most promising, yet most overlooked, forms of wound management.

Once considered the stuff of science fiction, the low-level laser is rapidly becoming one of the primary weapons in the wound-management arsenal. The idea of simply shining a light over a wounded surface sounds too easy, but the reality is that the resultant healing process is scientific fast. Chukuka S. Enwemeka, PhD, PT, dean of New York Institute of Technology’s School of Health Professions, Behavioral and Life Sciences, is one of the world’s leading advocates of low-level laser therapy. “The effectiveness,” he explains, “is based on the ability of light to stimulate adenosine triphosphate (ATP) production. ATP is utilized to synthesize DNA, RNA, proteins, enzymes, and other biological materials necessary in the repair or regeneration of cell and tissue components. This occurs because most cells possess chromophores, which are similar to the chlorophyll found in plant cells. They absorb light and transform it to ATP.”

Kathy Tisko, PT, from Dallas has had extensive firsthand experience with low-level laser therapy. “In hundreds of studies thus far,” she relates, “it has been analyzed how light at wavelengths between 600 mm and 1,000 mm (the partition of the spectrum that includes both visible and infrared light), at power levels less than 500 mw, a favorable biostimulatory response in the human body results. The research has confirmed that irradiation definitely promotes faster wound healing and appreciable reductions in pain. The therapy bombards the skin with a stream of photons that can be transformed by cells below the surface into ATP.”

Unfortunately, although the utilization of the technique is growing, Enwemeka feels that the physical therapy profession is walking slowly when it comes to embracing a proven therapy. “In the United States,” he points out, “we generally have a conservative approach because we’re conditioned to the painfully slow FDA approval process. But there is a natural tendency to resist newer technology, especially technology developed outside of the United States. Low-level laser technology was first used in Europe, so it didn’t get a priority in the approval process. There is skepticism about newer protocols, which can work against us if we allow other practitioners to get a head start.”

Tisko’s interest in light therapy stemmed from a personal experience. “I had an attitude of, ‘Hey, it’s just light. How can it conceivably help a patient?’ ” she says. Then one day, while working in her kitchen, a knife slipped and sliced open the top sides of the fourth and fifth fingers of her left hand. A colleague suggested using his laser therapy device on her fingers. Tisko, figuring she had nothing to lose, decided to give the equipment a personal trial. As a control, she treated one finger with light, the other with conventional salves. The results stunned her. The finger that underwent light therapy (2 to 3 minutes’ duration over a span of 5 days) had fully healed 10 days after the accident, and was pain-free for nearly the entire time. The finger that did not receive light therapy took nearly twice as long to heal and pained her for nearly the entire time of treatment.

“I think the reason PTs are slow to embrace low-level laser therapy,” Tisko says, “is that there is a certain confusion surrounding the treatment. Different brands operate at different combinations of light wavelength and power output levels. This makes evaluating the therapeutic effectiveness of one product versus another a challenge. Also, there is the nomenclature. Any time you use the word ‘laser,’ people immediately think of surgical lasers, which burn or cut.”

Enwemeka feels that cost may be another consideration. “While you can pay as much as $20,000 for some equipment, the equipment used in this therapy typically begins at $5,000. And there is very rarely a reimbursement problem as long as the treatments are coded properly.”