Laser therapy - any opinions?

RE: Laser therapy - any opinions?

Francisco Gomez — Mon, 22 Feb 2016 09:18:52 GMT

I'm not totally convinced that ursudeoxicolic acid is of any benefit for liver patients, but even referral practicioners recommend it. As far as I know, there is only one study that support its usage and it is done in humans.

I do use it, because I find its mechanism sound even if I don't have 100% undeniable true confidence in it.

I find laser therapy work in a much less degree that people who sell it claim, the same a nutraceuticals.

I think the ethical dilemma comes when you know full well that the product not only doesn't work at all, but it is also in the way of proven products. So if someone ask for either laser therapy or nutraceuticals I tell them what I think, but I don't try to stop them from using them. With homeopathy I don't take it that lightly.

And for sure, like John Flynn said earlier in the thread, NSAIDs is usually the first medication that I mention.

RE: Laser therapy - any opinions?

Martin Atkinson — Mon, 22 Feb 2016 09:00:39 GMT

[quote user="CatherineThomas"]A lot of clients see the posters about it and ask to book for it without us having to recommend it.[/quote]So if putting posters about something in the waiting room is not recommending it it is certainly selling it. Get real Catherine. You've said yourself you're not convinced of the benefit. This is first and foremost a money making exercise.

RE: Laser therapy - any opinions?

CatherineThomas — Mon, 22 Feb 2016 05:21:20 GMT

[quote user="Martin Atkinson"]

[quote user="CatherineThomas"]I'm not convinced of the efficacy but the clients love it[/quote]Yes but they love homoeopathy and any other snake oil shit that doesn't work. If the vet recommends it that legitimatises it. That doesn't mean it works, it depends on whether you do this job purely for profit or for the benefit of your patients. I choose the latter as do my nurses whether they could do it or not and they would leave if I started selling this sort of mumbo-jumbo.

[/quote]

It's only ever used as an adjunctive treatment and it means that the animal is coming in for regular nurse appointments. If the nurse thinks the animal needs re-assessment or further treatment it is passed back to a vet appointment. So I think it means the animal is monitored more closely and therefore benefits from that. It also helps bond the client to the practice. Even if nothing else it does provide heat at the affected joint or area of interest which is likely to be beneficial. So maybe it's not working because of the stimulation of cells or whatever they claim but it does have benefits to the animal.

A lot of clients see the posters about it and ask to book for it without us having to recommend it. I've also had clients ask me where they can get laser treatment for their animals when i've been working in other practices that didn't offer it.

RE: Laser therapy - any opinions?

Martin Atkinson — Sun, 21 Feb 2016 19:23:19 GMT

RE: Laser therapy - any opinions?

Utlendigur — Fri, 19 Feb 2016 22:10:53 GMT

[quote user="CatherineThomas"]One of the practices I have worked in bought a k laser last year. I'm not convinced of the efficacy but the clients love it, a lot of them go back for regular course for various problems, but mainly arthritis. It's also used for wounds and other conditions such as stomatitis. The treatments are all done by the nurses and the nurses love doing it because of all of the positive feedback from the clients.[/quote]

It would be interesting to see whether it's as effective given by the vets. I'm just wondering if it's the time taken over the treatment, and the interaction with an enthusiastic empathetic nurse that is causing the success rather than the laser.....

RE: Laser therapy - any opinions?

CatherineThomas — Fri, 19 Feb 2016 19:42:56 GMT

One of the practices I have worked in bought a k laser last year. I'm not convinced of the efficacy but the clients love it, a lot of them go back for regular course for various problems, but mainly arthritis. It's also used for wounds and other conditions such as stomatitis. The treatments are all done by the nurses and the nurses love doing it because of all of the positive feedback from the clients. I believe that the boss worked out that he had already covered the first year's payments for the machine from takings in the first 3 months of use.

I would offer it to clients as an option being clear that there is no reliable evidence that it works but that it was really popular with other clients who seemed to report positive results.

Several of the staff had also used it on their own injuries and said that it gave some relief.

RE: Laser therapy - any opinions?

Bob Russell — Fri, 19 Feb 2016 10:30:24 GMT

Brilliant thread. I think I will save the £20K for my retirement or have a good holiday!!

RE: Laser therapy - any opinions?

Francisco Gomez — Thu, 18 Feb 2016 21:04:07 GMT

[quote]

How is it 'sold' to the client?

[/quote]

Well... I want to say the same way as nutraceuticals: I don't.

And people do ask for them.

RE: Laser therapy - any opinions?

Michael Woodhouse — Thu, 18 Feb 2016 21:00:18 GMT

[quote user="Francisco Gomez"]

We use it routinely in my practice. Mainly for osteoarthritis and an aid for wound healing. I haven't seen studies to prove its use, but I believe they exist, I just don't know how reliable they are.

