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US vs LASER. Which is the best choice if I can purchase only one?

Which modality has the most clinically meaningful effect? Meaningful means a change in symptoms that allows better function in a timely fashion. For example, if the modality has a statistical significance of decreasing VAS pain by 1.4/10 after 30 ten minute treatments...this is not relevant enough to justify charging patients for so many visits.

Bryce Kelly

6 months ago

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Dr Ethne Nussbaum
Dr Ethne Nussbaum

I agree with Dinesh Verma. Also to keep in mind is your treatment goal. Do you only want to treat symptoms, e.g. pain? If so, you might do well with laser in the short term. But long term I believe one must address the underlying condition. US with proper parameters can increase extensibility of dense tissue (scar tissue such as tendon adhesions, etc) & combined (immediate) with stretching & followed by active exs can increase ROM - pain reduction is then secondary benefit. Low intensity pulsed US promotes healing of soft tissue & bone - again pain reduction is a secondary benefit. I have seen impressive softening of scar tissue in the hand using 830 nm laser diode at 30 J per cm sq. I have not been able to achieve good results on deeper tissue problems.

Dinesh Verma
Dinesh Verma

Hi Kelly

Its hard to ENDORSE ..One Modality OVER another...Also - We cannot generalize effects of Pain relief IN GENERAL - Unless we review - pain relief by Modality A versus Modality B for any Specific condition. Mechanism of Actions for Each modality are different and this must be Kept in Mind while selecting them for EACH Specific application.
US and Low Power LASER may both have their place - in different stages of pain management within Same condition . It is not uncommon - to use different modalities - for same condition as we evolve within pain stages... !


I feel thé same experience in thé 'field', but would also mention thé extra effect on lymphatics with laser. Do you agree.

Cliff Eaton
Cliff Eaton

It has been reported that Laser therapy is the only one to promote the production of ATP to assist the healing process. Transfering the Oxygen molecules from HbO into the affected tissue. This hypothesis infers that it will be most affective on vascular tissue. Where as US has been shown to be most effective on avascular tissue such as ligaments and tendons My personal issue with laser is that LLLT requires a long treatment time to provide enough energy for a therapeutic value. The depth of penetration is also a subject of debate. Therefore, practically in clinic a High Power Laser (HPL) is warranted but at a price! So there is an argument to have both! :) Personally if I could only choose one I would select HPL for acute injuries. I would support this with Shokwave for chronic conditions

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