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Guidelines for Treatment With Laser Therapy

World Association for Laser Therapy (WALT) was founded in 1994 in Barcelona, Spain at the congress for The International Laser Therapy Association (ILTA) and The International Society for Laser Application in Medicine (ISLAM). When these two international organizations merged WALT was formed. It is the world’s leading organization for the purpose of promoting research and education in the field of photo-biostimulatory treatment with lasers and other light sources. Currently, the worldwide organization WALT and its members comprise the world’s leading experts in all forms of treatment with photo-biostimulatory light treatment; including Photobiomodulation Therapy (PBMT) which is the best technical term.

 

WALT has made a table of recommendations to the dosage of laser for a number of common disorders. The table is included here or can be downloaded from WALT’s website: https://waltza.co.za/wp-content/uploads/2012/08/Dose_table_780-860nm_for_Low_Level_Laser_Therapy_WALT-2010.pdf

 

Recommended treatment doses for Low Level Laser Therapy (LLLT) / Photobiomudulation Therapy (PBMT)

Laser class 3 B, 780 – 860nm GaAlAs Lasers. Continuous or pulsed, mean output: 5 – 500mW

Irradiation times should range between 20 and 300 seconds

 

Diagnoses

Tendinopathies Points or cm2 Joules 780 – 820nm Notes
Carpal-tunnel 2-3 8 Minimum 4 Joules per point
Lateral epicondylitis 1-2 4 Maximum 100mW/cm2
Biceps humeri c.l. 1-2 6
Supraspinatus 2-3 8 Minimum 4 Joules per point
Infraspinatus 2-3 8 Minimum 4 Joules per point
Trochanter major 2-4 8
Patellar tendon 2-3 8
Tract. Iliotibialis 1-2 4 Maximum 100mW/cm2
Achilles tendon 2-3 8 Maximum 100mW/cm2
Plantar fasciitis 2-3 8 Minimum 4 Joules per point
Arthritis Points or cm2 Joules
Finger PIP or MCP 1-2 4
Wrist 2-4 8
Humeroradial joint 1-2 4
Elbow 2.4 8
Glenohumeral joint 2-4 8 Minimum 4 Joules per point
Acromioclavicular 1-2 4
Temporomandibular 1-2 4
Cervical spine 4-12 16 Minimum 4 Joules per point
Lumbar spine 4-8 16 Minimum 4 Joules per point
Hip 2-4 12 Minimum 6 Joules per point
Knee medial 3-6 12 Minimum 4 Joules per point
Ankle 2-4 8

 

Daily treatment for 2 weeks or treatment every other day for 3-4 weeks is recommended Irradiation should cover most of the pathological tissue in the tendon/synovia.

Start with energy dose in table, then reduce by 30% when inflammation is under control Therapeutic dose windows typically range from +/- 50% of given values, and doses outside these windows are inappropriate and should not be considered as Low Level Laser Therapy / Photobiomudulation Therapy. Recommended doses are for White/Caucasian skin types based on results from clinical trials or extrapolation of study results with similar pathology and ultrasonographic tissue measurements.

 

Disclaimer

The list may be subject to change at any time when more research trials are being published. World Association of Laser Therapy is not responsible for the application of laser therapy in patients, which should be performed at the sole discretion and responsibility of the therapist.

Revised April 2010

 

Recommendation for treatment with Photobimodulation Therapy

The chart below describes the recommended treatment with PBM and is based on articles along with guidelines from the website Laser World (www.laser.nu), which is sponsored and operated by the Swedish Laser-Medical Society, SLMS. Laser World is a non-profit website. Dosage and number of treatments are not definitive but general recommendations. In the case of deeper damage, the dose should be increased accordingly.

 

Table of recommendation for treatment with Photbiomodulation Therapy

ENERGY-LASER L500pro (Bluetooth) transmits 5 joules between each emission, “beep” (10 sec.)
Studies / documentation: www.laser.nu

Ailments / symptoms

Dose (Joule/Area)

Method

Time interval between treatments

Total number of treatments
Acne Vulgaris 2 – 5 J / cm² Spot treatment 2 – 3 days 4 – 10
Allergic rhinitis 4 -5 J / cm² Spot treatment 2 – 3 days 5 – 10
Herpes simplex (cold sore) 4 -5 J / cm² Spot treatment Every day 2 – 3
Arthritis 4 -5 J / cm² Spot treatment 2 – 3 days 8 – 10
Epicondylitis 4 -5 J / cm² Spot treatment 2 – 3 days 8 – 10
Mucositis 4 -5 J / cm² Spot treatment 2 – 3 days 5 – 10
Fibrositis 4 -5 J / cm² Spot treatment 2 – 3 days 10 – 20
Hypersensitive dentine 4 -5 J / cm² Spot treatment 2 – 3 days 5 – 10
Wound healing (edge of wound) 4 -5 J / cm² Spot treatment (edge of wound) 2 – 3 days 3 – 10
Wound healing (open wound) 2 J / cm² Laser held 2 cm above wound 2 – 3 days 3 – 10
Scars and pregnancy stretch marks 4 -5 J / cm² Spot treatment 2 – 3 days 10 – 20
Nerve inflammation 4 -5 J / cm² Spot treatment 2 – 3 days 5 – 10
Muscle knots and pain 5 – 50 J / point Spot treatment Every day (new injuries), max 3 days
Muscle knots and pain 4 -5 J / cm² Spot treatment 2 – 3 days 5 – 10
Pain (acute) 5 – 50 J / cm² Spot treatment Every day (new injuries), max 3 days
Pain (subacute) 4 -5 J / cm² Spot treatment 2 – 3 days 5 – 10
Arthritis in joints 4 -5 J / cm² Spot treatment 2 – 3 days 10 – 15
Acupuncture and reflexology 5 – 15 J / cm² Spot treatment 2 – 3 days 3 – 10
Tendinitis 4 -5 J / cm² Spot treatment 2 – 3 days 3 – 10
Removal of foot warts 5 – 10 J / point Spot treatment 6 – 10 days 3 – 5
Trigger Points 5 -15 J / cm² Spot treatment 2 – 3 days
Tinnitus 50 – 300 J / ear Spot treatment 2 – 3 days 10 – 20
Inflammation of the ear 50 – 300 J / ear Spot treatment 2 – 3 days 2 – 3
Sinusitis 5 – 10 J / ear Spot treatment 2 – 3 days 2 – 3
Sjögren Syndrome 5 – 10 J / ear Spot treatment 2 – 3 days 3 – 10
Post Herpetic Neuralgia 5 – 10 J / ear Spot treatment 2 – 3 days 3 – 10
  

Dosage and total number of treatments should be taken as general recommendations

Treatment of animals = same method as for humans           –      –     –      –    –     –    –     –    –     –      Higher dosage is required for deeper lying injuries