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104 Veterinary Laser Therapy in Small Animal Practice
But if you ever read examples of recommendations I won’t insult your intelligence by offering up a
in the form of “fractures are best treated with X wave- standard lookup table where X pathology gets Y laser
length of light” or “arthritis responds best to Y frequen- parameters. With that said, I can’t in good conscience
cies,” do me a favor and cringe a little. leave this section without giving you at least a ballpark
You may be able to say that bones, being higher in approximation of how best to tailor your treatments to
calcium content and lower in water content, may be the patient and condition presented.
targeted with lower frequencies. But you still have to One last hesitation: literature references for what
get through dermis and soft tissue to get to that bone, you are about to see are scarce, again simply because
so it is important to keep that in mind. most clinical papers are meant to show THAT a
To talk about arthritis in general terms, though, given parameter-set worked, not compare two differ-
is entirely too vague. Arthritis is inflammation of the ent parameter-sets. And even then, there are so many
joint, which is composed of bone, cartilage, tendons, more variables to consider than just frequency (dose,
ligaments, blood vessels, and even some musculature. wavelength, power density, treatment frequency, etc.)
Granted, your goal is an anti-inflammatory effect, and to find the optimum treatment. Please don’t email us
to a lay technician you are simply shining light on the saying, “but I read a paper that used frequency X on
stifle and hoping to decrease the size of it, but having tissue Y and you said that one wouldn’t work.”
read this far into the book, you (we hope) have a better So the final disclaimer is that Table 8.1 shows our
understanding of how the individual tissues respond opinion – formed from the theory of the fundamental
for the greater good. interactions of light with tissue combined with per-
sonal experience treating patients with lasers of a wide
Different pathologies can have different therapeutic frequency spectrum (CW and pulsing up to 25,000 Hz)
goals. Tendinitis means a tendon is inflamed, and and sprinkled with a little literature review – of the ball-
that it has undergone an acute or heavy force that park scale of frequencies suited for the variety of tissue
has led to small tears. So the goal would be to either types found in your patients.
decrease inflammation and/or make it resolve faster
and with a better result. If the body fails to properly
resolve this inflammatory state, chronic degenerative Summary from a
changes can happen to the collagen, leading to different perspective
tendinosis. At this point, rather than treating
inflammation, the goal is to help the Firstly, a reminder that dose and effect don’t
tendon generate proper (in terms of have a linear relationship. What’s more, different
amount and type) collagen and blood tissue types may respond differently to changes in
supply. Although tendon and connective parameters of dose and frequency of pulsing. The
tissue in general would have a higher affinity for reason why frequency of pulsing and dark phase
medium frequencies due to their water content and duration are important seems to be related to the
structure, with the scientific data available today ability of the cells to dissipate the heat, and this
there is no point in saying 500 Hz will be stimulating is closely related to the amount of water in the
collagen synthesis while 2000 Hz will treat tissue. It is therefore hypothesized that tissues
inflammation. Or that it won’t absorb and make with lower water content, such as bone, can
good use of CW. The tendon will absorb the light, benefit more from lower frequency pulses (longer
improve metabolism, and work in a more dark phases). But in practice, most injuries/
physiological way. conditions involve different tissue types, so a
Nevertheless, you may want to keep in mind that good strategy seems to combine different pulsing
an acute tendinitis can be painful and may tolerate frequencies, either in a single treatment or at least
lower power density or less pressure/contact during over the course of a series of visits.
the treatment.
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