doctor with patient

Who, what, when, where, & why of Cold Laser Therapy

therapy on leg
January 6, 2019

Here at Dr. Autoimmune, we not only offer Chiropractic, Nutritional, and Neurological rehabilitation, but we also have therapeutic equipment that permit a unique, more natural mechanism of healing the body. These therapies work to treat the underlying cause of an issue, rather than merely treating the symptoms. In office, we offer Cold Laser therapy, Pulsed Electromagnetic Frequency (PeMF) therapy, LivO₂, Back on Trac traction, and Vibration Plate.

Cold Laser Therapy:

What is it?

Laser is a Light Amplification device that works by Stimulated Emission of Radiation (LASER). Low level laser therapy (LLLT), or Cold Laser, are words to describe these medium powered lasers which are the best and most widely accepted type of laser used in rehabilitation. Historically these devices have been classified as non-thermal modality, meaning they do not generate heat within the tissue. Simply put, it’s a form of light energy that can be used to create physiological response in the body, similar to electrotherapy or ultrasound.

There are many types of lasers which are used in a wide range of application for laser technology. Lasers are classified based on their power outputs (measured in Watts or milliWatts) and the associated risk for causing biological damage. There are 5 classes of laser (1, 2, 3A, 3B, and 4). As we ascend through the classes of laser from 1-4, the power output and the risk for biological damage increase. In Cold Laser, we typically are referring to class 3A or 3B lasers.

How does it work?

There are four basic components to any laser:

  1. Optical Cavity
  2. Laser (Lasing) Medium
  3. Power Source
  4. Laser Applicator

One of the key elements to laser operation is the process known as stimulated emission. Stimulated emission occurs as energy is inputted into the lasing chamber and energy is absorbed by atoms of the active laser medium, driving them to a higher energy level. As those atoms return to lower energy level, photons are released, which can go on to stimulate other atoms, amplifying the process. As amplification continues and more photons are released, they are directed out of one end of the laser chamber in a concentrated beam. In therapeutic lasers, a laser applicator is used to direct the laser beam(s) to the targeted treatment area to stimulate a physiologic response.

Laser therapy uses a process called photobiomodulation to change the condition of damaged tissue by stimulating cellular metabolism, thereby accelerating the healing process (essentially energy in the form of ATP is juiced into the tissue). As light pores into the tissue, photons are scattered, reflected and absorbed. Lasers operating in the near infrared spectrum, from 650 to 1300 nanometers, can penetrate to deep tissue structures (our Lumix 250 can penetrate 3” deep!). Light that penetrates into the tissue can be absorbed by melanin, hemoglobin, oxyhemoglobin, and water. Energy from these absorption events will be dissipated as heat, generating a soothing warmth in the tissue. The primary target for photobiomodulation is the cytochrome c complex (think detox and anti-oxidant powerhouse of the cell), which is found in the inner membrane of the mitochondria that resides within the cell. Cytochrome c is a vital component of the electron transport chain that drives cellular metabolism. As light is absorbed, cytochrome c is stimulated, leading to increased production of ATP, the molecule that facilitates energy transfer within the cell. In addition to ATP, laser stimulation also produces free nitric oxide and reactive oxygen species. Nitric oxide is a powerful vasodilator (increases blood flow) and an important cellular signaling molecule involved in many physiological processes. Reactive oxygen species have been shown to affect many important physiological signaling pathways, including the inflammatory response. Together, the production of these signaling molecules have been shown to induce growth factor production, to increase cell proliferation and motility, and to promote extracellular matrix deposition and pro-survival pathways.

Outside the cell, nitric oxide signaling drives vasodilation which improves microstimulation in the damaged tissue, delivering oxygen, vital sugars, proteins, and salts while removing wastes. These mechanisms of action have been proved by over 40 years of laboratory experiments using lasers of minimal power. The recent development of higher-power, Class IV systems affords the device the ability to efficiently deliver adequate doses of light deep into tissue to reduce pain, reduce inflammation, and accelerate healing. The advent of cold laser therapy has made it possible to not only apply the benefits of photobiomodulation superficially, but to also treat a greatly expanded range of conditions by delivering a clinically effective quantity of photos to cells deep within the tissue (meaning, we use it on a lot of conditions at Dr. Autoimmune).

