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 | |
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Dosage and total number of treatments should be taken as general recommendations |
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| Treatment of animals = same method as for humans – – – – – – – – – – Higher dosage is required for deeper lying injuries | |||||