Guidelines for Treatment With Laser Therapy

World Association for Laser Therapy (WALT) was founded in 1994 in Barcelona, Spain at the congress for The International Laser Therapy Association (ILTA) and The International Society for Laser Application in Medicine (ISLAM). When these two international organizations merged WALT was formed. It is the world’s leading organization for the purpose of promoting research and education in the field of photo-biostimulatory treatment with lasers and other light sources. Currently, the worldwide organization WALT and its members comprise the world’s leading experts in all forms of treatment with photo-biostimulatory light treatment; including Low Level Laser Therapy (LLLT) or Photobiomodulation Therapy (PBMT) which is the best technical term.

WALT has made a table of recommendations to the dosage of laser for a number of common disorders. The table is included here or can be downloaded from WALT’s website: https://waltza.co.za/wp-content/uploads/2012/08/Dose_table_780-860nm_for_Low_Level_Laser_Therapy_WALT-2010.pdf

Recommended treatment doses for Low Level Laser Therapy (LLLT)/Photobiomudulation Therapy (PBMT)

Laser class 3 B, 780 – 860nm GaAlAs Lasers. Continuous or pulsed, mean output: 5 – 500mW

Irradiation times should range between 20 and 300 seconds

Diagnoses

*Tendinopathies*	Points or cm2	Joules 780 – 820nm	Notes
Carpal-tunnel	2-3	8	Minimum 4 Joules per point
Lateral epicondylitis	1-2	4	Maximum 100mW/cm2
Biceps humeri c.l.	1-2	6
Supraspinatus	2-3	8	Minimum 4 Joules per point
Infraspinatus	2-3	8	Minimum 4 Joules per point
Trochanter major	2-4	8
Patellar tendon	2-3	8
Tract. Iliotibialis	1-2	4	Maximum 100mW/cm2
Achilles tendon	2-3	8	Maximum 100mW/cm2
Plantar fasciitis	2-3	8	Minimum 4 Joules per point

*Arthritis*	Points or cm2	Joules
Finger PIP or MCP	1-2	4
Wrist	2-4	8
Humeroradial joint	1-2	4
Elbow	2.4	8
Glenohumeral joint	2-4	8	Minimum 4 Joules per point
Acromioclavicular	1-2	4
Temporomandibular	1-2	4
Cervical spine	4-12	16	Minimum 4 Joules per point
Lumbar spine	4-8	16	Minimum 4 Joules per point
Hip	2-4	12	Minimum 6 Joules per point
Knee medial	3-6	12	Minimum 4 Joules per point
Ankle	2-4	8

Daily treatment for 2 weeks or treatment every other day for 3-4 weeks is recommended Irradiation should cover most of the pathological tissue in the tendon/synovia.

Start with energy dose in table, then reduce by 30% when inflammation is under control Therapeutic dose windows typically range from +/- 50% of given values, and doses outside these windows are inappropriate and should not be considered as Low Level Laser Therapy/ Photobiomudulation Therapy. Recommended doses are for White/Caucasian skin types based on results from clinical trials or extrapolation of study results with similar pathology and ultrasonographic tissue measurements.

Disclaimer

The list may be subject to change at any time when more research trials are being published. World Association of Laser Therapy is not responsible for the application of laser therapy in patients, which should be performed at the sole discretion and responsibility of the therapist.

Revised April 2010

Recommendation for treatment with Photobimodulation Therapy

The chart below describes the recommended treatment with LLLT/PBM and is based on articles along with guidelines from the website Laser World (www.laser.nu), which is sponsored and operated by the Swedish Laser-Medical Society, SLMS. Laser World is a non-profit website. Dosage and number of treatments are not definitive but general recommendations. In the case of deeper damage, the dose should be increased accordingly.

Table of recommendation for treatment with Low Level Laser Therapy/Photbiomodulation Therapy

ENERGY-LASER L500 PRO (Bluetooth) transmits 5 joules between each emission, “beep” (10 sec.)
Studies / documentation: www.laser.nu

Ailments / symptoms	Dose (Joule/Area)	Method	Time interval between treatments	Total number of treatments
Acne Vulgaris	2 – 5 J / cm²	Spot treatment	2 – 3 days	4 – 10
Allergic rhinitis	4 -5 J / cm²	Spot treatment	2 – 3 days	5 – 10
Herpes simplex (cold sore)	4 -5 J / cm²	Spot treatment	Every day	2 – 3
Arthritis	4 -5 J / cm²	Spot treatment	2 – 3 days	8 – 10
Epicondylitis	4 -5 J / cm²	Spot treatment	2 – 3 days	8 – 10
Mucositis	4 -5 J / cm²	Spot treatment	2 – 3 days	5 – 10
Fibrositis	4 -5 J / cm²	Spot treatment	2 – 3 days	10 – 20
Hypersensitive dentine	4 -5 J / cm²	Spot treatment	2 – 3 days	5 – 10
Wound healing (edge of wound)	4 -5 J / cm²	Spot treatment (edge of wound)	2 – 3 days	3 – 10
Wound healing (open wound)	2 J / cm²	Laser held 2 cm above wound	2 – 3 days	3 – 10
Scars and pregnancy stretch marks	4 -5 J / cm²	Spot treatment	2 – 3 days	10 – 20
Nerve inflammation	4 -5 J / cm²	Spot treatment	2 – 3 days	5 – 10
Muscle knots and pain	5 – 50 J / point	Spot treatment	Every day (new injuries), max 3 days
Muscle knots and pain	4 -5 J / cm²	Spot treatment	2 – 3 days	5 – 10
Pain (acute)	5 – 50 J / cm²	Spot treatment	Every day (new injuries), max 3 days
Pain (subacute)	4 -5 J / cm²	Spot treatment	2 – 3 days	5 – 10
Arthritis in joints	4 -5 J / cm²	Spot treatment	2 – 3 days	10 – 15
Acupuncture and reflexology	5 – 15 J / cm²	Spot treatment	2 – 3 days	3 – 10
Tendinitis	4 -5 J / cm²	Spot treatment	2 – 3 days	3 – 10
Removal of foot warts	5 – 10 J / point	Spot treatment	6 – 10 days	3 – 5
Trigger Points	5 -15 J / cm²	Spot treatment	2 – 3 days
Tinnitus	50 – 300 J / ear	Spot treatment	2 – 3 days	10 – 20
Inflammation of the ear	50 – 300 J / ear	Spot treatment	2 – 3 days	2 – 3
Sinusitis	5 – 10 J / ear	Spot treatment	2 – 3 days	2 – 3
Sjögren Syndrome	5 – 10 J / ear	Spot treatment	2 – 3 days	3 – 10
Post Herpetic Neuralgia	5 – 10 J / ear	Spot treatment	2 – 3 days	3 – 10
*Dosage and total number of treatments should be taken as general recommendations*
Treatment of animals = same method as for humans – – – – – – – – – – Higher dosage is required for deeper lying injuries