Application Technique:

Application of Cold Laser therapy is very easy and similar to ultrasound, but there are a few key differences. In order to effectively used Cold Laser therapy, the skin should be cleaned with alcohol prior to treatment. No coupling media, lotions, gel, or ointments should be used during the delivery of Cold Laser, the laser head applicator is applied directly to the skin above the treatment area. No movement is necessary during the duration of the treatment and maintaining firm, direct contact with the head of the laser onto the skin is important because pushing down on the treatment area will squeeze the blood out of the treatment area, which prevents blood from absorbing the laser energy and preventing it from affecting the target tissue. Lastly, patients and clinicians must put on the provided protective eyewear and continue to wear them throughout the duration of the treatment (it is a laser and eyeballs don’t mix well). Even if the laser is not visible to the human eye, it can still cause damage if directed at the eye.


Although Cold Laser therapy is typically very safe, there are a few contraindications, typically associated with light sensitivity. Some of these include using the laser on cancer (tumors or cancerous areas), placing it directly on the eyes, for patients with photophobia or abnormally high sensitivity to light, when using photosensitizing medication, placing it directly over the fetus or the uterus during pregnancy, placing it on symptoms of unknown cause, over hemorrhaging lesions, or near/on a pacemaker.

Positive Physiological Effects of Cold Laser Therapy:

The benefits of using Cold Laser therapy are extensive. Some of the most pertinent benefits include the acceleration of tissue healing, increased localized circulation, pain and swelling reduction, decreased inflammation.
Cold Laser is used to treat; Alzheimer’s Angiogenesis, autoimmune diseases (all of them, including hashimoto’s hypothyroid, rheumatoid arthritis and lupus), Bell’s Palsy, bone repair, brain injury/concussion, burns, cancer, cardiac disease, circulation improvement, collagen fiber growth, degenerative osteoarthritis, depression, diabetic ulcers, eczema, herniated discs, herpes, immune system, migraines, neonatal jaundice, neurological problems, nerve injuries, psoriasis, psychological problems, scar tissue and postsurgical adhesions, shingles, stroke, tinnitus, traumatic brain injury, wound healing and more!

Case Study Testimonial:

By Sophie Numbers, Neurofeedback Technician

“I sprained my ankle climbing up in Summit County and it was incredibly painful. Right after falling of the rock, I rushed to Urgent Care with fingers crossed that it was just a minor sprain. After an examination and X Ray, the doctor said that I would need to be in a boot and on crutches for about 3-4 weeks, and then in a brace for another 3 or so weeks before I would be able to use my ankle again. It was a deep sprain of my ATF (anterior talofibular) ligament. I was more than bummed as I am a yoga instructor, my neurofeedback job requires me to be on my feet all day long, and I am a fairly active person. Of course, the doctor told me to take three ibuprofen at 200mg every six hours, to ice my ankle as much as I can, and to stay off of it completely for at least a week. From my time working here at RTWC, I knew immediately that there had to be a better, more natural way to heal my ankle that didn’t involve only treating the symptoms of a sprained ankle (like swelling and pain), but that actually helped the cellular healing process. So, as I drove away from Urgent Care I texted both Dr. Ian and Dr. Henry asking what I should do. Their replies were one of the same; do not take NSAIDs, get on Cold Laser right away, get it adjusted the following day, and start moving it gently and carefully as soon as it was comfortable to do so. Also, they said that I would have to get out of the ankle boot as soon as possible to limit any other issues in my spine and hips from the imbalance the boot creates.

The next day I hobbled to work on crutches and in the boot, unable to put even an ounce of weight on my foot. The first few hours of work I was in agonizing pain and was struggling to get around the office on my crutches. Then, Dr. Ian examined and adjusted my foot (yes it was a bit uncomfortable, but the pain relief from the resulting drainage of the swelling and from reestablishing the neurological connection to my ankle was palpable) and I got on the Cold Laser machine. After just one session on the Cold Laser, I was able to put weight on my ankle (while in the boot) and after a second session the next day, I was out of the boot. Yes, out of the boot! I used the Cold Laser on my ankle every day for a week and by the end, I was walking normally on it, the swelling was pretty much completely gone, and I was back to doing gentle yoga again. After two weeks of dedicated therapy, I had 80% full mobility and 4 weeks later, I barely felt pain and was using it as though I was never injured. Incredible! I highly recommend using Cold Laser therapy and avoiding taking anti-inflammatory medications for too long as through this process, I cut my recovery time down by more than half! The most important thing I learned through this experience was that immediate relief of swelling symptoms from an injury are good, such as icing and taking a few doses of anti-inflammatory medication, but essentially what that does is just puts off the healing process and can make the healing prolonged, whereas Cold Laser therapy speeds up the natural healing process of the body and can increase recovery time substantially.”

Have you considered cold laser to optimize your health?

[LightForce Lasers]. (2013, April 10). Deep Tissue Laser Therapy Medical Animation
[QB Medical]. (2014, January 29). Low Level Laser Therapy (LLLT): An Introduction

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