Shoulder conditions, such as subacromial impingement, rotator cuff tear, and adhesive capsulitis (frozen shoulder), can lead to a range of problems, including pain and reduced range of motion. Mainstream treatments, such as nerve block, are not much effective, while surgical interventions pose the risk of permanent scar tissue.[1]
Laser Therapy also known as Low-Level Laser Therapy (LLLT) is now commonly used in the treatment of various conditions, including musculoskeletal and post-operative pain. It can provide relief from pain and inflammation by restoring damaged tissue and accelerating the healing process. The medical world is now turning towards Laser Therapy to address shoulder related conditions, as it is a safe, non-invasive, yet effective method of treatment.[2]
Laser Therapy and Shoulder Pain
Laser therapy is the use of photons to cause irradiance; a process that helps influence biological activity. The basic mechanism of laser therapy is the absorption of red and near-infrared light by cytochrome C oxidase, which are mitochondrial chromophores.[3]
Research suggests that LLLT stimulates fibroblasts and facilitates collagen synthesis, aiding in connective tissue repair.[4] In addition to this, LLLT also has anti-inflammatory and analgesic effects.[5] Studies with animal models also demonstrate that Laser Therapy accelerates nerve regeneration.[6] Here are some of the other processes involved in Laser Therapy:
- Reduced nerve sensitivity
- Reduced inflammation due to increased ATP production
- Accelerated tissue repair
- Augmented healing
- Increased formation of new capillaries
- Reduction in scar tissue
Shoulder conditions are most commonly caused by musculoskeletal pain, which can also result in restricted motion. Laser Therapy is found to be effective in treating pain and disability caused by musculoskeletal conditions. A meta-analysis that investigated the efficacy of Laser Therapy among patients with musculoskeletal conditions found a 95% difference in pain.[7]
A systematic review of literature studied the efficacy of non-drug, non-surgical interventions in the treatment of four shoulder conditions: shoulder impingement syndrome, disorders related to the rotator cuff, adhesive capsulitis, and chronic pain.[8] Exercise, physical therapy, shockwave therapy, and Low-level Laser Therapy were studied. The results concluded that among all modalities, LLLT was the only treatment modality which was effective for all four conditions.
Sub-acromial Impingement Syndrome
This is the most common cause of shoulder pain and involves inflammation of the rotator cuff tendons. Subacromial impingement syndrome can also result in a reduced range of motion. A study assessed the effect of Laser Therapy when used in conjunction with exercise to measure several parameters, including pain, overall movement, and disability in patients with this condition. [9] The Study involved 67 patients and the results showed that all participants demonstrated significant improvements in all parameters. Another study assessed the levels of pain and shoulder range of motions among 80 patients who suffered with subacromial syndrome. [10] The results showed that exercise and Laser Therapy combined were more effective in improving pain and range of motion than exercise alone.
Rotator Cuff Tear
Laser Therapy can be effective in speeding up the healing process of a torn rotator cuff. Healing from a torn rotator cuff involves complex processes that may alter the tissue negatively. Evidence shows that Laser Therapy can help restore the tissue by biologically augmenting the cells.[11] This suggests that Laser Therapy can indeed be helpful not only with pain management of a torn rotator cuff but also enable a greater range of mobility by returning the tissue to its normal physiological state.
Adhesive Capsulitis (Frozen Shoulder)
This condition causes pain and stiffness in the shoulder, beginning with inflammation and ending in fibrosis. Since Laser Therapy can target joint stiffness and inflammation, it is effective to treat frozen shoulder, as it enhances blood circulation and cellular repair—restoring mobility.[12]
Post-Operative Shoulder Pain
Laser Therapy has been found to be highly effective in post-surgery recovery. It can not only inhibit the formation of scar tissue, but due to its anti-inflammatory and analgesic effects, it can also accelerate the healing process after shoulder surgery.[13] One study that assessed the efficacy of Laser Therapy in addressing post-operative aseptic wound. The results showed that it can stimulate the healing process, causing rapid recovery. [14]
Benefits of Laser Therapy
During this treatment, the laser is placed against the skin, where photons initiate several physiological processes that restore normal cellular function. You can avoid painful physical therapy or surgery and opt for a treatment with no known side effects.
Laser Therapy is widely being used to treat a variety of conditions as it is painless, non-invasive, and saves patients from surgical intervention. It is also a quick and easy process and doesn’t affect the patient’s normal routine during or after the treatment.
Laser Therapy is increasingly being used as an adjunct in treating pain and inflammation in a variety of musculoskeletal conditions.[15] Evidence, as shown above, suggests that the addition of photobiomodulation in shoulder treatment can play a key role in stimulating healing, accelerating tissue repair, providing relief in pain and inflammation, and restoring function. With our FDA-cleared laser devices, you get a variety of different wavelengths so that you can customize the treatment. You can contact us if you have more questions, and we would be happy to assist.
