Home » Electrotherapy; Actinotherapy
LASER Therapy


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

Under:
Infrared radiations


Infrared rays are electromagnetic waves with wavelength of 750 – 4 lac nanometer. Any hot body emits infrared rays. For example the sun, gas fire, coal fire, electric fire, hot water pipes etc. The infrared rays are produced by two types of generators.
  1. Luminous generator
  2. Non luminous generator

Non luminous generator provides infrared rays only while luminous generator emits visible and a few ultraviolet rays as luminous generator is often called radiant heat. The term infrared is generally being applied to the radiations from non luminous source.

Therapeutic uses of infrared:

A.  Pain relief:

Infrared radiation is an effective mean of relieving pain, when heating is mild the relief of pain is due to sedative effect on superficial nerve endings. Stronger heating of infrared stimulate the superficial nerve endings. It has been also noticed that pain is due to accumulation of waste product and because of stronger heating the blood flow increases which remove that waste product and the pain is relieved. In some cases the relief of pain is probably associated with muscle relaxation.
                                               
In acute inflammation, pain is reduced with mild heating because in recent injury tissue fluid accumulates in that area, the use of stronger heating will increase these processes which cause pain.
In chronic type of inflammation pain is reduced due to stronger heating. The infrared causes comfortable warmth and the treatment time should be round about 30 min.

B.  Muscle relaxation:

Muscle relaxes most readily when the tissue is warm. The relief of pain also facilitates muscle relaxation. Infrared radiation is most helpful to achieve muscle relaxation and for the relief of muscle spasm associated with acute injury or inflammation.

C.  Increased blood flow/ supply:

The effect of infrared is mainly in the superficial tissues and this may be used in the treatment of superficial wounds and infections. Because a good supply of blood is essential for healing to take place and if there is infection, the increased number of WBCs and the increased exudation of fluid assist in the destroying of bacteria. When superficial joints are affected for example small joints of hand and feet (arthritis), the infrared radiation is more helpful in the vasodilatation of blood vessels. This vasodilatation can increase the blood flow (increased supply of oxygen and removal of waste product and food stuffs are available to bring about the resolution of inflammation).

Application of infrared treatment:

The intensity of radiation should be low at the beginning but after 5 – 10 min when the vasodilatation occur (when the increased blood flow establishes). The strength of radiation may increase; this can be achieved by moving the lamp nearer to the patient. The physiotherapist should be at the hand throughout the treatment session and should reduce the intensity of radiations when the heating become excessive. Sweating is encouraged if the patient is provided with water drink.

Dangers of infrared radiations:

     i.        Burn:

Infrared radiations can cause superficial heat burn. Red patches are seen on the skin which subsequently blisters during or after the treatment. The burn is most often caused by 2 grade intensity of radiation. This process can occur when the patient does not understand the nature of treatment or fails to report the overheating or move neat the lamp or falls asleep. The physiotherapist must be at hand during the whole treatment session.

   ii.        Electric shock:

It can occur as a result of touching some exposed part of the circuit but the main danger arises if the live wire comes in contact with the apparatus casing.

  iii.        Gangrene:

Gangrene may be occurred when infrared is applied to the area of defective arterial supply.

  iv.        Headache:

Headache may occur if the sweating does not take place properly or if the treatment is given in hot weather.

    v.        Faintness and Giddiness:

Extensive irradiation may cause fall in BP which may result in faintness or giddiness due to hypoxia of the brain.

  vi.        Injury to the eyes:

It has been suggested that exposure to IRR can cause cataract.

Contra – indications:

a)      Defective arterial supply
b)      Defective skin sensation
c)      Areas where there is danger of hemorrhage

Under: