Laser therapy: indications and contraindications forlaser treatment

Update: October 2018 Laser therapy refers to
physiotherapeutic methods of treatment and is based on the use of
optical radiation that the laser generates. Most
the main feature of the laser, which determines its efficiency,
is the presence of a fixed wavelength, i.e. this
monochromatic light.

The average power of physiotherapeutic lasers varies in
range 1-100 mW, the pulse power is 5-100 W at
the duration of light pulses is 100-130 ns. Energy
laser radiation parameters are selected depending on the mode
the work of the apparatus and the methods used, as well as indications for
treatment.

All existing laser equipment today is divided into
three groups: for surgical, for therapeutic treatment and for
diagnostics. Surgical lasers – most often, high-intensity,
whereas diagnostic and therapeutic – low-intensity.
Accordingly, the latter will be discussed in our article.

A tour of the history of laser radiation

Physiotherapy treatment with artificial light sources
waves practiced in the late 19th century. This treatment was
developed and implemented by a physiotherapist from Denmark Finsen NR, for which
in 1903 he received the Nobel Prize.

лазеротерапия показанияFor all the time of study and development
techniques she went through several successive stages –
heliotherapy, light therapy and laser therapy. On the territory of the former
The USSR methodology is recognized as effective in 1974. In Moscow in 1986
The Institute of Laser Medicine was opened, which is currently
called the Laser Medicine Research Center of the FMBA RF, where
mechanisms of action are being studied and new methodologies are being developed
treatment.  Today, Russia is considered a world leader in
practical, scientifically based application of laser therapy,
indications and contraindications to which the most studied.

In Europe and in the USA, the technique was officially recognized in 2003,
what was the impetus for this boom in research and application
laser for the treatment and diagnosis of diseases.

Application

Application лазеротерапии требует строгого и последовательного
compliance parameters:

  • type of method;
  • wavelengths;
  • pulse frequency;
  • power and mode of operation of LLLT;
  • exposure time;
  • action localization;
  • periodicity.

Only in this case, the treatment will be effective and safe.
Hence the conclusion that qualification and professionalism
specialist working on a laser machine, plays a key
role. Despite the simplicity of the technology and methodology of laser
therapy should be very clearly understand the features of the application
method.

Benefits of laser therapy

One of the most significant advantages of the method is very small.
number of absolute contraindications. Even oncology,
pregnancy and old age which are strict
contraindications in most other cases are
relative constraints and should be considered when choosing
techniques.

Laser therapy is standard treatment for most
directions of medicine.

Laser therapy and oncopathology

For several decades more than a thousand studies
conducted around the world, safety has been proven
low intensity laser radiation (LLLT) for the treatment and
rehabilitation of cancer patients. Moreover, there are more
clinically confirmed cases proving the promise and
safety of laser therapy in the complex treatment of patients with
oncology.

При thisм достаточно распространено ничем не обоснованное
the fallacy that laser light can stimulate tumor growth.
Чаще всего this связано с безграмотным объединением термина
�“Irradiation” with a technique that has nothing to do with a laser.
This myth is actively supported by a number of unscrupulous companies.
целью которых является дискредитация method.

При thisм редко кто задумывается о том, что солнце, лампочки,
flashlights and other devices are also sources of light,
which “irradiates” us almost every day and hour. При thisм
only NILI is able to normalize physiological processes, and
also activate them when needed. The main difference
НИЛИ от других световых источников – this его монохроматичность
(fixed wavelength), which causes medical
properties.

Mechanisms of action of the laser

As a result of exposure to LLLT, due to absorption of light
energy a number of photobiological processes. Short term
increasing the concentration of free calcium in the cells triggers
the subsequent cascade of body reactions to the impact:

  • proliferative and metabolic processes are activated;
  • normal immune system function;
  • the condition of vessels improves, in particular, occurs
    dilation of the vascular walls;
  • there is an anesthetic effect;
  • cellular and humoral immunity is corrected;
  • increases indiscriminate resistance of the body;
  • blood rheology is improved;
  • microcirculation increases;
  • normal oxygen-transport function of the blood;
  • increases antioxidant and proteolytic activity
    blood;
  • hematopoiesis is stimulated;
  • improved metabolic processes;
  • tissue regeneration is activated;
  • there is a detoxification, anti-inflammatory and
    antiallergic effect, as well as a number of other positive
    effects.

