How It Works
How Do Cold Lasers Work?
Cold laser therapy also known as Low Level Laser Therapy (LLLT) is a treatment that utilizes specific wavelengths of light at low powers to interact with tissues in the human body in order to stimulate and accelerate the healing process. Cold Lasers can be used on patients who suffer from a variety of acute and chronic conditions in order to eliminate pain, swelling, reduce spasms and increase functionality.
Cold Lasers are handheld devices used by a clinician and are often the size of a flashlight. A laser or multiple lasers may be used simultaneously and are placed over the injured area on the knee. During this time non-thermal photons of light are emitted from the laser and pass deep through the skins layers (the dermis, epidermis and the subcutaneous tissue or tissue fat under the skin). This light has the ability to penetrate 2-4 inches below the skin*. Once the light energy passes through the layers of skin and reaches the target area, it is absorbed and interacts with the light sensitive elements in the cell. Cold Lasers (low-level lasers) have the most profound effect on the mitochondria of the cell. Mitochondria are the energy producing centers of our cells. When the gentle but penetrating beam of the low level laser illuminates the mitochondria, mitochondrial energy production is increased.  This process can be compared to photosynthesis in plants. Sunlight is absorbed by plants, which is then converted to usable energy so that the plant can grow.
When cells absorb this light energy, it initiates a series of events in the cell that stimulate the healing process and eventually result in normalizing damaged or injured tissue, a reduction in pain, inflammation, edema, and an overall reduction in healing time by increasing intracellular metabolism. [2, 3]
This chemical reaction in the cell allows several things to occur:
- Increases the speed, quality, and tensile strength of tissue repair- Low-level lasers or cold lasers have been effective in helping people relieve acute and chronic knee pain by enhancing tissue healing. For example, when an individual suffers with knee pain it’s typically because the tissue in and around the knee joint is damaged or injured. The damaged/injured cells response to a cold laser treatment is increased mitochondrial energy production which allows for enhanced growth factor response within the cells and tissue, protein synthesis, and cellular proliferation. In addition, cold laser therapy stimulates the cells ability to re-energize cell membranes allowing the transport of essential nutrients, specific enzymes, and greater oxygen flow across cell walls allowing a healthy new cell to grow. (Nutrients will not cross an injured or sick cell wall, thus slowing the healing process and not allowing new cells to grow). As a result, a patient often completes treatments pain-free.
- Reduces/Eliminates Pain- Cold lasers help with pain relief by increasing endorphin (the hormone that helps reduce pain) release.
- Reduces Swelling/Inflammation- Many people who suffer with knee pain have some swelling or inflammation. Cold lasers help decrease the inflammation by releasing histamine, nitric-oxide, and serotonin to create a vasodilation (opening) of the cells. This in turn stimulates the lymphatic system (or the system in charge of getting rid of waste). In other words it opens up the cells so they can get rid of the waste in the tissues.
- Promotes Faster Wound Healing- Low-level lasers or cold lasers help in the process of wound healing by boosting microcirculation, promoting cellular proliferation, and reducing inflammatory activity that contributes to the cycle of chronic pain.[4,5]
- Stimulates Nerve Function- Most dramatically, Australian researchers have identified a direct effect on the flow of cellular materials down the long axon that makes up the “wiring” of nerve cells. They have discovered that laser induces a neural blockade which allows for pain relief. 
- Stimulates the immune system- Cold Lasers have a direct effect by stimulating immunoglobulin and lymphocytes.
*The penetration depth of the laser is dependent upon the power and wavelength of the laser. All lasers used in Dr. Schnee’s office are powerful enough to help treat a variety of knee conditions. They penetrate 2-4 inches below the skins surface without damaging any cells.
This flowchart demonstrates how cold lasers create a cellular cascade to reduce inflammation.*
This flowchart demonstrates how cold lasers create a cellular cascade to reduce/eliminate pain.*
This flowchart demonstrates how cold lasers create a cellular cascade to reduce healing time. 
 Wilden L, Karthein R. Import of radiation phenomena of electrons and therapeutic low-level laser in regard to the mitochondrial energy transfer: J Clin Laser Med Surg. 1998 Jun; 16(3): 159-65.
 Martin R. Laser-Accelerated Inflammation/ Pain Reduction and Healing. Practical Pain Management. Nov/Dec 2003 3(6):20-25.
 Marovino T. Cold Lasers in Pain Management. Practical Pain Management. Sep/Oct 2004. 4(6):37-42.
 Vladimorivov, I, Klebanov GI, Borisenko GG, Osipov AN. Molecular and Cellular Mechanisms of the low intensity laser radiation effect. Biofizika. 2004 Mar; 49(2):339-50.
 Gavish L, Asher Y, Becker Y, KleinmanY. Low level laser irradiation stimulates mitochondrial membrane potential and disperses sub nuclear promyelocytic leukemia protein. Lasers Surgical Med. 2004; 35(5):369-76.
 Chow RT, David MA, Armati PJ. 830nm laser irradiation induces varicosity formation, reduces mitochondrial membrane potential and blocks fast axonal flow in small and medium diameter rat dorsal root ganglion neurons: implications for the analgesic effects of 830nm laser: J Peripher Nerv Syst. 2007 Mar; 12(1):28-39.
How Cold Laser Therapy Works to Help Treat Joint and Knee Pain. Doctor Alexandra Schnee, D.C. Specializes in Relieving Knee Pain Dallas-Fort Worth using her Cold Laser Therapy Knee Treatment Protocols.