Training...


Healthcare Providers, Technicians, and Administrative Staff

Laser Training: How to apply laser therapy

Why do doctors need training for laser therapy?

If you've already gone through years of schooling, why is more training needed to provide photobiomodulation treatments for your patients? When done properly, laser therapy offers huge potential for success. With the right settings and protocols, providers can give their patients immediate, predictable effects, improving the patients' trust and outcomes. Unlike other modalities, professional laser devices allow for endless customization—both a benefit and a challenge. Different settings and techniques deliver different results. Even the simple questions like "how often should I treat?" are unclear without basic education.

Who else needs to be trained in laser therapy?

It's not just healthcare providers. Support staff and physician extenders can also become a vital and profitable part of a laser therapy clinic. Certified laser techs can deliver treatments, as can medical assistants. Administrators and front desk staff can be educated to assist with laser clinic operations, selling care plans, and answering patient questions with confidence.

What will laser therapy training do for me and my practice?

Laser treatment science is continually developing with hundreds of new studies published each year. These advancements can be difficult to stay up-to-date with and even more challenging to implement into your methods. Laser Therapy Institute's professionals stay engaged in current findings and keep member clinics briefed and continuously supplied with new settings, protocols, and guidance. Training also supplies healthcare providers with effective laser solutions for common conditions and additional treatment options for difficult cases. This leads to improved patient outcomes, which produces increased revenue. Your results make your practice, and being an expert in laser therapy will help your clinic stand out from the rest, driving referrals from other healthcare practitioners. 

Make your clinic more competitive and earn a reputation as a laser therapy expert with a Laser Therapy Institute membership today!

Sample our expertise by viewing the free information and resources below.

 

A meta-analysis took 19, high-quality studies on laser and musculoskeletal pain conditions. It found that 94% of the studies revealed positive effects of laser therapy on pain!

So, the question is not, "Does laser work?" The question is:

How do laser providers deliver consistent, high-quality laser treatments?

Make sure your confidence matches your competence and vice versa.

Every treatment modality has its complexities. At first glance, laser is simple: Apply laser to the area that hurts, right? Not so fast.

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While the science behind laser is straightforward, taking basic approaches to that science will give your patients basic results. If you want to offer your patients great results, start studying the modality further, and there will be a lot more to learn! 

Laser is easy to apply, but there are many ways to apply it, and each patient and condition requires a unique treatment plan. For patients to be confident in their treatment plans, they need to have confidence in their provider. For patients to receive consistently good results, they need their provider to be competent.  

Receiving LTI training makes it easy for you to have both the confidence and competence patients are looking for!

Our mission is to enable patients to receive effective, safe, non-pharmaceutical treatments by providing medical providers with both the confidence and the means to treat their patients with high-intensity laser therapy across the spectrum of conditions

To do this, we offer self-paced, online courses that you can access at anytime throughout your membership. We constantly update the courses, and there are no update fees; in fact, membership fees decrease every year until the fifth year of your membership! We specialize in how to operate a laser clinic. Our team is comprised of experienced laser clinic owners, operations managers, administration managers, technicians, healthcare providers, and more! We give you everything you need to optimize your laser therapy practice.

How often should your patients receive laser therapy treatments? What settings should be used for each condition? Learn how to approach these questions with LTI's in-depth protocols that have been clinically tested in multiple locations for years.

We do the training for you!

Your staff is a big part of delivering laser therapy treatments because you can have staff members operate the laser for your patients. Laser technicians need training and proper oversight to gain confidence in delivering treatments. After they are trained, you will have more free time in your practice, along with happy patients who are receiving great laser therapy results.

Your technicians can significantly impact the flow of your clinic and help get it running to its highest potential. To encourage patients to continue visiting your clinic, you will want them to experience efficiency in your practice. From checking in, to having their consultation with a provider, to receiving their laser treatment from a technician, to checking out, the flow of operations is critically enhanced by having well-trained technicians.

Online courses for laser therapy

Are you confident in training your staff members? If you are not able to train your staff members specifically on how laser works, then are you or your staff members able to explain to your patients how laser works? LTI provides training not only for the healthcare provider, but also for the staff; this helps to free up the providers' time, allowing them to devote more time to their primary duties. Everything from the basics of room setup and patient positioning to the video demonstrations of the advanced techniques needed to apply our customized treatments, LTI Members' technicians receive comprehensive training. 

Laser Therapy Training

When your laser practice grows, you will need effective management strategies specifically designed for laser clinics. LTI Expert Members gain access to courses that address this. 

From hiring, to billing, to marketing, our courses set your office managers up for success. Not only will your administrative staff receive training on laser safety, but they will also be given resources on how to promote patient education and networking through referrals in your community. For more details, view our page on inspiring clinic growth and patient success.

 

Laser therapy is the use of light to produce a specific stimulatory effect on biological tissues, usually repair, regeneration, and pain reduction. Using laser and LED light to stimulate the body’s healing mechanisms is now termed “photobiomodulation.”

