Low-level laser therapy: Western Science vs. Eastern Science

Sergey V. Moskvin

Low-level laser therapy (LLLT) is one of the most common methods of physiotherapy, which is the modern stage in the development of heliotherapy and light therapy. At the end of the 19th century, Nobel laureate N.R. Finsen proved that it is possible to significantly increase the effectiveness of light therapy by using “special” lamps instead of sunlight, so that one is able to control their power, area, exposure time and is also able to allocate the desired spectrum of light. In the early 1960’s, lasers appeared on the market. They were sources of monochromatic light (therefore, it is not necessary to use light filters to isolate a part of the spectrum), whose energy parameters were much easier to control. These qualities led to the emergence of a fundamentally new direction – low-level laser therapy, which is characterized by its higher efficiency and universality [Moskvin S.V., 1997].

Exposure to low-intensity laser illumination (LILI) causes a reaction in the body, and as a result, homeostasis (which was disturbed beforehand) is restored, resulting in the recovery of the patient. After absorption of laser light in the cells, Ca²+-dependent processes are the first to activate, launching numerous secondary reactions at the tissue and organism level (Fig. 1) [Moskvin S.V., 2008, 2014, 2016, 2017].

LLLT used successfully in almost all areas of modern medicine:

  • obstetrics and gynecology [Fedorova T.A., et al., 2009];
  • andrology and urology [Ivanchenko L.P., et al., 2009; Mufaged M.L., et al., 2007];
  • neurology [Kochetkov A.V., Moskvin SV, 2004; Kochetkov A.V., et al., 2012];
  • otorhinolaryngology [Nasedkin A.N., Moskvin S.V., 2011];
  • pediatrics [Moskvin S.V., et al., 2010¹];
  • dentistry [Amirkhanyan A.N., Moskvin S.V., 2008; Moskvin S.V., Amirkhanyan A.N., 2011];
  • musculoskeletal diseases, joint and muscle pain [Moskvin S.V., Kisselev S.B., 2017];
  • et al.

Correlated and combined methods of laser therapy are developing quite rapidly, such as laser phoresis [Moskvin S.V., Konchugova T.V., 2012; Moskvin S.V., et al, 2010; Khadartsev A.A., et al., 2016], laser-vacuum massage [Moskvin S.V., Gorbani N.A., 2010; Moskvin S.V., et al., 2014] and High Frequency laser therapy [Brekhov E.I., et al., 2007; Moskvin S.V., Khadartsev A.A., 2016].

The development of medicine in the context of globalization is impossible without the exchange of information coming from different countries. This allows specialists not only to get acquainted with new medical technologies, but also to more objectively evaluate their own achievements. If some methods allow you to get better results, why not try it, especially when aware of the known limitations of “conventional” treatment regimens. Conservatism is necessary in medicine as it is anywhere, but the artificial limitation by the framework of the customary does not allow its developing.

Many methods of treatment offered by specialists from different countries are quite unique, as they developed in conditions of political and linguistic isolation. From the point of view of their authors, the good results which are demonstrated by them, and even the remarkable results of the treatment, allow the technique to be distributed automatically throughout the world. However, very often this opinion is only based on many years of successful experience of practical application, even in several clinics, but not on data of standardized studies. In addition, in most cases there is no theoretical justification, an explanation of the mechanisms of therapeutic action. Therefore, their value for science world and medical practice is often questioned.

On the other hand, the rejection of unusual (non-standard, non-traditional) methods of treatment, in turn, is almost always justified by phrases such as “I do not believe” and “this cannot be”, rather than scientific (objective) evidence of an absence or presence of a therapeutic effect. Once upon a time LLLT was referred to as “voodoo medicine” [Coulter A.H., 1994], in the 1980’s-90’s, conferences did not accept reports on the therapeutic use of lasers, and we listened to the ridicule from foreign colleagues. While laser surgery was easily accepted because everything was “clearly understood”, laser therapy was denied even with the theoretical possibility that LILI may have any influence on a living organism [Berlien H.P., Müller G., 1989].

Except for subjective factors, there are two main objective reasons at the basis of this mistrust. The first of them is – in many aspects – the fundamental differences in scientific medical education.

One syllabus of education can be generally referred to as the “Western School (WS), where students learn more about the specifics of everything, and “disassemble” a person into organs, specialized cells, cell organoids, molecules and atoms. Accordingly, diseases are classified by organs and targets that have been pathologically affected, and almost all treatments are based on the principle of substitution and external compensation. For example, a tooth that has fallen out – the necessary way to treat this is to implant an artificial tooth. The body cannot cope with an infection – antibiotics must be used to kill the bacteria.

