Theory Behind Laser Treatment for Plantar Fasciitis

What is Laser Treatment?

Laser treatment utilizes a spectrum of the light wave to penetrate the human body and provide treatment. There are a variety of ailments in a variety of specialties that espouse the virtues of this treatment. Chiropractors, physical therapists, acupuncturists and medical doctors all use lasers to treat certain problems.

Although there may be a benefit to using laser therapy for some problems, this product/technique may not be able to do all for which it is marketed. One product advertises the following list of benefits to physicians:

  • Anti-inflammatory
  • Analgesic
  • Accelerated tissue repair and cell growth
  • Improved vascular activity
  • Increased metabolic activity
  • Trigger point relief
  • Acupuncture points
  • Reduced fibrous tissue formation
  • Improved nerve function
  • Immunoregulation
  • Faster wound healing

The Science Behind Laser Treatment

Cytochrome c oxidase absorbs laser wavelengths in the mitochondria. The mitochondria is a structure within a cell that stores energy and DNA (maternal). The cell is the basic building block of life. The overall effect of the laser depends on the wavelength frequency, location and length of treatment.

The theory states that the mitochondria in a stressed cell produce nitric oxide.  This blocks oxygen from binding to the Cytochrome c oxidase and reduces the production of adenosine triphosphate (ADTP). This is happening in the mitochondria and there is consequently less energy.

Cellular energy can come from ATP. Worse, stressed-out cells produce reactive oxygen species that damage tissue. The laser is thought to stop this process. Low-level laser dissociates the nitric oxide and lets in the oxygen. Therefore, there is less oxidative stress from the reactive oxygen species.

Laser treatments are known as ‘photobiomodulation’. Basically, it means that light manipulates tissue and biologic processes. Infrared or near-infrared wavelengths called ‘low’ level are utilized because it is not the laser of weapons and such. Additionally, low-level lasers are not powerful enough to heat tissue and therefore it is also sometimes called ‘cold’ laser.

 

Laser Treatment In Practice

Laser therapy has good clinical evidence that it works, but it is unclear exactly how it works. It heals wounds by causing the tissue to release cytokines, chemokines and other inflammatory modulators that start the healing cascade.

There is a consideration that the laser increases the production of macrophages and fibroblasts; this increases the production of collagen. It is also thought to promote vascular growth. Nonetheless, the literature available is conflicting and there is no definitive evidence yet of its efficacy. A low-level laser is used for hair growth as well. Apparently, the light waves manipulate the hair follicle’s growth stage. This promotes growth and also can make hair thicker and more robust.  The hair caps and combs one sees advertised on television are utilizing this theory.

There is some clinical evidence that LLL therapy can treat pain and trigger points effectively as well. This is why some practitioners use lasers to treat plantar fasciitis pain. However, it is not known what exact wavelength, for how long, at what depth and in what clinical scenario is best.

Utilization and application vary widely between studies. Therefore, it is very difficult to state that the laser really worked. Most treatment programs involve multiple visits for a certain amount of time; insurance does not cover this treatment.

 

Written by Dr. Merefith Warner