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 Low Level Laser Therapy (LLLT) or 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

TendinopathiesPoints or cm2Joules 780 – 820nmNotes
Carpal-tunnel2-38Minimum 4 Joules per point
Lateral epicondylitis1-24Maximum 100mW/cm2
Biceps humeri c.l.1-26
Supraspinatus2-38Minimum 4 Joules per point
Infraspinatus2-38Minimum 4 Joules per point
Trochanter major2-48
Patellar tendon2-38
Tract. Iliotibialis1-24Maximum 100mW/cm2
Achilles tendon2-38Maximum 100mW/cm2
Plantar fasciitis2-38Minimum 4 Joules per point
ArthritisPoints or cm2Joules
Finger PIP or MCP1-24
Wrist2-48
Humeroradial joint1-24
Elbow2.48
Glenohumeral joint2-48Minimum 4 Joules per point
Acromioclavicular1-24
Temporomandibular1-24
Cervical spine4-1216Minimum 4 Joules per point
Lumbar spine4-816Minimum 4 Joules per point
Hip2-412Minimum 6 Joules per point
Knee medial3-612Minimum 4 Joules per point
Ankle2-48

 

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 LLLT/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 Low Level Laser Therapy/Photbiomodulation Therapy

ENERGY-LASER L500 PRO (Bluetooth) transmits 5 joules between each emission, “beep” (10 sec.)
Studies / documentation: www.laser.nu

Ailments / symptomsDose (Joule/Area)MethodTime interval between treatmentsTotal number of treatments
Acne Vulgaris2 – 5 J / cm²Spot treatment2 – 3 days4 – 10
Allergic rhinitis4 -5 J / cm²Spot treatment2 – 3 days5 – 10
Herpes simplex (cold sore)4 -5 J / cm²Spot treatmentEvery day2 – 3
Arthritis4 -5 J / cm²Spot treatment2 – 3 days8 – 10
Epicondylitis4 -5 J / cm²Spot treatment2 – 3 days8 – 10
Mucositis4 -5 J / cm²Spot treatment2 – 3 days5 – 10
Fibrositis4 -5 J / cm²Spot treatment2 – 3 days10 – 20
Hypersensitive dentine4 -5 J / cm²Spot treatment2 – 3 days5 – 10
Wound healing (edge of wound)4 -5 J / cm²Spot treatment (edge of wound)2 – 3 days3 – 10
Wound healing (open wound)2 J / cm²Laser held 2 cm above wound2 – 3 days3 – 10
Scars and pregnancy stretch marks4 -5 J / cm²Spot treatment2 – 3 days10 – 20
Nerve inflammation4 -5 J / cm²Spot treatment2 – 3 days5 – 10
Muscle knots and pain5 – 50 J / pointSpot treatmentEvery day (new injuries), max 3 days
Muscle knots and pain4 -5 J / cm²Spot treatment2 – 3 days5 – 10
Pain (acute)5 – 50 J / cm²Spot treatmentEvery day (new injuries), max 3 days
Pain (subacute)4 -5 J / cm²Spot treatment2 – 3 days5 – 10
Arthritis in joints4 -5 J / cm²Spot treatment2 – 3 days10 – 15
Acupuncture and reflexology5 – 15 J / cm²Spot treatment2 – 3 days3 – 10
Tendinitis4 -5 J / cm²Spot treatment2 – 3 days3 – 10
Removal of foot warts5 – 10 J / pointSpot treatment6 – 10 days3 – 5
Trigger Points5 -15 J / cm²Spot treatment2 – 3 days
Tinnitus50 – 300 J / earSpot treatment2 – 3 days10 – 20
Inflammation of the ear50 – 300 J / earSpot treatment2 – 3 days2 – 3
Sinusitis5 – 10 J / earSpot treatment2 – 3 days2 – 3
Sjögren Syndrome5 – 10 J / earSpot treatment2 – 3 days3 – 10
Post Herpetic Neuralgia5 – 10 J / earSpot treatment2 – 3 days3 – 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