I think the practice is doing really well on paying it back.

[/quote]

How is it 'sold' to the client? I don't doubt such a device may be very profitable, but selling it as an efficacious treatment should be ethically wrong - given the current evidence base.

RE: Laser therapy - any opinions?

John Flynn — Thu, 18 Feb 2016 20:50:53 GMT

There may be a reason why neither of us know much about it at all... perhaps there's nothing to know?

Here's one summary from "humans":

http://www.aetna.com/cpb/medical/data/300_399/0363.html

and here are some reviews from a vet:

http://skeptvet.com/Blog/2010/05/cold-laser-therapy/

http://skeptvet.com/Blog/2011/06/small-study-suggests-cold-laser-therapy-not-beneficial-for-intervertebral-disk-rupture-in-dogs/

http://skeptvet.com/Blog/2015/05/evidence-update-cold-laser-therapy-for-dogs-cats/

I would stick to discussing reliable treatments that I am sure work for many patients:

1) Weight loss

2) NSAIDs

3) Adapting the patient's environment

4) John Flynn's Joint Dust*

*This is very affordable and 100% proven and comes with a 100% money back guarantee (minus postage&packaging) if you are in any way dissastisfied, indeed you might wish to ignore the first 3 points and focus mainly on this - it is also very environmentally friendly and 100% risk-free.

RE: Laser therapy - any opinions?

Francisco Gomez — Thu, 18 Feb 2016 20:04:39 GMT

A bit of info (albeit not much) here:

http://www.myklaserpet.com/Home.html

We use it routinely in my practice. Mainly for osteoarthritis and an aid for wound healing. I haven't seen studies to prove its use, but I believe they exist, I just don't know how reliable they are.

In my personal opinion, I don't think is that good for osteoarthritis, more than a bit of placebo effect with some warming of the joints. Of course, if you warm a cold osteoarthritic joint, you'll see an immediate relief, but I don't think that's going to help for very long. So I personally don't ask patients to come for it.

On the other hand, I believe there is some help by using it in open wounds. They help healing by warming the deeper areas, not just he surface of the wound, this promotes blood flow without burning the surface, and therefore increasing healing speed. It's only my personal experience. I agree it's way too expensive for what it can achieve, but I think the practice is doing really well on paying it back.

[quote user="grumpyoldman"]

try to get you to point it at everything from an osteosarcoma to interdigital cyst

[/quote]

They're absolutely against you using this on neoplastic tissue: Aiding blood flow into a tumour, not a good idea. They're also worried about causing abrassion on the eyes, so against using it there too, and wear dark goggles while handling the instrument.

RE: Laser therapy - any opinions?

Cat Henstridge — Thu, 18 Feb 2016 19:30:53 GMT

Oh dear, OK, I shall write something suitably noncommittal.

Thanks all!

RE: Laser therapy - any opinions?

Lindsey Edwards — Thu, 18 Feb 2016 18:32:07 GMT

there are a number of articles exploring use of coherent (laser) and non-coherent (LED) light sources are comparable. have had some response to LED light therapy units with acral lick lesions and skin healing but not convinced for deeper / musculoskeletal lesions and definitely not convinced about the laser price tag

RE: Laser therapy - any opinions?

nikki — Thu, 18 Feb 2016 18:24:07 GMT

I tried a Photizo laser to help with a crack in my horse's lip that wouldn't heal. It did naf all.

RE: Laser therapy - any opinions?

Clive Ansell — Thu, 18 Feb 2016 18:08:03 GMT

I was recommended laser therapy by my GP and a physiotherapist for a frozen shoulder following a cycling accident. The consultant I eventually got to see dismissed it as nonsense stating there was no evidence to support its use, and said the injury will take about a year to heal with laser and 12 months without.

I once did a locum in a practice that used laser therapy to aid the conservative management of cruciate disease among other things, they swore by and thought it was wonderful. Its anecdotal I known, but their cases took 6- 12 months to heal while everyone else's would get better in a half to 1 year!

RE: Laser therapy - any opinions?

grumpyoldman — Thu, 18 Feb 2016 17:58:27 GMT

I know one local practice has it , paid about 20k for it, seduced by the slippery tongued reps at BSAVA who will no doubt have you thinking its the next big thing, and try to get you to point it at everything from an osteosarcoma to interdigital cyst, with instant success ,after an initial honeymoon period its now occupying a corner collecting dust most of the time . There are no papers .........................!

RE: Laser therapy - any opinions?

Martin Atkinson — Thu, 18 Feb 2016 16:48:23 GMT

Well it did sweet FA for my knee when I tore my ACL! There are some who believe class IV lasers have some therapeutic value but it is still nothing more than causing a mild inflammatory reaction which may improve healing like massage. Up there with snake oil and homoeopathy if you ask me.