Indications

Indications для лечения лазеротерапией очень разнообразны,
since the technique is not specific. Here are some
of them:

  • non-specific and specific inflammatory processes in
    acute and chronic course;
  • sepsis;
  • inflammatory processes after injuries and operations;
  • diseases of limbs of thrombobliteritis type
    (obliterating atherosclerosis and endarteritis 1-3 v.);
  • phlebothrombosis and thrombophlebitis of different localization in acute and
    chronic course;
  • CHD;
  • cerebrovascular insufficiency is chronic;
  • diseases of the lymphatic vessels of various etiologies;
  • acquired lymphostasis;
  • immunodeficiency of different course and character provoked
    operations, diseases, etc .;
  • autoimmune processes (bronchial asthma, rheumatoid arthritis
    and etc.);
  • allergies;
  • acute and chronic pancreatitis;
  • gastroduodenitis;
  • YABZH and 12 duodenal ulcer;
  • dermatosis;
  • neurodermatitis;
  • burns;
  • psoriasis;
  • diabetes;
  • poorly healing wounds;
  • Ptrophic ulcers.

With the preventive purpose, the technique is shown for
warnings:

  • complications after surgery, injuries of the abdomen, chest and
    limbs;
  • relapses of neurodermatitis and psoriasis, bronchial
    asthma;
  • infections in individuals with hemoblastosis;
  • immunosuppressive states after radiation or cytostatic
    therapy.

For the purpose of well-being, therapy is indicated when
health, breakdown, frequent colds, etc. In
cosmetology technique is actively used for skin rejuvenation,
getting rid of scars, stretch marks, wrinkles.

Contraindications to laser therapy

Absolute contraindications to laser treatment are:

  • individual intolerance;
  • first trimester of pregnancy;
  • open tuberculosis;
  • thyroid pathology;
  • anemia;
  • violation of blood formation;
  • poor blood clotting and bleeding tendency.

Relative contraindications that are resolved in
the positive or negative side are heavy
vascular and heart diseases, cerebrovascular accidents,
hepatic and renal failure in the stage of decompensation,
benign and malignant tumors, tuberculosis in
chronic course (without isolation of bacteria).

Basic methods of laser therapy

When conducting sessions of laser therapy, preference is given to
emitters that operate in the red and infrared areas
spectrum. Recently, light sources have also been actively introduced.
other waves. Cutaneous non-invasive effects – the most popular
method which is carried out by imposing the emitter on the projection
sick organs.

Method Impact / Impact Mode Wavelength / nm (Frequency) Power Time raised on 1 zone / min
Local Наружное / Импульсный и непрерывный 365, 405, 445, 525, 635, 780, 904 (80-150) 10-100 mW – continuous, 5-20 W – pulse 2-5
On the projection of the internal organs Наружное / Импульсный 635, 904 (80-3000) 15-100 watts 2-5
On the projection of immunocompetent organs Наружное / Импульсный 904 (80-150) 10-15 watts 1.5-2
Acupuncture, through a special nozzle Наружное / Импульсный и непрерывный 635 – continuous, 904 – pulse (80-150) 2-3 mW – continuous, 5-7 W – pulse 20-40 s
Paravertebral Наружное / Импульсный 904 (80-150) 10-15 watts 1.5-2
Intracavitary exposure ATнутриполостное / Импульсный и непрерывный 635, 904 (80-150) 10-100 mW – continuous, 5-10 W – pulse 2-5
Intravenous Blood Purification ATнутривенное / Непрерывный 365, 405, 445, 525, 635 2-20 2-20
External blood screening Наружное / Импульсный 635, 904 (80-150) 15-100 watts 2-5

The process of laser therapy

As we have already noted, no objective patient sensations
is experiencing. Special preparation before treatment is also not required.
Most often, treatment is carried out without hospitalization, and after the procedure
You can go home.

