Laurie's Blogs.


Sep 2012

Hot, Cold & Laser...

Question – Is it important when using a laser that the patient is not warmed up?  I know in my course-work, I was taught that ice increases the effectiveness of the laser.  I have always tried to laser first before I do anything.  Now that I have an assistant it is really hard to do this routinely, as we only have one laser.  Is it still effective if they get a laser treatment after massage, mobilization or exercise?  I can’t find any research on this topic.

Cheers, E.


Answer - Hey E!

So, all based on conventional wisdom (as I cannot find literature regarding cold increasing laser efficacy - outside of a report about using YAG-laser through ice to treat kids with hemangiomas):

1) Any kind of heating of the tissues (passively or actively as with exercise, & manual therapies) will cause an increase in blood flow which can dissipate / flush away the laser energy you are putting in.  So, not that you laser will be entirely ineffective, just less effective.  In that scenario you can use laser - but perhaps at higher dosages and/or with the probe pushed firmly against the tissue so as to create a very localized ischaemic effect (this only makes sense for a class 3b laser – not the high powered class 4’s that need the distance away from the skin to avoid burning).

2) Icing before laser MAY have an impact in regards to total joules delivered to the target tissue.

3) Laser has been shown to increase blood flow, & help with pain relief by reducing nerve conduction:  So a case could be made that using it before exercise could yield a better exercise performance.  This has been shown with ultrasound on knees and isometric strength thereafter.  I THINK the same phenomenon would hold true for laser.  We always try to laser first before using the UWT in our therapy session for that reason anyways!


I hope this helps a little!