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What is Laser?
Laser is an acronym for
L - Laser
A - Amplification by
S - Stimulated
E - Emission of
R - Radiation
The correct internationally recognised term is low level laser for therapeutic laser that is non thermal (no heat is produced). This is quite different from laser used in general and eye surgery, which are very high powered units designed to remove or "cut" tissue.
Different types of lasers will produce different types of light or wavelengths.The units used in lymphoedema management and musculoskeletal treatments produce wavelengths of laser between 632 and 904 nanometers. Some lasers such as the scanning units used in our clinic use 2 wavelenghts of light at the same time. Different wavelengths have different depths of penetration and can have slightly different effects on the tissue.
Scanning units cover large areas of tissue (up to 10cm x 10cm) in a session.Hand held units are also frequently used by lymphoedema practioners as they are much cheaper to purchase, and there is reduced risk of eye damage if there is accidental beam irradiation into the eyes. They can also be used at home. They have a small aperture and so treat small areas at a time (1cm x 1cm).
Our clinic can advise clients on renting or purchasing handheld units if this is appropriate to augment their treatment outcome.
Lasers were first used for wound healing in Europe in the 1960's, and there is a large body of research to illustrate how laser light enhances healing and reduces pain. Research papers have been published indicating positive effects can be achieved in many areas, such as healing diabetic ulcers, reducing pain associated with shingles and reducing plantar warts.
Use in Lymphoedema
Its use however in the management of lymphoedema was pioneered at this clinic in 1988 on the basis that previous research had shown that laser increases lymphatic function and regeneration.(Lievens, 1985)
The first clinical trial in 1995 (Piller et al, 1995) showed that laser alone caused an average volume reduction of 19% in 10 women with breast cancer related lymphoedema. A randomised double blinded trial was then performed in 2003 using a hand held unit (Carati et al, 2003).
No immediate changes in volume occurred, but at 1 and 3 month follow ups, 31% of subjects had at least a 200ml reduction compared to only 4% of those who did not receive laser (control subjects). Significant softening of hard fibrosis was also measured.
How is it used at our Clinic?
Our laser treatments consist of about 45 minute sessions in which several segments of up to 10cm x 10cm areas of a limb are treated directly with the laser light. In this way much of an arm or leg can be treated in one session. Hand held units can be used concurrently, particularly on areas of fibrosis and tightness as these further obstruct lymphatic return.
There is usually no sensation during laser treatment and it produces no ill side effects when used by experienced practioners. Many of our clients report immediate softening of hard areas and will describe a reduction in symptoms such as heaviness, aching and tightness.
This improvement can continue for several weeks in many individuals and further treatments appear to have a cummulative effect so that treatment times can be extended to 4-6 weekly or even longer as conditions stabilise.
There is no such thing as one treatment plan fits all, as we seek to encompass individuals differing needs and social situations.