For light to have an effect on tissues, you need 3 things: absorption of light energy by critical cellular components, penetration of light to the depth of the tissues to be effected, and an effective dose delivered to that depth.

Read more here.

Laser therapy induces changes in blood flow, and microcirculation promotes healing by controlling ischemia, hypoxia, and edema after injury; this limits the zone of secondary tissue damage. The increased circulation in and around the injury zone creates a favorable environment for biological repair after musculoskeletal injury.

 

When you have a sprain/strain injury, swelling is a major component of that, and minimizing swelling is very important. Why? Because the more swelling you have around the injury, the less blood flow gets into those tissues—generating more pain and causing slower healing. Controlling swelling is a significant piece in the initial stages of managing a sprain strain injury. You want to use the RICE method, but the latest data shows that icing should really only be done in the first day, and it should not continue to be used past that for sprain/strain injuries because icing reduces circulation, which slows down recovery.

 

When you have the swelling controlled, you want to increase circulation. Getting more blood flow to the injured area and around that injured area helps to maximize the healing capability of the body: It reduces ischemia and hypoxia, and it reduces edema if you apply laser to and around the injured tissue soon after the injury has occurred.

If you have the wrong dose, you're not going to get the right level of effect. If your dose is too low, or if it's too high, you either understimulate or overstimulate the area, which can slow down healing. When looking at the science behind light therapy and laser, you will see a lot of people talk about the Arndt Schultz principle, which is the idea that both overstimulation and understimulation are not ideal; however, when a proper dose is delivered, healing is accelerated.

Proper dosing for laser therapy is generally considered 4 - 10 J/cm2. Sometimes, though, a lower dose can produce good results, and many times doses from 40 - 100 J/cm2 provide good results. You can learn a lot more about this in our Laser Basics online courses. For 83% off, email us to receive your discount code.

Online photobiomodulation training

A class 3 or class 3B laser can go from 5 to 500 milliwatts, whereas class 4 lasers will be any lasers that can go over 500 milliwatts.

You may have heard people say that class 4 lasers always damage tissue, but that simply is not true. Therapy lasers are designed to perform therapy in that class 4 range, which means it is delivering more energy in a shorter period of time (5-10 minutes instead of 30-45 minutes), but utilizing the same mechanisms as a Class 3 laser: promoting increased blood flow and stimulating better cellular respiration to improve tissue healing.

The primary difference between high intensity laser and low power laser is that "the more powerful beams are irradiated to penetrate deeper, bringing a desired high amount of multi-directional energy to deep tissues in a short time."

So, higher intensity means deeper light penetration, which is beneficial when treating deeper injuries. This is not pertaining to surgical lasers, nor cosmetic lasers. Therapeutic laser does not ablate or super heat any of the tissues. There can sometimes be a little bit of a thermal effect from Class 4 lasers, and even LED light therapy can generate quite a bit of warmth and give you some level of thermal effect. But the warmth is not what generates a biomodulation response. The infrared light that is going into the tissues stimulates a number of responses in the cells of the damaged area, and that promotes healing.

Research suggests certain colors of light have an effect on cytochrome C oxidase, as well as on the mitochondrial-bound interfacial water layers. If you can improve the efficiency of the cytochrome C oxidase's functioning, and you can improve transport qualities of mitochondrial-bound water, then you can have more efficient and effective mitochondrial function. This means more energy production, and more energy production means:

  • increased cellular vitality

  • increased cellular ability to repair

  • increased cellular ability to replicate

  • increased cellular ability to divide.

Certain colors of red and near-infrared light absolutely do speed up the production of ATP. So, if you can get light to these organelles, you should be able to improve their function, which improves their cellular function and health.

Less than 400 nanometers (nm) are invisible types of radiation, such as ultraviolet, x-rays, and gamma rays. They are very short and can be damaging to the tissues. Over 400nm is the visible spectrum; violet, blue, green, yellow, orange, and then red (all the way up to about 700nm) is the visible spectrum that we humans see. From 700nm to about 2,000nm is termed "near infrared." This spectrum is invisible, but it does not have the damaging characteristics that UV and x-rays do; the infrared spectrum goes all the way up to the far-infrared wavelengths that CO2 surgical lasers will put out at 10,600 nanometers. Once you get longer wavelengths and you encounter radar, FM channels, TV, short wave, and AM radio waves. 

 

Photobiomodulation wavelengths are specifically between the 600-700nm range as well as from 770nm to about 1100nm. Those are the most common and seemingly most efficient parameters for wavelengths in regards to photobiomodulation or laser therapy or light therapy, though researchers are continually learning more. The penetration of the light into the tissues is governed by the absorption and the scattering of the deeper tissues, and the reflection at the surface, as well as by the molecules and the structures that are present in the tissues.

At 600 nanometers (nm), you have a moderate amount of absorption in the melanosomes, whereas at 400nm, the absorption is very high. For that reason, color dependent lasers (the greens and blues) cannot target deeper than the skin: They are highly absorbed in the colored part of the skin.

