What is LLLT?

Coldlasers.com knows cold lasers inside and out. Not only do we sell the largest selection of cold lasers—from class 1 to class 4—for just about any application you can think of, but we also provide unbiased information about the advantages and disadvantages of cold lasers as well the different applications. Consider us the ultimate cold laser resource.

Some of the cold laser brands we carry include Apollo, Avant, DioWave, Laserex, Pilot, LiteCure, TerraQuant and Thor. Just because we don’t carry a particular brand, it doesn’t mean we aren’t familiar with it. The Coldlasers.com team makes a point of learning about the industry from products, to trends to the latest research on treatments.

Both doctors and consumers buy from Coldlasers.com. Have a question? Give us a call at 1-800-388-0850. You can also use the chat option for questions and comments.

Keep in mind several things as you research cold lasers: the three FDA-cleared applications are pain reduction, inflammation reduction and increased blood flow. As you’ll see with the examples below, other applications have been successful as well. Just be careful about claims that sound too good to be true.

Because cold lasers are a significant investment in your health, we have researched and compiled extensive information to help you make the best decision possible. For example, this National Institute of Health (NIH) study of the effects of a low-level laser on knee osteoarthritis patients found that the treatment “reduces pain and increases microcirculation.”

Another NIH study found that cold laser treatments in superficial wound healing “resulted in enhanced healing as measured by wound contraction.” These are just two of the hundreds of published studies showing the positive effects of cold laser treatment in a variety applications.

CUTTING THROUGH THE SALES TALK

On Coldlasers.com, you’ll find in-depth specifications on each of our professional grade cold lasers such as Apollo, Avant, Thor, DioWave and others. Each of the lasers we sell has a solid reputation with both practitioners and professionals. Unlike some other cold laser sites, we do not sell products that make dubious claims and that are not based on photobiomodulation (low level laser therapy or LLLT).

It’s sometimes hard to know when a manufacturer is making claims based in fact or simply trying to differentiate their product. Because we are associated with just one company, we can provide an apple-to-apple comparison. We make recommendations based on the specs of the products and stay away from hyper marketing. No marketing fluff. No slick sales copy (OK, we have some slick copy). Just the facts.

HOW COLD LASERS WORK

When you think of a laser, you probably envision a red beam of light cutting, burning through some material. Cold lasers aka low-level lasers (LLL) use a non-invasive beam of light that alters cellular function. The light emitted does not burn but may have a small heating effect.Cold lasers are only FDA cleared for pain reduction, inflammation reduction and increase blood flow but there is another key element to biostimulation.

Here is a short excerpt from the website of the manufacturer of the Apollo cold laser:

When laser light is absorbed by a living tissue, it triggers biological reactions in the cells. Chemical substances are produced, released and carried by the blood and lymphatic flow to other parts of the system. In this way the effects of cold laser light may not be only local, but can also achieve wide systematic physiological responses: Reduction in pain by causing production of natural pain killer endorphins. Reduction in inflammation by suppressing inflammatory enzymes that create swelling, redness, pain and heat. Enhanced lymphatic drainage, which increases circulation and speeds healing. Release of tight muscles that create chronic pain, joint problems and decreased mobility. Faster bone repair by stimulating fibroblastic and osteoblastic proliferation.

Here is except from the DioWave website

Studies have shown that when tissue cultures are irradiated by Lasers, enzymes within cells absorb energy from laser light. Visible (red) light and Near Infrared (NIR) are absorbed within the mitochondria and the cell membrane. This produces higher ATP levels and boosts DNA production, leading to an increase in cellular health and energy. When applied as treatment, therefore, Lasers have been shown to reduce pain and inflammation as well as stimulate nerve regeneration, muscle relaxation and immune system response.Lasers have no effect on normal tissues, as photons of light are only absorbed and utilized by the cells that need them.

Cold laser therapy is an alternative to traditional treatments such as surgeries and endless, sometimes addictive drug prescriptions. It’s often placed in the same category as chiropractic therapy, massage, acupuncture and physical therapy. Many practitioners, particularly chiropractors, will use cold laser therapy in conjunction with their own specialties.

While cold lasers have only been in use in the US since 2001, they have been used around the world since the late 1960s. Over 3000 studies have proved cold lasers completely safe. And the FDA has cleared over 25 different cold lasers for a number of different treatments.

One of the ways cold lasers are rated is by their power level. Power is the rate which the energy is produced—watts. The power level of cold lasers is between 10 milliwatts (mW) to 60,000 milliwatts (mW), though they are usually at least 500mW.

Another specification is the wavelength (nM). Basically, the lower the wavelength, the more superficial the treatment. The higher the wavelength, the deeper the penetration. Additional specifications to consider are the number of laser beams—the larger the array, the wider the treatment area and the increased probability you will treat the affected area.

