Treatment considerations M6

Laser therapy penetration

• Laser can reflect of objects – remove metal objects on patient from treatment area (watches, jewellery, rings)
• The laser therapy must be applied to exposed skin
• The treatment will not work through clothing.
• The treatment dose may need to be adjusted in the presence of tattoos and/or large amounts of hair; consider using the Phototype B preset. In the presence of tattoos with dark ink, it is suggested that if the area cannot be avoided, to adjust the INTENSITY to the lowest setting and the area be covered with a fast motion.
• The treatment area may be shaved if appropriate. However, shave the patient in another room.
• The penetration depth of a laser depends on the wavelength and tissue type and is independent of the power at the surface.

Contraindications

• The MLS Laser is used for symptomatic treatment, and is contraindicated where analgesia may mask progressive pathology, and should not be used where the clinician would normally avoid the use of any other analgesia in order to retain the beneficial aspects of pain.
• Do not use LLLT over the pregnant uterus. It may be used on the pregnant woman as an adjunct to the other modalities for CTS.
• Laser should not be used over the thyroid gland.
• It is conceivable that laser-mediated vasodilatation may worsen a haemorrhage.

Precautions

• Patients may suffer an exacerbation of symptoms after laser therapy in conjunction with a recent steroid injection. For this reason laser should not be used within 2-3 weeks of a recent steroid injection on or near the same site.
• Some patients are on drugs known to cause photosensitivity reactions. It is unlikely that a combination of laser and drug will trigger this response. ASA recommend that “at risk” patients or patients with a history of such reactions be “patch tested” for the minimum recommended treatment time.
• Patients using topical or systemic steroids or N.S.A.I.D’s for pain or skin conditions may experience mild “flare up” of their symptoms. If such a reaction occurs, low level laser therapy should be stopped.