With the help of a special sensor effects on
skin or organ projection: at a distance, with a touch to the body
without compression and with compression. When acupuncture method
3-5 points are selected that correspond to pathology, for each
of which affect 1-3 minutes.

The duration of the procedure and the multiplicity of treatment is selected
individually.

Laser therapy equipment

The first device for mass use was created in the early 70s
yo The principle of operation and sources of laser light in many
devices are the same.

The most common are devices with
using:

  • helium-neon, argon, nitrogen and other lasers;
  • semiconductor lasers that generate pulsed and constant
    shine;
  • multicolor radiation generating waves of different
    ranges.

There are combined devices acting magnetic
field and laser.

Before working with patients the equipment is subject to individual
setting, testing, and specialists must strictly adhere to
safety instructions.

Laser treatment of gynecological diseases

Laser therapy in gynecology is used quite often due to
high therapeutic efficacy, externally (on the projection
organs) and vaginally using a special sensor.

The treatment is painless, well tolerated by the patients and indicated
in chronic inflammatory processes, menstrual dysfunction,
disruption of the ovaries, endometriosis in the lung and moderate
for endocervicitis, infertility (not in all cases), as well as for
improve the postpartum period.

Especially widely used laser is used to treat cervical erosion.
uterus, especially for the treatment of young, not giving birth women, from 5 to 7
cycle day.

As for contraindications, a number of specialists do not
recommends laser treatment in the presence of cysts, myomas, mastopathy,
acute inflammatory diseases and malignant
neoplasms.

Laser therapy for ENT pathology

The impact on the ENT organs is carried out by low-intensity
special design lasers that produce special flashes
light with different frequency.

Chronic adenoiditis – the main indication for the appointment
laser therapy for children. The treatment avoids complications and
relapses, and, despite the duration of the course (10-15 sessions 1-2
once a day), proves high efficiency at stage 1-2. AT
Unlike traditional resection, laser treatment is painless.
Often, nasal laser therapy is carried out in chronic and vasomotor
rhinitis – 10-15 sessions leads to a complete cure of 90%
cases.

ATо время процедуры осуществляется точечное воздействие именно на
affected tissue, which allows to remove puffiness and inflammation. After
procedures, follow the recommendations of the doctor (rejection of hot
food, rest, etc.). To consolidate the result of laser therapy for
adenoids in children, as well as in chronic and vasomotor rhinitis
held 2-3 times a year.

Laser therapy for joints

This procedure for joints is indicated for arthritis, primary and
secondary arthrosis of the shoulder, knee, etc., as well as
the presence of injuries of the joints and ligaments.

Often, therapy is prescribed in the rehabilitation period after
joint surgery – light therapy helps the fastest
tissue repair and healing.

Laser for the treatment of somatic pathology

ATнутривенная лазеротерапия – методика, имеющая широчайший спектр
показаний, среди которых болезни ССС (стенокардия, ATСД, гипертония,
ischemia, thrombophlebitis), respiratory diseases (inflammation
bronchi, lungs, pleurisy, asthma), pathologies of urinary organs
(pyelonephritis, urethritis, prostatitis, ICD), female diseases (uterine
bleeding, adnexitis, etc.), digestive diseases (gastritis,
gastroduodenitis, non-infectious hepatitis, cholecystitis).

Is carried out by introducing into the blood vessel of the fiber:
the blood liquefies, decreases its clotting, which warns
the development of blood clots, activates blood flow, accelerates
restoration of damaged organs, inflammatory level is leveled
reaction and pain.

Laser complications

  • Strengthening pain syndrome. Occurs more often with non-compliance.
    laser therapy techniques and in the presence of individual features
    the patient.
  • Headaches, dizziness. ATозможны при поломке аппарата,
    violation of individual sensitivity.
  • Hyperthermia on the background of active release of liver toxins in
    blood flow and their elimination from the body. As a rule, such a reaction
    проходящая, поthisму не требует отмены treatment.

Автор: врач-гигиенист, эпидемиолог

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