If you have a chronic condition, one that you need to treat often, the cost of a cold laser can be recouped in less than a year depending on the laser’s price. Cold lasers are as low as $2,000; one cold laser therapy session can cost between $30 and $100. Add in your time, gas, and aggravation and it’s easy to see how owning a cold laser can pay for itself.

The following are some treatment uses for cold lasers:

• Pain relief including acute and chronic back, neck and wrist pain
• Carpal Tunnel Syndrome
• Wound healing
• Joint pain
• Elbow disorders
• Rheumatoid arthritis
• Tinnitus
• Post-surgery recovery
• Fibromyalgia
• Bruising
• Tendonitis and bursitis
• Plantar fasciitis
• Burn healing
• Scarring
• Muscle and nerve regeneration

TWO TREATMENT STYLES

The two main types of cold laser treatment are broad therapy and trigger point treatments or laserpuncture.

Broad Treatment Therapy

In broad treatment therapy, the practitioner uses a broad-focus (larger than a dime) laser that will cover a larger area, penetrating deep tissue to induce natural healing. The larger emitters used with this treatment can cover an area up to 4.6 inches. These larger emitters can accelerate healing time.

Laser Trigger Point Therapy

When you think of laser trigger point therapy, think of the precision of an acupuncturist’s needle. The cold lasers used are a sharply focused concentration of energy that stimulate an acupoint. The area stimulated is very small but the laser can penetrate an area 5 inches deep.

EVALUATING COLD LASERS

As discussed above there are a number of specifications to consider when considering a cold laser. These make up what are known as treatment parameters and include:

Wavelength (nM) The wavelength determines the depth of penetration. The lower the wavelength, the shallower the penetration. For example, a 600-700nm wavelength will reach a depth of 1cm and would be adequate for superficial wound healing. A higher wavelength will penetrate deeper because it’s not as easily absorbed by the skin. Wavelengths in the 700-1,000nm range are more effective for reaching tendons and joints.

Power (mW) Power is the rate which the energy is produced and is expressed as watts. The power level of cold lasers is between 10 milliwatts (mW) to 60,000 milliwatts (mW), and usually at least 500mW. Another factor to consider with power is time (seconds or minutes) because power x treatment time = energy delivered. A higher-powered laser can deliver more energy is less time.

Pulsing Versus Continuous Pulsing lasers are generally regarded as best for promoting healing while continuous wave (CW) lasers are best used for pain control. A pulsing laser delivers high power while still remaining safe to use.

A continuous wave laser has no interruption in the delivery of its energy and its energy output is consistent over time.

Treatment Time Most treatment times range between 10 seconds and up to a minute depending on the patient and the nature of the condition. The more areas to be treated and the bigger those areas are can greatly increase treatment time in a practitioner’s office. However, having your own cold laser allows you to “self-treat” whenever it’s convenient: in bed at night, on the couch watching TV, etc.

Coverage Area As stated above, the size of the coverage area will affect the treatment time. It may also affect the type of cold laser you buy. A laser with a larger emitter will cover a larger area in a shorter amount of time.

Protocols and Guidelines A protocol is a treatment library and is important, particularly for new cold laser owners who are just learning. Essentially, it’s a guidebook—either a paper manual or built-in to the cold laser—that explains how to use the cold laser for every application the laser is designed for.

OTHER NAMES FOR COLD LASERS

As you search on Coldlasers.com and other sites around the web, you’ll come across several different name variations: cold laser, low-level laser (LLL), low-level laser therapy (LLLT), therapeutic laser, light therapy, phototherapy, or soft laser. You may even see stimulating lasers and resonating lasers. The term “low-level” doesn’t mean these lasers are not very powerful—they certainly can be. And a cold laser isn’t cold at all (though it is relative to some lasers). It emits a light that warms. On this site, we will refer to them as cold lasers.

COLD LASER CLASSES

All lasers are classified according to the IEC 60825 (International Electrotechnical Commission)—an international organization that publishes standards for all electrical, electronic and related technologies.

Lasers range from class 1 (no hazard during normal use), the safest, to class 4 (severe hazard for eyes and skin), which are over 500mW CW per beam and are the most dangerous cold lasers. Higher class lasers are not necessarily better but they are typically:

· More dangerous

· More expensive

HOME AND PROFESSIONAL USE

At Coldlasers.com, we sell cold lasers to professionals and consumers. And even though the majority of buyers are practitioners such as chiropractors, home users are buying more cold lasers every year, especially as they become educated about the applications and benefits.

And in most states there is no limitation for home cold laser users. Home users can buy class 1 and 2 lasers without restrictions; they can buy a class 3 laser with a health care provider recommendation.

Class 4 lasers, depending on their power, can be sold to most professionals. DioWave cold lasers are restricted to professionals while many of the TerraQuant products are great for home users and practitioners.