This approach has been developed over several centuries in Europe, although not without professionals opposing this in favour of another point of view. Even at the stage of the formation and development of modern medical science in WS’s, there were fierce debates about the approaches to the studying of structures and principles of the existence of living objects, as well as the fundamental basis of treatment, which was perfectly reflected in the immortal work of the great German poet (Goethe J.W. Faust: a tragedy. Translated, in the original metres, with copious notes, by Bayard Taylor, London: Ward, Lock, and co., 1890, p. 71):

He who would study organic existence,
First drives out the soul with rigid persistence;
Then the parts in his hand he may hold and class,
But the spiritual link is lost, alas!

In studying only the “build” of a living being from which it consists, without constantly correlating the knowledge gained with the general laws of the functioning of the biological system as a whole (basically, without studying the larger picture that is life), there is very little useful information which is learned. This situation was described very accurately by the remarkable American science fiction writer Harry Harrison: “Facts for them were always hooked up in a series. Whereas in truth they had to be analyzed as a complex circuit with elements like positive and negative feedback, and crossover switching. It’s little wonder they did do badly.” (Harrison H. The K-Factor – 1960, p.11)

Nevertheless, it is necessary to admit the obvious, WS has given the world thousands and thousands of highly effective treatment technologies, thanks to which the quality and duration of life of people in those countries that use this technology. The older generation live a full life, rather than simply “surviving” their century. This is all thanks to science and research, conducted by scientists of various profiles.

The second direction of medicine is the “Eastern School” (ES), in which a patient is treated as a whole and is not treated based solely on the disease, more often using non-specific methods of treatment, and at the core of their restoration is the disturbed ability of the body to protect and normally regulate various physiological processes. For example, instead of antibiotics, we restore the body’s ability to normalize (activate) the patients own human immune system.

If in the WS more they study the “device” of living, what the bio-object consists of and how the different parts interact with each other, the ES studies the “function” of the living system as a whole, the laws of its response to external influence. For ES, the word “science” has a special meaning, the response of the biological system to external influences is studied, primarily from the position of sanogenesis, i.e., the ability of the living organism to independently fight the disease by activating internal functional reserves.

The most striking example of medical technology in this area is acupuncture, in which, for therapeutic purposes, effects are exerted on certain points on the human or animal body, causing the necessary response of the organism. These “biologically active” points and the necessary sequence of effects on them were determined empirically. Despite the fact that these local zones are not morphologically different from surrounding tissues, and the mechanism of healing is not only unknown, there aren’t even any theoretical ideas, this method is quite common. The reason for this is its effectiveness in most cases.

One of the problems for ES is that its representatives very often use non-standard, terms that only they themselves understand to describe their medical technologies, and they do not bother explaining the mechanisms or scientific justification of how all this “works”. For example, acupuncture uses concepts such as the Five Element System (Fire, Earth, Metal, Water and Wood) and Meridians. It is quite understandable that such an approach often causes rejection by WS specialists.

Recently, due to the clearly observed tendency to blur the borders between East and West, the ES’s views are gaining an increasing understanding among Western doctors. For example, in English there are quite a lot scientific journals on acupuncture that have gained the attention of many readers, and a high enough IF (Impact factor) (For example, Acupuncture in Medicine, http://aim.bmj.com).

In our opinion, in each of the directions, both WS and ES have its pros and cons, but one must take all the good and ignore all the bad in both schools.

Low-level laser therapy is a vivid example of highly effective medical technology, and despite being successful, to the ES it is completely unclear technology. Unlike many other therapeutic methods of ES (even acupuncture), we have rigorously demonstrated the mechanisms (primary and secondary – see Fig. 1) underlying the method, and understanding of which, in turn, allows us to not only explain the numerous experimental and clinical data, but also to substantiate the most effective parameters of treatment methods, as well as ways to optimize them. In LLLT, when describing techniques, only standard terms and definitions are used that are familiar to all WS representatives. The effectiveness of laser therapy has been proven in the course of tens of thousands of clinical studies.

Low-level laser therapy is a perfect example of a close interaction between WS and ES specialists, which resulted in the birth of a new, remarkable, extremely effective, simple and reproducible treatment that has no side effects and contraindications in many diseases, a large part of the diseases according to the WS canons, with the use of standard WS schemes are “not treatable”.

It is, of course, necessary to apply LLLT correctly, and it is very easy to do this. We developed strict recommendations, standard methods and principles for their optimization, which allows specialists of all types to treat their patients easily and effectively [Moskvin S.V., Kochetkov A.V., 2017].

  1. For low-level laser therapy only lasers can be used, not light bulbs or LED’s. [NB. By definition, this is true. However, other monochromatic light sources can be used effectively for photobiomodulation, of which LLLT is a sub-set, if the parameters are also appropriate. (PAJ, Ed.)]
  2. In the methodology it is necessary to consistently set all parameters: wavelength, operating mode (continuous, modulated, pulsed), laser light power (average or pulsed), frequency for pulsed or modulated modes, exposure, localization, number of procedures per course. Area of illumination (and the energy density) is distinguished by special nozzles. If even one of the parameters is set incorrectly, the technique will not be implemented, the effect will not be reached.
  3. All the selected parameters should be exactly optimal, for example, increasing the laser power does not always lead to an improvement in the result, it often becomes worse.
  4. When the frequency is changed for pulsed lasers, the average power also varies proportionally. This allows you to select the optimal energy parameters, which cannot be realized for continuous lasers and modulated mode.
  5. It is strictly forbidden to illuminate one zone (point) for more than five minutes, and the total time of the procedure should not exceed 20 minutes!

