The body can develop fibrous connective tissue in response to cellular damage or injury, leading to permanent scar tissue formation.[1] Fibrosis can refer to either the extra tissue buildup that results from a pathological event or the connective tissue deposition that takes place as part of normal healing. Essentially, it is an accelerated wound healing reaction that impairs organ function.
Both the pathogenic condition of excessive fibrous tissue deposition and the placement of connective tissue during healing are referred to as fibrosis. The most commonly used treatment for fibrosis is surgical debridement, which causes the formation of scar tissue; so alternative methods are being explored with Laser Therapy, promising positive results.
What is Laser Therapy?
Laser stands for Light Amplification by Stimulated Emission of Radiation and has been used in pain management for years.[2] [3] Also called Low-Level Laser Therapy (LLLT) and photobiomodulation, Laser Therapy is a form of phototherapy where light is used to trigger biochemical changes within cells. Studies have demonstrated several benefits of Laser Therapy through enhanced ATP production and an increase in Nitric Oxide, which is an important signaling molecule that plays a key role in cellular function.[4]
How does Laser Therapy Treat Fibrosis?
Fibrosis is caused by excessive accumulation of extracellular material in response to injuries. Lower power lasers are generally used by therapists to treat chronic fibrosis.[5] It is shown to have reduced the risk of scar formation by enhancing absorption of hematoma through improved circulation in musculoskeletal injuries.[6] Laser Therapy can also speed up the degradation of both fibrin networks and clotted blood.[7]
For the treatment of fibrosis, it is necessary to inhibit the acute inflammatory response and accelerate cellular regeneration and recovery. Laser helps prevent or reduce fibrosis by modulating the body’s inflammatory response and preventing cellular oxidative stress.[8]
Laser and Fibrosis: Research
Numerous bodily tissues are susceptible to fibrosis, which often results from injury or inflammation. Both surgical and pharmacological measures are not much effective and have potential side effects such as scarring. Laser Therapy is a safe, non-invasive, non-pharmacological treatment for fibrotic conditions. Here are some studies that document the efficacy of Laser Therapy for fibrosis.
Treatment of Muscle and Tendon Injuries
LLLT is commonly used to treat muscle injuries due to its positive effects. It has been shown to modulate the inflammatory response, enhance the tissue repair process, and prevent the onset of fibrosis in traumatized muscles or tendons.[9]
Acute Tibial Anterior Muscle
A study assessed the effects of LLLT on the morphological characteristics of muscle tissue, collagen remodeling, and matrix activity in rat skeletal muscle after acute damage.[10] The findings revealed that LLLT reduced inflammatory infiltration after 1 day, increased blood vessel density after 3 and 7 days, and increased the number of immature muscle fibers after 7 days. In summary, LLLT improves the structure and distribution of collagen as well as the inflammatory process in the rat skeletal muscle regeneration process, preventing fibrotic activity.
Similar results were shown by another study, which suggests that in case of muscle injury, LLLT may be a useful treatment modality for skeletal muscle regeneration and tissue fibrosis prevention.[11]
Achilles Tendon Injury
The effects of Low-Level Laser Therapy were studied on experimental Achilles models of tendon injury in rats. Inflammation, angiogenesis, loss of normal architecture, and formation of extracellular matrix as a result of trauma. The experimental group underwent 21 days of Laser Therapy. The results showed that LLLT prevented oxidative stress by reducing histological abnormalities and collagen concentration in traumatized Achilles tendons, resulting in reduced fibrosis.[12] In rats with chronic alcohol consumption, LLLT was able to boost the regeneration of skeletal muscle.
Post-Operative Oral Submucous Fibrosis
OSF, or oral submucous fibrosis, is among the most common, potentially malignant oral disorders. Multiple treatments, including medicinal and surgical approaches, are used, which can result in negative fibrotic changes. One research project studied the effects of LLLT on arecoline-induced OSF.[13] The results showed that Laser Therapy inhibited the expression of fibrotic markers in almost all patients. Another study included a systematic review of 20 studies, where almost all of them showed that a Laser poses an effective post-operative treatment in OSF patients.[14] With variations in each case, patients’ complaints, such as decreased tongue protrusion and reduced burning sensation, all improved along with complete healing and enhanced mouth openness.
Laser Therapy can be your ultimate approach to treating fibrosis, as its effectiveness is well documented. It finds major application in treating muscle and tendon injuries, which make up around 55% of all acute sports injuries.[15] [16] Check out our continuous wave lasers. These are FDA-cleared and can be customized to suit each patient’s needs. Have questions? Feel free to contact us, and we would be happy to help.
Citations
[1] Mahdy MAA. Skeletal muscle fibrosis: an overview. Cell Tissue Res. 2019 Mar;375(3):575-588. doi: 10.1007/s00441-018-2955-2. Epub 2018 Nov 12. PMID: 30421315.
