Indications and Contraindications for Laser Therapy

Laser has been used successfully in physical medicine and rehabilitation for more than 30 years in various parts of the world and has begun to increase in popularity in the United States since the FDA has cleared its use for a number of medical indications. Laser treatment involves introducing the energy of light into damaged or injured tissues to promote healing through the stimulation of ATP production and lymphocyte activity among other physiological responses.

In the United States, the FDA has thoroughly evaluated and subsequently cleared a number of laser devices for the treatment of neck and shoulder pain and carpal tunnel syndrome. The FDA has also cleared infrared light, which is light energy with wavelengths longer than visible light, to do the following:

  • increase local blood circulation
  • alleviate minor muscle or joint aches, pain, and/or stiffness
  • relaxation of muscles
  • relieve muscle spasms
  • ease the pain and stiffness of associated with arthritis

Though laser therapy has been used safely and effectively throughout the world in animal research since the 1960’s and safely with humans since the 1970’s, there are precautions with regard to the use of laser and specific instances where laser should not be used.

Only authorized and trained medical professionals should use laser for medical treatment. Since the beam of an infrared laser cannot be detected by the human eye, protective eye wear that is designed for the wavelength being used should be worn to prevent accidental exposure. Infrared light will not usually cause the eye to blink for protect itself. Another precaution relates to the use of laser over growth plates in the bones. Though very few, if any, studies have concluded that the use of laser has any negative effect on growth plates, it is probably wise to avoid using a laser directly over them. Highly reflective jewelry should be removed from the area being treated, and treatment should not be done over or near reflective surfaces. Laser should only be applied to the area to be treated and should not be used over areas where sensation has been compromised, as the patient may not be able sense discomfort if the laser is too intense.

Laser should not be used to irradiate the eyes, over cancerous tumors, within 4 to 6 months of radiation therapy, over hemorrhage, over or near the thyroid or endocrine glands, over a fetus or uterus during pregnancy, in cases where the patient has sensitivity to light, if the patient is using medication that is photosensitive, or with patients that have vascular disease.

Laser use has been proven effective for the treatment of a number of conditions, and may prove to be effective in the treatment of others as the use of laser increases. However, when laser is used caution should be exercised and attention should be paid to the conditions under which laser may be harmful to avoid negative effects.