It is recent modality of Physiotherapy and stands for Light Amplification by Stimulated Emission of Radiation.
Production of Laser: It is produced by the excitation of the atoms of some elements through electromagnetic radiations.

Type of Laser:

1         Power Laser
2         Soft Laser
3         Mid Laser
Ø  Power Laser is used for the destruction of tissues or surgical purposes.
Ø  Soft Laser is used in skin diseases.
Ø  Mid Laser is used for the therapeutic purpose. It is used by the Physiotherapist as their dept of penetration is sufficient to produce biological effects in deeper tissues without damaging the skin.

Mid Laser:

In Physiotherapy two types of Mid Laser are used.

o   One type of Mid Laser contains Helium – neon Laser combined with infrared Laser having wavelengths of 630 nm and 904 nm respectively. Both combine are used to treat the deeper tissues i.e. 30mm from surface. It should be placed at 30 cm distance from the surface of patient to be treated.
o   In another type, there is only infrared Laser and will be placed in contact with the surface of patient. The depth of penetration will be 30 mm.

Physiological effects of Laser:

Physiological effects of Laser are same just like other radiation by the processes of reflection, refraction and penetration depending upon the wavelength, nature of the tissues and angle of incidence.
Angle of incidence for the Laser should be 90°. It may be attenuated partly due to the divergence from the angle of incidence, partly due to the absorption and partly due to reflection.
Laser on getting entry to the body leads to increase kinetic energy at molecular level and cellular level. The depth of penetration of Laser is due to photochemical effect. The following are the physiological effects of Laser.

o   Cellular effects:

It activated the electron transport chain, increases ATP synthesis and reduction of the cellular PH. Laser also initiate reactions at cell membrane through its photochemical effect on the Ca channels. These biochemical effects (electron transport chain, ATP synthesis, and decrease cellular PH) and cell membrane changes cause increase macrophages, fibroblasts and lymphocyte activities (wound and Fracture healing)

o   Effect on nerve conduction and nerve regeneration:

Some studies shows that it increases the nerve conduction, some shows that it decreases the nerve conduction and some shows that it has no effect on nerve conduction. It decreases the sensory latency.

o   Effects on vasodilatation:

It increases microcirculation which may help in wound healing by the phenomenon of vasodilatation at capillary level.

Indications/ Therapeutic effects of Laser Therapy:

Ø  Wound and fracture healing
Ø  Arthritic conditions at distal extremities
Ø  Musculoskeletal disorders
Ø  Pain Management

Contraindications:

v  Patient with active or suspected carcinoma
v  Recent radiotherapy (4 – 6 months)
v  Areas of hemorrhage
v  Direct irradiation over a pregnant uterus
v  Local to the endocrine glands

Precautions for the use of Laser:

ü  Epilepsy
ü  Fever
ü  Eye (glasses to be wear)
ü  Confused or disoriented patient
ü  Infected tissues
ü  Sympathetic ganglion
ü  Vagus nerve
Cardiac region in cardiac patients