TREATMENT AREA

The size of the treatment area is an important consideration when researching cold lasers. A laser with a larger treatment area is not only easier to use, it is safer. For example, if you have knee pain, a larger emitter will increase the chances that you will hit the affected area and you will do it quicker.

HEALING VS PAIN CONTROL

As discussed above, a pulsed wave cold laser is more effective for healing while continuous waves work better for pain control. For a patient (and practitioner) it comes down to preference. Is your first priority immediate pain relief? Or is healing your primary goal? Healing can take months of therapy so it’s important to think about these two when you start your therapy.

POTENTIAL FOR TISSUE DAMAGE

We want to set the record straight: With class 1, 2, or 3 FDA-cleared cold lasers, you do not have to worry about tissue damage. Has tissue damage from heating occurred? Yes, but most of it is just hype from manufacturers of low-level lasers wanting to push their products. Here is some more info on the risks associated with different lasers.

An FDA-cleared, class 4 laser below 5,000mW (5W) has an insignificant chance of causing tissue damage for most skin types. Many cold lasers have automatic timers that shut off the laser after a few minutes. Some warming may occur for those with tattoos, hair, fur, or dark skin but if the probe is moving, this will not be an issue.

Class 4 cold lasers with 30,000mW (30W) and above are required to have cryogenic cooling system that reduces the chance of tissue heating. These systems are also rated for insured and highly trained practitioners such as chiropractors.

INSURANCE REIMBURSEMENT

Insurance plans do not cover the purchase of cold lasers. However, some cold laser therapies may qualify for insurance reimbursement, though there is no CPT (Current Procedural Terminology) code specifically for cold lasers. Typically the code used is 97039 (unlisted modality), which will require an explanation of the service provided and whether the service was attended or unattended. More information on the CPT codes used can be found here (see below)

ColdLasers.com makes no guaranty regarding reimbursement from insurers and no guarantees with respect to appropriate diagnosis and/or procedure codes for insurance billing and reimbursement codes.

CLASSIFICATION OF DISEASES

Insurance billing for cold laser therapy starts with classifying the particular medical condition that is being treated. The Centers for Disease Control (CDC) classifies medical conditions and assigns codes to diagnoses and procedures. These codes are used for billing and reimbursement by medical practitioners and insurance companies.

This classification system is called the International Classification of Diseases, Clinical Modification and is in its 10 ^th Revision known as ICD-10-CM.

The following list of diagnoses may be appropriate for cold laser therapy. Coldlasers.com strongly suggests you consult your doctor for more information.

Suggested Clinical Uses for Cold Laser Therapy:

INFLAMMATORY CONDITIONS

• Plantar Fasciitis
• Rheumatoid Arthritis
• Epicondylitis
• Bursitis

Primary Diagnosis

1. Pain
2. Restricted range of movement/stiffness
3. Edema
4. Effusion
5. Paresthesia
6. Inflammation
7. Adicular pain
8. Muscle spasms
9. Myofasciitis

PAIN MANAGEMENT

• Lower back pain
• Neck/Cervical pain
• Fibromyalgia
• Bursitis
• Myofascial pain
• Fasciitis

Primary Diagnosis

1. Pain
2. Restricted range of motion/stiffness
3. Inflammation
4. Effusion
5. Edema
6. Muscle spasms
7. Mysofasciitis

CONNECTIVE TISSUE INJURY

• Sprains
• Strains
• Tendonitis
• Tendon ruptures

Primary Diagnosis

1. Pain
2. Inflammation
3. Restricted range of motion/stiffness
4. Effusion
5. Edema
6. Muscle spasms
7. Myofasciitis
8. Radicular pain

JOINT INJURY

• Temporomandibular (TM) disorders
• Osteoarthritis
• Ligament injury
• Dislocations

Primary Diagnosis

1. Joint pain
2. Inflammation
3. Restricted range of motion/stiffness
4. Joint effusion
5. Edema

MUSCLE INJURY

• Muscle bruises/contusions
• Muscle ruptures
• Muscle contractures
• Myositis

Primary Diagnosis

1. Muscle Pain
2. Inflammation
3. Restricted range of motion/stiffness
4. Muscle spasms
5. Edema
6. Myofasciitis

NEUROLOGICAL INJURY

• Prolapsed disc
• Ruptured disc
• Neuritis
• Crush injuries

Primary Diagnosis

1. Radicular pain
2. Myofasciitis
3. Decreased range of motion/stiffness
4. Inflammation
5. Muscle spasms
6. Paresthesia
7. Edema
8. Effusion

SKIN INJURIES AND CONDITIONS

• Surgical incisions
• Skin ulcers
• Skin grafts
• Burns

Primary Diagnosis

1. Joint pain
2. Inflammation
3. Restricted range of motion/stiffness
4. Edema