[2] Montes-Molina R, Prieto-Baquero A, Martínez-Rodríguez ME, Romojaro-Rodríguez AB, Gallego-Méndez V, Martínez-Ruiz F. Interferential laser therapy in the treatment of shoulder pain and disability from musculoskeletal pathologies: a randomised comparative study. Physiotherapy. 2012 Jun;98(2):143-50. doi: 10.1016/j.physio.2011.02.007. Epub 2011 May 28. PMID: 22507365.
[3] Hsieh RL, Lee WC. Short-term therapeutic effects of 890-nanometer light therapy for chronic low back pain: a double-blind randomized placebo-controlled study. Lasers Med Sci. 2014 Mar;29(2):671-9. doi: 10.1007/s10103-013-1378-2. Epub 2013 Jul 3. PMID: 23820974.
[4] Farivar S, Malekshahabi T, Shiari R. Biological effects of low level laser therapy. J Lasers Med Sci. 2014 Spring;5(2):58-62. PMID: 25653800; PMCID: PMC4291815.
[5] GD Baxter, AJ Bell, JM Allen, J Ravey, Low Level Laser Therapy: Current Clinical Practice in Northern Ireland, Physiotherapy, Volume 77, Issue 3, 1991, Pages 171-178, ISSN 0031-9406,
[6] Kiyoizumi T. Low level diode laser treatment for hematomas under grafted skin and its photobiological mechanisms. Keio J Med. 1988 Dec;37(4):415-28. doi: 10.2302/kjm.37.415. PMID: 3066958.
[7] O’Kane S, Shields TD, Gilmore WS, Allen JM. Low intensity laser irradiation inhibits tritiated thymidine incorporation in the hemopoietic cell lines HL-60 and U937. Lasers Surg Med. 1994;14(1):34- doi: 10.1002/lsm.1900140110. PMID: 8127205.
[8] Fujimaki Y, Shimoyama T, Liu Q, Umeda T, Nakaj S,Sugawara K. Low-level laser irradiation attenuates production of reactive oxygen species by human neutrophils. J ClinLaser Med Surg 2003;21:165–170
[9] Leal-Junior EC, de Almeida P, Tomazoni SS, de Carvalho Pde T, Lopes-Martins RÁ, Frigo L, Joensen J, Johnson MI, Bjordal JM. Superpulsed low-level laser therapy protects skeletal muscle of mdx mice against damage, inflammation and morphological changes delaying dystrophy progression. PLoS One. 2014 Mar 5;9(3):e89453. doi: 10.1371/journal.pone.0089453. PMID: 24599021; PMCID: PMC3943729.
[10] Alves AN, Fernandes KP, Melo CA, Yamaguchi RY, França CM, Teixeira DF, Bussadori SK, Nunes FD, Mesquita-Ferrari RA. Modulating effect of low level-laser therapy on fibrosis in the repair process of the tibialis anterior muscle in rats. Lasers Med Sci. 2014 Mar;29(2):813-21. doi: 10.1007/s10103-013-1428-9. Epub 2013 Aug 28. PMID: 23982721.
[11] Assis L, Moretti AI, Abrahão TB, de Souza HP, Hamblin MR, Parizotto NA. Low-level laser therapy (808 nm) contributes to muscle regeneration and prevents fibrosis in rat tibialis anterior muscle after cryolesion. Lasers Med Sci. 2013 May;28(3):947-55. doi: 10.1007/s10103-012-1183-3. Epub 2012 Aug 17. PMID: 22898787; PMCID: PMC3521873.
[12] Fillipin LI, Mauriz JL, Vedovelli K, Moreira AJ, Zettler CG, Lech O, Marroni NP, González-Gallego J. Low-level laser therapy (LLLT) prevents oxidative stress and reduces fibrosis in rat traumatized Achilles tendon. Lasers Surg Med. 2005 Oct;37(4):293-300. doi: 10.1002/lsm.20225. PMID: 16196040.
[13] Yeh, MC., Chen, KK., Chiang, MH. et al. Low-power laser irradiation inhibits arecoline-induced fibrosis: an in vitro study. Int J Oral Sci 9, 38–42 (2017). https://doi.org/10.1038/ijos.2016.49
[14] Gupta, S., & Jawanda, M. K. (2021). Laser as a promising non-invasive technique to treat oral submucous fibrosis: A systematic review of the literature. The Saudi Dental Journal, 33(7), 413-423.
[15] Maffulli N, Del Buono A, Oliva F, Giai Via A, Frizziero A, Barazzuol M, Brancaccio P, Freschi M, Galletti S, Lisitano G, Melegati G, Nanni G, Pasta G, Ramponi C, Rizzo D, Testa V, Valent A. Muscle Injuries: A Brief Guide to Classification and Management. Transl Med UniSa. 2014 Sep 1;12:14-8. PMID: 26535183; PMCID: PMC4592039.
[16] Wu F, Nerlich M, Docheva D. Tendon injuries: Basic science and new repair proposals. EFORT Open Rev. 2017 Jul 27;2(7):332-342. doi: 10.1302/2058-5241.2.160075. PMID: 28828182; PMCID: PMC5549180.
