This question is becoming more common as we see more laser and light therapies being done by inexperienced therapists, often with insufficient devices. Now is a good time to dig into this somewhat difficult topic of why laser therapy does not always work for every patient.
We have addressed the frequently asked question, "how much does laser therapy cost? " That is an important factor. If you are going to commit to a course of laser therapy, or if you are investigating this treatment option for a loved one, it is good to know what you can reasonably expect out of laser therapy. Laser is not a magic wand that makes all your problems go away. Although we do not think anybody consciously thinks that, sometimes there is the underlying idea that this "magical" light will fix any problem. As with anything, laser therapy has success and failure rates. Laser therapy generally has high success rates for a lot of different conditions, but there is always going to be a small percentage of people who do not have the same success.
Make Your Laser Therapy Care Successful
What we want to do is to talk about why failure rates for laser may happen, as well as what you can do as a patient to respond to that failure. There are a number of variables to understand, such as what is going on behind the scenes and what you can do to make sure you are doing your part to help the healing process progress.
What can you do to help give this process the best chance of success?
One crucial factor is activity modification. This means changing the activities you are doing that might be feeding into or aggravating the problem. For example, if you visit your laser provider's clinic with carpal tunnel syndrome (burning, stinging and numbness in the hand), it might be because you are utilizing a bad setup at your desk are overworking your wrist. This may cause both swelling and irritated nerves. If that were the case, you would have to change that, right? We cannot simply laser that wrist while you continue using the same, poor ergonomics at your desk. If that problematic activity does not stop, your carpal tunnel syndrome will also not stop. A problem will persist until you remove the cause. Similarly, the same thing applies for things like diabetic neuropathy: If you have diabetic neuropathy, the nerves have been damaged from high levels of sugars. Laser therapy can have amazing results with diabetic neuropathy, but not if your sugars stay high. If you are drinking alcohol and are partaking in uncontrolled sugar binges every night, you are not going to get better. At best, laser may prevent you from continuing to get worse, but you have to address whatever is creating the problem.
This is the most influential reason why we see patients fail to improve while receiving laser treatments: They cannot (or will not) address what has created and further agitated their condition. So, whatever the condition is that you are looking to get evaluated or looking to treat with laser therapy, you need to look at the causative factors as well. What is creating this problem for you? Have you removed those factors from your lifestyle?
2. Am I being treated by the right type of laser?
The next thing you should look at is the light therapy device that is being used. There are a large number of therapeutic light/laser therapy devices out there, and they are not all created equally. There are differences in laser vs. non-laser light sources, differences in the power, differences in the ways in which the settings are used, and variances in the way the light is actually delivered, as well as in the wavelengths (colors) each device includes. The color of the laser is a massive factor because, if you are not using the right wavelength of light, you are not going to get the desired results.
Near-Infrared vs. Red Light Therapy
If you have been reading other articles from this blog, you probably already know that we are a research-based organization. So, we are going to give you a quote on wavelength, and we are going to refer to this source a couple of times throughout this post. A paper was published in February of 2020 in Lasers in Surgery and Medicine, titled: Microcirculatory Response to Photobiomodulation-Why Some Respond and Others Do Not: A Randomized Controlled Study. The authors of the study say that, when it comes to wavelength, "near-infrared light was found to induce greater stimulation of skin blood flow and arteriolar blood volume pulse compared to the red light." The near-infrared light that is invisible to the human eye produced greater results while the visible red light did not produce that same increase in blood flow.
They go on to say that "it is well-established that near infrared light has greater penetration of depth compared with red light, which might explain the superior effects on the microvascular response found in this study." What they are saying there is that visible red light does not have the same deep-tissue effects as near-infrared light has (which is light that is in the range from 700 to approximately 1100 nanometer wavelengths). Again, this is outside the visible spectrum and is invisible. Because of this, you cannot distinguish the difference with the human eye, but the tissues respond differently to wavelengths in that near-infrared spectrum compared to how they respond to visible light. The same thing goes for visible blue light or green laser. Simply put, your doctor must use the correct color of laser light to deliver positive results.
The Right and Wrong Way to Laser
The next factor here is the technique and application of laser treatments.
The technique that the doctor or laser tech uses while applying therapeutic light makes a big difference. If the provider does not know what they are doing—for instance, if they are using the wrong application pattern or if they are not staying perpendicular to the tissues with the actual laser handpiece—very poor results can and will occur.
Here is another large factor: the number of treatments.
Laser is not a "one and done" type of treatment. Typically, most cases are going to need a series of treatments—maybe a few times a week for a number of weeks; after that, some patients may need more (depending on the case). It is important to have a repetition in treatments. That way, the tissues can respond over time and produce good, accumulative results. Laser therapy is an additive treatment, which means that each treatment builds on the ones before it. So, if you have a condition that needs significant tissue repair and regeneration, treating that condition will take time. The number of laser sessions necessary for improvement is also dependent on the type of tissues being treated. Nerve tissues (treated in conditions such as neuropathy) are slow to heal and slow to rebuild. As such, one treatment for diabetic neuropathy does not necessarily mean you will immediately feel better, so you should not really expect any success after just one or two treatments with neuropathy. That said, there are outliers: There are patients who notice improvement after one or two treatments. However, in the vast majority of cases, patients need to receive multiple treatments in a row. This does not necessarily mean you must get treated for the rest of your life. It just means that most conditions require a series of treatments before getting resolved. In most cases, if a healthcare provider tells you that it will probably take X number of treatments, they have reasons behind that. You can ask. . .
