It is a popular sport in the LLLT industry to sneer at Big Pharma for their side effects and marketing practices, but the LLLT industry is far from criticism itself. Whilst LLLT side effects are hard to find, marketing overstatement and misdirection are common place.
In this months literature watch is a paper titled “The Effectiveness of Therapeutic Class IV (10 W) Laser Treatment for Epicondylitis”. This small study showed that 10 Watt Class IV laser (mixed 8W 970nm, 2W 810) was successful in reducing pain and improving function in an RCT with 15 patients, and that there was good statistical significance at 6 months following a course of 6 treatments.
The claim by class IV laser manufacturers is that class IV lasers are better (faster, deeper and more effective) than Class 3b and LED systems. Conversely the 3B laser and LED manufacturers argue that less power density is more effective because delivering energy too quickly can overdose tissues and class IV lasers might burn the skin.
Throughout this paper there are marketing messages claiming the advantages of shorter treatment times than low power LLLT systems and of course the title shouts “10 Watt Class IV laser” just in case the reader is in any doubt that more power is what you need.
Regular readers of this column know my obsession with irradiation parameters, particularly dose rate effects (W/cm2) and will not be surprised to learn that I deconstruced the irradiation parameters used in this trial . Surprise, surprise they were the same low irradiance levels typically used by 3B lasers and LED systems, if not less and the treatment time was longer too.
Yes, it was a 10 Watt laser and yes, 3,000 joules was delivered, however it had a very large beam area and treatment was delivered over a very large area (45cm2) in a “painting fashion”. The fluence (dose) was 6.6 Joules/cm2 and the power density was a tiny 22mW/cm2, consequently treatment time was a hefty 5 mins.
The average irradiance was not disclosed in the paper and the reader is directed to think that more power is quicker. Perhaps LLLT companies are no better than the pharma industry when it comes to disseminating specious information.
P.S. research trials with 3B lasers are typically 30 seconds to 3 mins and our recommended treatment is 1 min with a large LED cluster to the lateral epicondyle and 30 seconds for any related trigger points.
Attend a THORLaser One Day Training Course to see the research and get all the information in making an informed decision: https://www.thorlaser.com/courses/
James, a rant is so valuable when it stands for truth. Thank you.
I would like to clarify one doubt:
Considering the same power and the same wavelength, the LED light has the same efficiency of laser light, in inflammatory processes tendon and wounds?
Geraldo Nascimento ( Brasil)
in theory yes but in practice maybe LED seems to be better.
An unexpected, but perfectly rational, experience to look forward to….
For those with chronic conditions, especially when pain has ruled their lives, the slight lift in spirits after a photobiomodulation is like lifting the ‘load’ in the mind as well.
Intensity of this effect varies, (with the personality of the recipient), but it is palpable and beneficial.
Most people feel ‘better’ when they walk into sunlight after being inside a dwelling (random light).
How much better it is to have coherent light delivered to the site of pain or injury – and feel targeted relief!