The Scoop on “COLD” Laser

By Kateri Kane PT, DPT

Have you ever experienced a chronic neck or back issue that nothing seems to fix, or been in acute pain after a recent injury?  These are just a couple of conditions that “cold” or low level laser therapy (LLLT) claims to help.  So, are the claims valid? Does LLLT truly work?

According to The Department of Labor and Industries’ technology assessment in 2004, low level laser therapy is defined as follows: “a light source treatment that generates light of a single wavelength.  LLLT emits no heat, sound, or vibration.  Instead of producing a thermal effect, LLLT may act via nonthermal or photochemical reactions in the cells, also referred to as photobiology or biostimulation.”  It benefits the tissues by altering cell and tissue function, stimulating collagen production, altering DNA synthesis, and improving function in damaged nerve tissue.  Several theories exist as to cold laser’s underlying mechanism for healing and these can be reviewed here.

Unlike corticosteroids and other medications that may be used to relieve symptoms of pain, LLLT has NO known side effects.  It is only contraindicated for direct usage over the eyes, pregnant uterus, carcinomas, the thyroid gland, and hemorrhages.  It also should not be used for patients who are taking immune suppressant drugs and over the sympathetic ganglia, vagus nerves, and the cardiac region in patients with heart disease.

Several studies have been performed to test the effectiveness of LLLT.  In the past 3 years, six different systematic reviews (highly reliable research) found evidence in favor of LLLT for conditions including frozen shoulder, myofascial pain, tennis elbow, Achilles’ tendonitis, and neck pain.  Unfortunately, despite the number of studies that have shown positive responses, insurance companies do not typically reimburse for this form of treatment.  It is deemed to be investigative because there is not enough overwhelming evidence in favor of the benefits of LLLT.  One possible explanation for the mixed evidence found in the literature is the need for very specific parameters when treating certain conditions with LLLT.  Any study that does not utilize the appropriate parameters will not conclude in positive results.

Due to the lack of reimbursement, many providers have been forced to charge through self-pay routes in order to receive payment for the laser therapy services provided.  Treatment costs average between $50 and $150 per visit and treatment lasts about 10-15 sessions.  LLLT may not be right for everyone, but there have been positive findings for certain specific conditions.  Advanced Physical Therapy and Fitness is proud to announce that we are currently in possession of a Thor Laser and have begun using this treatment on a self-pay basis.  If you believe LLLT may benefit you, contact us to find answers to your specific questions or are curious about costs.

So do you feel like you have a better understanding of laser?  Feel free to leave any comments or suggestions regarding laser or any other topic in which you are interested.  Our next blog will discuss stress management and how exercise can help.  Thank you for reading and stay active.


WA Gov




The Lancet

Spine Journal


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