Introduction

Definition of laser therapy

Laser therapy is a modern treatment that uses a strong, focused beam of light to help heal tissues and reduce pain and swelling without surgery.¹ The word "LASER" stands for "Light Amplification by Stimulated Emission of Radiation." It's a relatively safe and painless therapy with a few side effects.³ This therapy is a type of local treatment, meaning it only affects a specific area of the body, like treating joint pain, arthritis, carpal tunnel, fibromyalgia, back pain, nerve issues, wounds, burns, scars, and even cancer. Different cells absorb light differently, so doctors choose the light wavelength depending on which tissue to target.² Laser therapy is becoming more popular because it's a gentle, non-invasive way to manage pain, heal wounds and remove tumours. It is often combined with other treatments like physical therapy, medication or surgery to improve results.³ In addition, lasers are used in other treatments like removing tumours, photodynamic therapy and laser interstitial thermal therapy (LITT), which is similar to heat treatment.²

Significance of back pain

Back pain can be either acute (short-term) or chronic (long-term). Acute back pain can be caused by accidents, falls, or lifting something heavy. The pain can usually last from a few days to a few weeks. In many cases, it improves on its own, but sometimes medical attention is needed. On the other hand ,chronic back pain that lasts longer than 3 months is less common. This can usually be treated without needing surgery. 

Back pain can affect any part of the spine and cause discomfort in the legs, making it harder to undertake everyday tasks. It can lead to changes in leg strength and tenderness in the spine. People with ongoing pain generally worry that movement will make it worse, which can also cause stress, depression or anxiety. Treating back pain is important because it can help relieve pain, improve mobility, and reduce the risk of future back issues.

Types of laser therapy

There are two types of laser therapy used generally in medicine: low-level laser therapy (LLLT) and high-intensity laser therapy (HILT). Low-level laser therapy (LLLT) encourages the release of substances like endorphins and nitric oxide, and assists tissue healing, reduces swelling, inflammation and pain, while also giving assistance in muscle relaxation and tissue repair. On the other hand, high intensity laser therapy (HILT) destroys damaged tissue by the use of stronger laser beams, which help in treating problems like sun damage, skin scars and dental issues by creating an inflammatory response. Common lasers used in these treatments include CO2, Er: YAG, and Nd: YAG lasers.³

How laser therapy works

Laser therapy works by using focused light to interact with your cells and their subcellular structures, particularly mitochondria, which are responsible for producing energy in your cells. Laser therapy, therefore, helps increase energy production in the cells, a process known as photobiomodulation, which can support healing and overall cell function. The process improves blood flow and circulation, which helps the body manage inflammation and pain. For effective therapy for a variety of conditions, the right light wavelength and power level must be used so that the cells can absorb the light properly.⁶ Laser therapy sessions usually last between 15 to 30 minutes, and the treatment is typically done 2-3  times a week, depending on how severe the pain is.

Benefits of laser therapy for back pain

Laser therapy is a modern treatment option that offers a wide range of benefits for back pain. It's a non-invasive method that reduces inflammation without the use of medications and surgery, relieves pain and speeds up healing. Here's a look at how laser therapy can help with back pain:

Pain relief: It helps in the alleviation of chronic and acute pain for a long time without causing side effects⁷

Better Blood Flow in the affected area: laser therapy can speed up healing by improving blood circulation⁸

Reduction in Inflammation:  helps reduce swelling around affected areas by reducing the amount of pain-causing hormones that are released within the body, and also increasing collagen production.⁹

Enhanced Tissue Repair: Laser therapy speeds up recovery of muscles, ligaments and joints by healing and regeneration of damaged cells in the back.¹⁰

Non-Invasive and Drug-Free: Laser therapy is a safe, non-surgical treatment that doesn't require medications. It's a painless procedure, usually resulting in the patient just feeling warm.¹⁰

Targeted Treatment: The treatment by laser therapy is effective because it allows doctors to focus the laser on specific areas of the back.¹¹

No Known Major Side Effects: Safe alternative with minimal risks.

Conditions treated with laser therapy

Laser Therapy is used to promote healing and reduce pain to treat several conditions, such as :

Back Pain and Disc Injuries: Back pain, especially lower back pain, can stem from a variety of causes, including muscle strain, herniated discs and degenerative disc disease. The laser therapy is highly effective for addressing both muscular and disc-related components of the problem, and helps reduce muscle spasms, inflammation and pain related to disc injuries.¹¹

Muscle and Ligament Injuries: Laser therapy helps in conditions like sprains, strains and tears by reducing inflammation, pain and improving blood flow of the muscles and ligaments.

Arthritis and Joint Pain: In situations like osteoarthritis and rheumatoid arthritis, laser therapy can help by relieving pain by affecting how pain signals are sent to the brain, reducing inflammation and aiding in cartilage repair.¹¹

Neuropathic Pain: Laser therapy is effective for nerve pain in conditions like diabetic neuropathy, nerve pain after surgery, or sciatica  by targeting the affected nerves directly. 

Tendinopathies and overuse injuries

Laser therapy can treat conditions like Achilles tendonitis or rotator cuff injuries, which often occur from overuse.It improves the  blood flow to the tendons, which speeds up healing.¹¹

Risks and considerations

Laser therapy can be a safe and effective treatment option, but it does have some risks and considerations:

Potential Side Effects: Laser therapy can create several risks, including skin issues such as burns, scarring, discolouration, bleeding and increased infection risk, especially if applied to open wounds. Vision loss or eye damage is a potential concern following steroid injections. Treating delicate structures like the thyroid is generally discouraged, and the specific risks can vary based on the area being treated and the patient's overall health and medical history.^3,13

Contraindications

There are several situations where laser therapy shouldn't be used. To protect the eyes from the beams, safety goggles must be worn. Pregnant women shouldn't use laser treatment near their uterus, and it shouldn't be applied to skin with other diseases. Epilepsy patients should avoid it, and people with pacemakers need to be cautious. It's also not safe for tumorous tissues, patients with lupus or those who have bleeding disorders. Additionally, people allergic to certain medications or unable to stay still during the procedure should not undergo laser therapy.¹⁴

Conclusion

Laser therapy is a promising non-invasive treatment for back pain and related conditions, utilising focused light to promote healing, reduce inflammation, and enhance blood circulation. It offers significant benefits such as pain relief and improved tissue repair with minimal side effects, making it an effective complement to other treatment modalities. However, careful consideration of potential risks and contraindications is essential to ensure patient safety. Overall, laser therapy holds great potential in the pain management landscape, offering hope for those suffering from acute and chronic back pain.