How do we measure success?
What are the benchmarks of success?
How do we make sure that I am actually getting better and going to stay better?
Will we be re-examining my condition intermittently to make sure I'm improving?
Are we retesting anything or redoing any imaging (such as x-rays)?
It is important that you are informed and that your provider takes the necessary steps to give you the best care available.
Nutrition and Laser Therapy
Another big factor that ties into the success rate of laser therapy is nutrition. If you have the best carpenter in the world and you bring them into your kitchen and say, "I want you to make me some awesome, new cabinets," yet you do not give them anything to work with, your cabinets are not going to look awesome. Matter of fact, nothing is going to happen, right? Even a master craftsman has to have the raw materials to work with. However, if you bring in the right materials—the glue, the nails, the wood—then you can expect a great product. It is the same with laser therapy and nutrition: If you expect to have any kind of lasting benefit from laser, including pain relief and healthier tissues, then you have to supply your body with the ingredients necessary to support the work laser will be doing for you.
There are several key aspects of nutrition that your doctor should review with you. We cannot make any recommendations on this blog because everyone has varying needs. What we can say is that what you put into your body matters—and it matters a lot. You have to pay attention to your nutrition. If you are eating one meal a day because you just do not have an appetite, you are not going to have enough intake to be successful with laser because your body will not have an ample supply of the ingredients it requires. To that point, even if you are eating well, if you are not taking any supplements, you might not be successful with laser. Why is this? Laser therapy helps the body accelerate its natural healing process. Everybody's natural healing process requires an adequate supply of nutrition. To accelerate that healing process, you will most likely need to increase your body's nutritional supply. Essentially, when receiving laser, your body will be saying, "If you want me to work overtime for you in order to speed up this healing process, I'm going to need you to provide me with more materials to work with." Just like the carpenter making your awesome cabinets, your input determines your output. One last thing we'll say on this subject is about hydration: Most individuals are dehydrated and do not realize it. The human body needs water, and it especially needs it while receiving laser treatments. Ask your doctor for more details on which nutritional and supplemental plan would work best for you.
For the last factor, we will go to what the authors of the aforementioned study said: "[P]hotobiomodulation induces arteriovasal dilation that results in both immediate and long lasting increased capillary flow and tissue perfusion." This means you get more, better blood flow. However, there's a catch: The researchers only observed these positive results in healthy individuals. So, light therapy produces better circulation, but only in healthy individuals. Why did they specify that? Well, what they found in this study is that the unhealthier individuals (particularly individuals with metabolic conditions) did not respond nearly as favorably as the healthier subjects did. Metabolic factors can include things like thyroid disorders or diabetes, which can limit laser therapy's effects. However, if you have a thyroid condition or a diabetic condition, you can still have good improvement with laser therapy. But understand that those types of conditions are potentially going to reduce the speed at which you can improve. Why is this? As you may know, laser therapy relies on getting more blood flow to damaged areas. So, when you have a metabolic disorder, your body's ability to improve blood circulation could be limited, resulting in lackluster outcomes or in delays in improvement.
These factors help to explain some of the failure rates patients and clinicians see. Now let's look at the factors for success!
7 Factors for Laser Therapy Success
To quickly recap what we just talked about:
There is always going to be a success and failure rate. In laser therapy, there is typically less than 20% of patients who do not benefit from a laser therapy care plan. For LTI Member Clinics, it is likely to be less than 10% who do not have success in their care.
You cannot expect laser therapy to resolve your condition if you keep doing the same thing that has caused the problem.
Seek out the correct laser device—typically a professional, class IV piece of equipment like LTI Members use.
Make sure you entrust your care to someone who knows what they are doing and applies the correct technique (again, like LTI Members).
Get a care plan that makes sense. Laser is not "one and done." It will require a treatment plan of several treatments linked together.
Have a doctor review your nutritional needs; work with your doctor to develop a plan you can follow; then stick to the plan.
Understand your condition and other disorders because they often affect your body's response to laser, as well as how fast it responds to laser. Remember, though: Experiencing slow results does not mean you are experiencing no results! Being healthy is a lifelong journey, but it is worth the time and investment.
3 Things You Can Do to Get the Best Laser Results
As a patient, there are 3 things you can do to help give you the best chance at success.
Find a good laser therapy provider.
You need to have someone who knows what they are doing. Not your cousin Bob who bought a laser pointer on eBay. You need to go to someone who has a professional level of training in delivering light therapies. If you go to a Laser Therapy Institute clinic, you will receive great applications of laser treatments with good techniques from high-quality laser devices that are being utilized by practitioners who are committed to delivering great care. If you visit a clinic that does not have those characteristics, your success rates will be much lower than they should be.
Completely describe all your additional health conditions and concerns.
This sounds obvious to a lot of people, but frequently we will have patients come to us, talk to us about their foot pain only, and we will start working on that. Then, come to find out a couple of treatments or weeks later, they have major problems with their lower back and hips. All along, those conditions were contributing to their foot pain. If they had disclosed that to us earlier, we could have been more successful more quickly. So, make sure you completely describe all those additional health issues because they could be impacting your primary condition, even if you don't think they are.
Follow your provider's instructions.
That might include things like not going to the gym (or going to the gym) or avoiding certain foods (even foods you love). You have to follow those recommendations. If that means controlling sugars or if that means you have to stop drinking, then you have got to do it. Otherwise, your success rate is going to go down.
If you can do those 3 things, you will be addressing everything you can on your end as a patient.