14 Theories to Optimize Laser Therapy

The most common theory—and probably the highest efficacy approach—is direct treatment of areas with known damaged cells. If cells were once healthy but are now damaged and lacking the energy to repair themselves (ATP), applying an appropriate dosage provides the most consistent results.

Most Class 3B manufacturers promote medium dosages as recommended by the European laser therapy associations. Class 4 manufacturers follow dosage theory as well, but generally believe higher dosages yield better results for appropriate conditions.

Another common LLLT theory focuses on pulsing the laser on and off at specific frequencies to stimulate the body. Some companies take this to extremes, promoting protocols with negligible dosage but heavy emphasis on specific pulsing frequencies.

This approach is mainly championed by Erchonia, who spends considerable time in chiropractic schools educating students on their theory. Their newest systems are just 20mW—a 10-minute session delivers only about 12 joules at the surface and less than 1 joule at depth. They also state it's acceptable to treat through clothing, which suggests dosage isn't their priority since a dark shirt can absorb 90%+ of the energy.

Using different wavelengths for different applications has been well established by several manufacturers, notably Thor, Avant, and K-Laser. If budget isn't a constraint, multi-wavelength systems add flexibility and allow practitioners to experiment beyond core photobiomodulation applications.

A small, focused laser with typical power of 100–500mW can be used exactly like a needle in traditional acupuncture. The dosage is typically 2–8 joules per point at the surface, accomplishing the same energy release about 98% of the time.

Laser acupuncture is excellent for children and others who don't like the sensations associated with needles. The therapy is based on releasing blocked energy within the body to restore balance and accelerate natural healing.

Similar to acupuncture, trigger point therapy is common among chiropractors, massage therapists, and physical therapists. In conventional trigger point therapy, pressure is applied to painful points for several seconds to relax problematic muscles.

A laser with a small, blunt tip can release the trigger point while simultaneously adding laser energy to this critical area. Treatment protocols often include these as "static treatment points." If your system doesn't have a dedicated trigger point probe, you can use a laser with a larger treatment area to accomplish similar results.

When an area like an ACL becomes damaged, the entire surrounding area typically becomes inflamed. Best practice involves delivering high photon density to the damaged area AND lower density to the surrounding activated tissue.

This theory treats both the problem (higher dosage) and the symptoms (lower dosage). It also provides superior outcomes when the patient is misdiagnosed—because you're at least delivering some energy to the area of the actual root cause, even if it's not where you think it is.

There's solid rationale for why some people need a somatic reset. In many patients with chronic pain and misalignment, the body has adapted by perpetually holding itself in positions that minimize pain. This causes a cascading effect—other body parts become chronically tight, fatigued, and always on the verge of collapse.

A somatic reset uses large dosages over large areas to reset the nervous system. This typically involves treating the entire back from hips to brain stem, with additional time on back muscles that attach in front. The therapy addresses both the muscles holding the structure in place and the nervous system at critical points.

A growing trend in laser therapy—championed mainly by Thor—is treatment of lymph nodes that control chemical balance and drainage in damaged areas. The dosages used are typically very small, but stimulating lymph glands can help accelerate recovery.

This theory works as an overlay to conventional dosage-based treatments, adding only a few extra seconds to each session. Many protocols in our library include lymph treatment as a standard component.

Another growing trend is treating the brain stem and top of the spinal column, especially important for neurological issues. The theory suggests there may be blockages in this area, and small dosages might help clear them—one doctor compared it to clearing "sludge buildup."

This area is typically covered with hair, which absorbs much of the energy, so medium dosages are acceptable since much energy is lost anyway. Practitioners often use the laser in this area for about 2 minutes, which patients find very pleasant.

This is a secondary treatment principle best used in conjunction with direct treatment of the primary problem area.

An interesting theory dating back to Russian research in 1981, laser blood irradiation originally used IV setups to get laser energy in direct contact with blood. Today, we typically place the laser over areas with major blood flow (wrists, neck, inner elbow).

For patients with problems in many different areas or mysterious systemic issues, treating main arteries can support the entire body through photobiomodulation. The theory is that we're triggering chemical release in the blood that then flows through all problem areas.

Recent research showed that treating bones with near-infrared light releases stem cells into the body. These stem cells can travel through the bloodstream to areas that need them.

In one study, researchers treated rats' shins and observed reduced scar tissue formation after the rats were given heart attacks—demonstrating that stem cells released at one location traveled to and benefited a completely different area.

This is somewhat of a "shotgun" approach useful for patients with multiple problems or widespread systemic issues. By releasing stem cells into the entire body, the hope is they'll migrate to areas needing correction.

Another theory for improving efficacy is having patients move their joints during laser treatment. This helps expose different parts of soft tissue to the laser and moves fluid around within joints, distributing energy more evenly throughout the treatment area.

This concept is mainly useful for treating knees, shoulders, elbows, wrists, ankles, and fingers. We also see benefit in treating immediately before athletic events or chiropractic adjustments.

The most effective practitioners don't limit themselves to a single theory—they combine multiple approaches based on each patient's specific presentation. A comprehensive treatment session might include:

• Brain stem treatment to start (patient comfort + neurological benefit)
• Palpation to identify all affected areas
• Direct dosage-based treatment on the primary injury
• Lower-density treatment on surrounding inflamed tissue
• Trigger point release on associated muscle tension
• Lymph node stimulation for drainage support
• Joint movement during treatment if applicable

The development of PBMT protocols and treatment strategies is still evolving. We share these concepts hoping practitioners will refine the technology and advance the entire field.