Low Level Laser Therapy and COPD

Every experienced clinician has met many patients with chronic obstructive pulmonary disease (COPD) in various clinical settings. The prognosis is generally poor, going from bad to worse and ending in death. Death in a COPD state is not a best-case scenario, because the patient with COPD is generally plagued by angst stemming from the fact that anyone lacking oxygen becomes afraid. This well-known fact is a factor that leads to a low dose of Benzdiazopine does this being prescribed to ameliorate the angst condition. The story described below is of a different nature, one that flies in the face of common knowledge and elucidates a methodology that can alleviate the burden on many COPD patients, while the same time-saving health care systems for billions in outlays that could otherwise be spared.

Chronic obstructive pulmonary disease (COPD) is a widespread killer of, especially, older smokers of tobacco and/or previous heavy users. The economic burden of COPD in Denmark was estimated to be about EUR 1.13 billion in 2010 (1). The authors utilized good methodology to ascertain many various costs not readily visible for all, including loss of workdays, next of kin loss of workdays, transport to and from the hospital, etc. Obviously, any method to reduce this burden would be beneficial. A 73-year-old woman had booked a time in my clinic due to back pain. The pain was diffuse lumbar pain with no neurological complications. On her first visit, the patient needed three pauses going from the ground floor to the level above, where the clinic is located and had a slightly wheezing inhalation and a heavily wheezing exhalation which continued throughout the treatment which lasted an hour.

The patient asked me if I thought that low level laser therapy (LLLT) could be beneficial for her COPD. The patient’s pulmonary capacity had been measured some days before her visit to 25%. I told her that I did not know, but I knew that a significant part of the COPD condition is inflammatory, and I thought it worth a try. The patient was treated sitting on the edge of the gurney, as she could not lie down flat, and the gurney does not have a raisable top half. The treatment consisted of adjacent pulses of low level laser therapy consisting of five diodes emitting 200 mW each for a total of 1 W. The laser element of the diode emits laser light with a wavelength of 810 nm as well as visible red light of 660 nm.

It has been established that the laser light emitted by Thor Photobiomodulation’s LX2/2 laser apparatus penetrates tissue to at least 6 cm, although this was established in necrotic brain tissue (2). It stands to reason that the penetration is greater the less dense the tissue is. LLLT has been shown to improve walking distance in a cohort of Egyptian COPD patients (3). Why the Egyptians did not use spirometry is curious, perhaps they did not have the apparatus. After 5 sessions, my patient was able to go up the stairs without pauses, and after 13 sessions, her pulmonary capacity was measured to 44%. Her quality of life had improved considerably and she was able to carry out many functions she had prior to my treatment considered undoable. This included participating in garden activities, doing her toiletries without assistance, enjoying eating instead of it being a chore, and many other small things that those of us without serious COPD consider naturally doable.

To my knowledge, no one has reported a gain of this magnitude in a COPD patient. The patient was obese and had large breasts, which of course reduced the amount of light reaching the inflamed tissue.  It stands to reason that slimmer individuals would benefit more from the treatment. The patient chose to discontinue the treatment after 13 sessions, so I do not know if further treatment would have bettered her condition even more. LLLT has been shown to be an effective anti-inflammatory treatment (4).

This study casts a ball in the air waiting to be grabbed by the open-minded professional who is willing to entertain the prospect that this novel treatment modality has the potential to save thousands of patients from their low quality of life and give them back pulmonary capacity allowing their activities which they have been shut out from due to COPD. At the same time, the treatment modality has the potential to save healthcare systems billions in direct and indirect costs.

References

Clark E, Tedord I, Scott DeLapp ,I Steven J, Anders J. 2015. "Quantitative analysis of transcranial and intraparenchymal light penetration in human cadaver brain tissue." Lasers in Surgery and Medicine 47 (4): 312 322.

Løkke A, Hilberg O, Tønnesen P, Ibsen R, Kjellberg J, Jennum P. 2014. "Direct and indirect economic and health consequences of COPD in Denmark: a national register-based study: 1998-2010." BMJ Open 6 (4): 237 246.

Sayed MA, El-Sherif RM, Mohammed AR et al. 2018. "Low-level laser therapy in chronic obstructive lung disease." Egypt Journal of Bronchology 12: 317 322.

Steele, Richard Evan. 2020. "Low Level Laser Therapy and Myofascial Pain." Journal of Pain Management 13 (1): 56 62.