 

At around 800nm, the amount of transmission through the skin improves; the absorption rate of the skin is much lower, and that absorption rate continues to penetrate through the skin to at least 1200nm. That means you will get much better penetration of light through the skin in that 800nm to 1200nm zone.

 

After you get through the skin, what's the next layer that you usually are going to have to deal with? The adipose tissue—the subcutaneous fat tissue. Looking at the absorption and the scattering and the penetration that light can have through fat, the dominant absorption peak of fat is at 930 nanometers. That means that if you are using a 930nm laser, you are going to have good penetration through the skin, but you are going to have a lot of absorption in the fat.

 

Once you get through skin and then the adipose or fat tissue, your next barrier to penetration is going to be blood and water in blood. Specifically, this is referencing the hemoglobin as it is the chromophore that absorbs light the most, and hemoglobin has different absorption peaks based on whether it is oxygenated or deoxygenated. For both deoxygenated and oxygenated hemoglobin, absorption peaks at about 806 nanometers. For oxygenated hemoglobin, approximately 900nm is good for absorption. In theory, when oxygenated hemoglobin absorbs light in that 900nm range, it will change conformation: it will drop oxygen and become deoxygenated. When dropping oxygen off from hemoglobin the result is the delivery of more oxygen to the tissues, which of course is critical for healing.

 

The next barrier is water, which is the most prolific chromophore that you will find in the tissues because there is bound water within cells and within mitochondria. Also, there is free water that floats in the interstitial fluid. Studies show that bound water has a peak absorption at 970 nanometers.

 

General info about insurance coverage of laser therapy in the USA in 2022.

International situations will vary. Contact us for additional resources. The info found below is not a replacement for competent legal advice, but it may serve as helpful guidelines as you assess your particular situation with your legal team. 

 

Provider type

  • MD, DO, NP, DDS, DMD, DC

    • Can supervise and bill photobiomodulation in all 50 states

  • DPM, PT, OT, LAc, OD

    • Can perform and bill photobiomodulation in most states with some restrictions

  • PA, LMT, LPN, RN, PTA, midwife, clinical psychologist, medical assistant

    • Can perform photobiomodulation only under supervision in most states

 

Remember, all healthcare providers must stay within their scope of practice and follow all state and federal laws and board guidelines.

 

Insurance type

  • Medicare/Medicaid

    • Medical providers may be able to bill and collect a small allowable

  • Private Insurance

    • Most plans will reimburse varying amounts for most providers

  • Personal Injury/Auto Accidents

    • Most plans will reimburse most providers at 100%, at least for 6-12 sessions

  • Worker's Compensation

    • Nearly every state is different! Contact us for details.

Nitric oxide inhibitors will actually eliminate the benefits of vasodilation from photobiomodulation. Medications or chemistry factors can inhibit nitric oxide and disrupt the body's microvasculature because that mechanism is not working. Because nitric oxide inhibition will interfere with the process of stimulating more blood flow through light therapy, it is important you address this with your patients.

Nutrition

LTI Members receive training on how to determine when a patient's macro nutrition is not sufficient and when micro nutrition problems, such as a lack of key trace minerals, occur. (B vitamins, trace minerals, calcium, potassium, and sodium all need to be balanced to have good blood flow fluid exchange and ATP production.) After identifying the patient's metabolic and nutritional issues, you will need to know if they are interfering with the patient's laser treatments and, if so, how to solve the problem. 

Prescribing exercise with laser therapy can facilitate very good effects on osteopenia, plantar fasciitis, and osteoarthritic knees. 

Physical activity often complements laser therapy because it helps prime the body's mechanisms that are needed for optimum results from photobiomodulation. 

However, when patients' pain is relieved through laser, they may overexert themselves physically, leading to setbacks, so it is important they receive instructions on how to properly exercise in conjunction with laser. 

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Sleep is another critical element of a successful laser treatment plan. It is imperative that patients receive enough sleep as it will give their bodies time to recover. 

Laser can cause patients to become tired because it forces the body to utilize its healing properties, leading to more work for the body. This feeling of fatigue is sometimes related to the fatigue a person experiences after a workout. It is highly beneficial for you to notify your patients of this possibility before they receive laser treatments. Some laser settings can cause soreness (similar to muscle soreness following exercise), and some may cause fatigue. Having the ability to tell your patients exactly what they will feel and why helps to promote their confidence in both the treatments and you as the provider of those treatments. 

Patients who are taking NSAIDs while receiving laser therapy get much poorer results than those who receive laser without NSAIDs. Corticosteroids can adversely affect patients, especially when laser therapy is applied to an injection site within a certain period of time after corticosteroids have been administered. Contact us for more specifics. 

 
Continuously Updated Training & Protocols

Our training programs are being continuously updated and expanded, so our members don't have to worry about making manual updates or missing out on new information or materials. We already have over 100 modules! Receive your no-obligation quote to start becoming an advanced laser therapy provider.