Citations
[1] Chang KV, Wu WT, Hung CY, Han DS, Yang RS, Chang CH, Lin CP. Comparative Effectiveness of Suprascapular Nerve Block in the Relief of Acute Post-Operative Shoulder Pain: A Systematic Review and Meta-analysis. Pain Physician. 2016 Sep-Oct;19(7):445-56. PMID: 27676661.
[2] Hamblin, M. R., Agrawal, T., & de Sousa, M. (Eds.). (2016). Handbook of low-level laser therapy. CRC Press.
[3] Enwemeka CS, Parker JC, Dowdy DS, Harkness EE, Sanford LE, Woodruff LD. The efficacy of low-power lasers in tissue repair and pain control: a meta-analysis study. Photomed Laser Surg. 2004 Aug;22(4):323-9. doi: 10.1089/pho.2004.22.323. PMID: 15345176.
[4] Pereira AN, Eduardo Cde P, Matson E, Marques MM. Effect of low-power laser irradiation on cell growth and procollagen synthesis of cultured fibroblasts. Laser Surg Med. 2002;31(4):263–7.
[5] Almeida-Lopes L, Rigau J, Zângaro RA, Guidugli-Neto J, Jaeger MM. Comparison of the low level laser therapy effects on cultured human gingival fibroblasts proliferation using different irradiance and same fluence. Lasers Surg Med. 2001;29(2):179-84. doi: 10.1002/lsm.1107. PMID: 11553908.
[6] Rochkind S. Phototherapy in peripheral nerve regeneration: from basic science to clinical study. Neurosurg Focus. 2009;26(2):E8. doi:10.3171?FOC.2009.26.2E8.
[7] Clijsen R, Brunner A, Barbero M, Clarys P, Taeymans J. Effects of low-level laser therapy on pain in patients with musculoskeletal disorders: a systematic review and meta-analysis. Eur J Phys Rehabil Med. 2017 Aug;53(4):603-610. doi: 10.23736/S1973-9087.17.04432-X. Epub 2017 Jan 30. PMID: 28145397.
[8] Hawk C, Minkalis AL, Khorsan R, Daniels CJ, Homack D, Gliedt JA, Hartman JA, Bhalerao S. Systematic Review of Nondrug, Nonsurgical Treatment of Shoulder Conditions. J Manipulative Physiol Ther. 2017 Jun;40(5):293-319. doi: 10.1016/j.jmpt.2017.04.001. Epub 2017 May 26. PMID: 28554433.
[9] Yeldan I, Cetin E, Ozdincler AR. The effectiveness of low-level laser therapy on shoulder function in subacromial impingement syndrome. Disabil Rehabil. 2009;31(11):935-40. doi: 10.1080/09638280802377985. PMID: 19031167.
[10] Abrisham SM, Kermani-Alghoraishi M, Ghahramani R, Jabbari L, Jomeh H, Zare M. Additive effects of low-level laser therapy with exercise on subacromial syndrome: a randomised, double-blind, controlled trial. Clin Rheumatol. 2011 Oct;30(10):1341-6. doi: 10.1007/s10067-011-1757-7. Epub 2011 May 4. PMID: 21538218.
[11] Eslamian F, Shakouri SK, Ghojazadeh M, Nobari OE, Eftekharsadat B. Effects of low-level laser therapy in combination with physiotherapy in the management of rotator cuff tendinitis. Lasers Med Sci. 2012 Sep;27(5):951-8. doi: 10.1007/s10103-011-1001-3. Epub 2011 Nov 4. PMID: 22052627.
[12] Stergioulas A. Low-power laser treatment in patients with frozen shoulder: preliminary results. Photomed Laser Surg. 2008 Apr;26(2):99-105. doi: 10.1089/pho.2007.2138. PMID: 18341417.
[13] Kuffler DP. Photobiomodulation in promoting wound healing: a review. Regen Med. 2016 Jan;11(1):107-22. doi: 10.2217/rme.15.82. Epub 2015 Dec 18. PMID: 26681143.
[14] Herascu N, Velciu B, Calin M, Savastru D, Talianu C. Low-level laser therapy (LLLT) efficacy in post-operative wounds. Photomed Laser Surg. 2005 Feb;23(1):70-3. doi: 10.1089/pho.2005.23.70. PMID: 15782037.
[15] S. England, A. J. Farrell, J. S. Coppock, G. Struthers & P. A. Bacon (1989) Low Power Laser Therapy of Shoulder Tendonitis, Scandinavian Journal of Rheumatology, 18:6, 427-431, DOI: 10.3109/03009748909102106
