Class IV Laser Therapy Photobiomodulation

Class IV Laser Therapy, via photobiomodulation, has been shown to quickly reduce pain and help injured tissue move through the stages of healing by stimulating mitochondrial activity. Class IV Laser Therapy works by flooding the tissue with photons, which energizes cells, resulting in increased circulation to the injured area and ultimately pain reduction, in a process called photobiomodulation. 

Photobiomodulation is the process of photons entering the tissue and interacting with the cytochrome c complex within the cell mitochondria (the energy producing part of a cell). The result of this interaction, and the point of conducting laser therapy treatments, is the biological cascade of events that leads to an increase in cellular metabolism (promoting tissue healing) and a decrease in pain. The main goal of laser therapy is to stimulate the cell to perform its natural functions, but at an enhanced rate. 

Class IV Laser Therapy is used to treat acute and chronic conditions as well as post-activity recovery. In contrast to “cold lasers” or “low level laser therapy,” high power Class IV Laser Therapy provides a warm, soothing feeling and quicker progression through treatment. It is also used as another option to prescription drugs, a tool to prolong the need for some surgeries, as well as pre and post-surgery treatment to help control pain. Unlike pharmaceuticals that mask pain or only address symptoms, Class IV Laser Therapy treats the underlying condition and promotes healing. 

Class IV Laser Therapy and photobiomodulation work by helping with:

• Anti-inflammation: Class IV Laser Therapy has an anti-edema effect as it causes vasodilation, but also because it activates the lymphatic drainage system (drains swollen areas). As a result, there is a reduction in swelling caused by bruising or inflammation.
• Anti-pain (analgesic): Class IV Laser Therapy has a beneficial effect on nerve cells, which decreases nerve sensitivity and reduces the perception of pain in the brain. Class IV Laser Therapy also reduces inflammation, which also reduces pain.
• Accelerated tissue repair and cell growth: Photons of light from Class IV Lasers penetrate deeply into your body to accelerate cellular reproduction and growth. Photobiomodulation increases the energy available to your cells so your cells can take on nutrients faster and get rid of waste products faster. This accelerates healing and cell growth.
• Improved vascular activity: Class IV Laser Therapy will significantly increase the formation of new blood vessels. This speeds up the healing process, closes wounds quickly, and reduces scar tissue.
• Increased metabolic activity: Class IV Laser Therapy creates higher outputs of specific enzymes, greater oxygen, and nutrients for blood cells.
• Trigger points and acupressure points: Class IV Laser Therapy stimulates muscle trigger points and acupressure points on a noninvasive basis providing musculoskeletal pain relief.

You will feel a soothing warmth during Class IV Laser Therapy. Many patients report enjoying the experience, especially when a massage-ball treatment head is used to deliver what is often referred to as a “laser massage.” Patients receiving treatments with higher-power Class IV Lasers also frequently report a rapid decrease in pain. 

•  Acute pain
• Chronic pain
• Improved fracture healing time
• Improved post surgery healing time
• Joint swelling
• Muscle strain and pain
• Tendinopathy and tendinitis
• Ligament sprains
• Muscle strains
• Myofascial pain
• Arthritis related pain
• Neck and back pain (chronic and acute)
• Neuropathy
• Plantar fasciitis
• Achilles tendon pathology
• DOMS (Delayed Onset Muscle Soreness)
• Subacromial impingement syndrome
• Headaches
• TMJ pain
• Lymphedema

Class IV Laser Therapy (now called photobiomodulation, or PBM) devices were cleared in 2004 by the FDA for the safe and efficacious reduction of pain and increasing micro-circulation. Class IV Lasers are a safe and effective treatment option to reduce musculoskeletal pain and improve healing. The biggest risk to injury during laser therapy treatments is to the eye, which is why certified, protective eyewear is always required.

Class IV Laser Therapy treatments are quick usually 3-10 minutes depending on the size, depth, and if your injury is acute or chronic. High-power lasers are able to deliver a lot of energy in a small amount of time, allowing therapeutic effectiveness to be quickly achieved. 

The best results are when patients receive 2-3 treatments per week for 2-4 weeks initially, then taper down as needed. There is a well-documented research showing the benefits of Class IV Laser Therapy are cumulative, suggesting that plans for incorporating laser as part of your plan of care should involve early, frequent treatments that may be administered less frequently as your symptoms improve.

Most Class IV Laser Therapy plans of care will involve 6-12 treatments. More treatment may be needed for longer standing, chronic conditions. Your Pinecone Physio Doctor of Physical Therapy will develop a treatment plan that is optimal for your condition.

Patients often report improved sensation, including a therapeutic warmth and some pain relief immediately after the treatment. For longer term, noticeable changes in symptoms and condition, patients should undergo a series of treatments as the benefits of Class IV Laser Therapy from one treatment to the next are cumulative.

Class IV Laser Therapy will not limit your activities.  The nature of a specific pathology and the current stage within the healing process will dictate your recommended activity level.  Deep tissue Class IV Laser Therapy will often reduce pain which will make it easier to perform different activities and will often help restore more normal joint mechanics. 

The cost is an add on to your appointment time: $60 each treatment, or 6 treatments for $270, plus the cost of your initial evaluation or appointment time. Appointment time cost may vary depending on if you are being treated by a doctor of physical therapy of a certified laser technician. During your evaluation and subsequent appointments, additional recommended treatments may include Functional Dry Needling, extracorporeal shockwave therapy (ESWT), and therapeutic activities. Health insurance often covers evaluations, therapeutic exercises, neuromuscular re-education, and therapeutic activities. ESWT, Functional Dry Needling, and Class IV Laser Therapy are usually not covered by health insurance.

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