The Laser Marketplace

The manufacturers of virtually all laser devices available today advertise that they are approved by the FDA, Underwriters Laboratory and other regulatory entities. In essence, these approvals simply mean that the devices will do no harm. It does not indicate that the unit is effective in treating most disease entities, whether priced at $250.00 or $25,000. Effective therapy is not necessarily related to the value of the device. The cost of marketing in many instances is responsible for a significant amount of the retail price, whereas the components of the device may be inexpensive and ineffective for appropriate therapy. High quality manufacturers generally do minimal advertising and then only of a scientific nature, adhering to the doctrine of “res ipsi loquitor”.

Low powered, inexpensive, light emitting or laser diodes are generally seated in some sort of a simple base. Power output however is often minimal with concomitant therapeutic value. As always in medicine the placebo effect is at work. In addition to the positive effort of nature, light invariably contributes a healing component no matter how minute, therefore a number of patients will improve with the psychological boost of laser therapy even though it may be of minimal value per se. Indeed, this is inevitable in simple easy to treat cases which would return to normal function without any treatment. As we all know many types of pathology are relieved by rest and nature alone. One must therefore be aware of devices that are marketed based on their cosmetic appearance and not necessarily in keeping with the lack of sophistication and quality of the unit. As always, we interject the axiom, “caveat empor”.

For a laser device to be effective it must have laser probes with diodes emitting between 100 to 200mW of power. Super luminous diodes should deliver somewhere between 6 - 10mW. Treatment must be applied in a therapeutically effective manner through control of frequency, duty cycle, wavelength, waveform, energy density, duration, etc. These settings need to be available over an infinite range with customization for each individual cellular genetic make-up in order to achieve a suitable response. As one can see, myriad factors are involved in engineering an optimally functioning device and considerable scientific and clinical knowledge must be incorporated in the process of evolving effective clinical approaches.

Frequently companies in their advertising claim that they have the “most powerful lasers” available therefore “they are the best.” Nothing could be more misleading. If a laser diode that is highly powerful is applied to the tissue, burning is a significant risk, or at best denaturing of the cellular proteins, processes counterproductive to the healing process.

Other manufacturers advertise the “highest powered laser." If the full power of these systems were placed close to the tissue being treated, cells would be destroyed similar to surgical lasers used to ablate tissue. With healing lasers the output power must be carefully controlled in order to stimulate the cell but not damage the micro-molecules or membrane in any way. One can readily see that the minefield of lasers selection and utilization is problematic and all advertising slogans must be carefully studied and assessed. Always question what you read!

Premium type devices are engineered to achieve maximum healing, without causing cellular damage. This is a relatively narrow spectrum and the margins must not be violated. The best indicator of the capacity to heal can be measured by the functionality achieved, obviating the need for pharmaceuticals and the absence of pain. You must always remember that the hype propagated by many sales personnel is simply designed to confuse you, the therapist, in order to sell the product they represent. Always choose the device that consistently produces the best results from the clinical perspective.