Low Level Laser Therapy for Plantar Fasciitis
TREATMENT OPTIONS FOR
LLLT has been shown to be safe at designated doses, and appears to have side effects similar to placebo (“sugar pill”) treatments.
Tuby H1, Hertzberg E, Maltz L, Oron U. Long-term safety of low-level laser therapy at different power densities and single or multiple applications to the bone marrow in mice. Photomed Laser Surg. 2013 Jun;31(6):269-73. doi: 10.1089/pho.2012.3395. Epub 2013 May 15.
Jimenez JJ1, Wikramanayake TC, Bergfeld W, Hordinsky M, Hickman JG, Hamblin MR, Schachner LA., Efficacy and safety of a low-level laser device in the treatment of male and female pattern hair loss: a multicenter, randomized, sham device-controlled, double-blind study. Am J Clin Dermatol. 2014 Apr;15(2):115-27. doi: 10.1007/s40257-013-0060-6.
Evidence of the effectiveness of LLLT for plantar fasciitis is conflicting, though considered promising by some researchers. One small recent study showed clinically significant improvement with LLLT, though other researchers have found little evidence it helps. Nevertheless, many providers will use LLLT in combination with other conservative approaches such as orthotics and stretching.
One problem with LLLT evidence is that there are simply not enough high-quality studies available. For this reason, most insurance companies consider it experimental or investigational and will not pay for it.
Jastifer J et al. Low-Level Laser Therapy for the Treatment of Chronic Plantar Fasciitis
A Prospective Study. Foot and Ankle Intern; 2014. 35(6).
SELF CARE: 0/5
While it might be possible to perform laser therapy to one’s self, this is unlikely. In most jurisdictions laser units are only sold to licensed professionals and tend to be cost prohibitive, ranging in price from hundreds to tens of thousands of dollars.
Laser therapy is relatively inexpensive, ranging from $20-$50 per session in most clinics. Typically laser therapy treatment plans run from one or two sessions to 10-12 sessions. In general, a reasonable course of laser therapy might include 6-12 sessions varying from daily to 2 times per week. It is widely available in chiropractic, physical therapy, and some orthopedic offices, among others.
USEFULNESS (overall rating): 3/5
The jury is still out on whether or not LLLT is really effective for PF. However, it is generally safe and inexpensive, and some studies have suggested it may help. We recommend it as a treatment option, especially before considering more invasive treatments such as injections, ESWT or surgery.
Also referred to as Photobiomodulation, or “cold laser”, this therapy has been around for more than 40 years. Laser therapy uses light, which is absorbed by tissues to produce cellular changes, which include increases in the production of cellular energy, among other effects. Low-Level Laser Therapy is believed to enhance healing, reduce pain and edema, reduce inflammation and increases circulation. LLLT does not produce its effects through heat.
LLLT is used on a variety of conditions, from shoulder and elbow injuries to neck and back pain, plantar fasciitis, knee pain, and other musculoskeletal conditions. While research is ongoing, there is evidence of effectiveness for some conditions (such as certain shoulder conditions and tennis elbow) and less evidence for other conditions.