The 2nd principle requires some clarification. In laser therapy, there is no such parameter as “dose” or “dosage”. There is “energy” = power ´ time [J] and “energy density” = energy/area [J/cm²]. The arithmetic demonstrations are absolutely not necessary! Let us give an example. The ED may be the same (most often the optimal 1J/cm²) in three different situations (assuming a contact-mirror technique and an effective area of 1cm²):

  • the power of 1mW is multiplied by the exposure time 1000 seconds (about 15 minutes) = 1J/cm²;
  • the power of 1000mW is multiplied by the exposure time 1 second = 1J/cm²;
  • the power of 10mW is multiplied by the exposure time 100 seconds (about 1.5 minutes) = 1J/cm².

But the effect, i.e., a positive result of the treatment, will be ONLY in the 3rd case, when all the optimal parameters are set, and even then, only for lasers of continuous operation with a wavelength of e.g. 635nm (red spectrum). In options 1 and 2, there will be no curative effect for any laser or mode of operation!

There are other recommendations that specialists in Russia are studying at specialized courses.

Analysis of different periods of development of LLLT allows us to conclude that its capabilities are still inadequately used, and there are all prerequisites for the active development and expansion of the application. This opinion is supported by the fact that only in 2016 more articles have been published in English-language journals than in the whole period since 1965 (the first reports) until 2000. Despite the fact that in the overwhelming majority of cases, the quality of publications is extremely low (this fact deserves a separate and detailed discussion), the positive trend is encouraging.


  1. Amirkhanyan A.N., Moskvin S.V. Laser therapy in dentistry. – M.–Tver: Triada, 2008. – 72 p. ISBN: 978-5-94789-271-0
  2. Berlien H.P., Müller G. Angewandte Lasermedizin, Lehr- und Handbuch für Praxis und Klinik, Hrsg: Laser-Medizin-Zentrum Berlin eccomed Landsberg, 1989. – 400 s.
  3. Brekhov E.I., Builin V.A., Moskvin S.V. Theory and practice of EHF-laser therapy. – Tver: Triada, 2007. – 160 p. ISBN: 978-5-94789-236-9
  4. Coulter A.H. Low-energy laser research in wound healing // Journal of Clinical Laser Medicine & Surgery. – 1994, 12(2): 117-118.
  5. Fedorova T.A., Moskvin S.V., Apolikhina I.A. Laser therapy in obstetrics and gynecology. – Tver: Triada, 2009. – 352 p. ISBN 978-5-94789-408-0
  6. Ivanchenko L.P., Kozdoba A.S., Moskvin S.V. Laser therapy in urology. – M.–Tver: Triada, 2009. – 132 p. ISBN 978-5-94789-376-2
  7. Khadartsev A.A., Kupeev V.G., Moskvin S.V. Fitolaserforesis. – M.–Tver: Triada, 2016. – 96 p. ISBN 978-5-94789-757-9
  8. Kochetkov A.V., Moskvin S.V. Laser therapy of patients with cerebral stroke. – Tver: Triada, 2004. – 51 p. ISBN: 5-94789-080-1
  9. Kochetkov A.V., Moskvin S.V., Karneev A.N. Laser therapy in neurology. – M.–Tver: Triada, 2012. – 360 p. ISBN 978-5-94789-472-1
  10. Moskvin S.V. Basics of laser therapy. Series “Effective Laser Therapy.” T. 1. – M. – Tver: Triada, 2016. – 896 p. ISBN 978-5-94789-738-8
  11. Moskvin S.V. Efficiency of laser therapy. Series “Effective Laser Therapy.” T. 2. – M.–Tver: Triada, 2014. – 896 p. ISBN 978-5-94789-636-7
  12. Moskvin S.V. Laser therapy as a modern stage of heliotherapy (historical aspect) // Laser medicine. – 1997. – T. 1. – Issue. 1. – P. 44–49.
  13. Moskvin S.V. Low-Level Laser Therapy in Russia: History, Science and Practice // J Lasers Med Sci 2017 Spring;8(2):56-65. doi: 10.15171/jlms.2017.11
  14. Moskvin S.V. To the question of the mechanisms of therapeutic action of low-intensity laser illumination (LLLI) // Bulletin of New Medical Technologies. – 2008. – T. 15, No. 1. – P. 167–172.
  15. Moskvin S.V., Amirkhanyan A.N. Methods of combined and combined laser therapy in dentistry. – M.–Tver: Triada, 2011. – 208 p. ISBN 978-5-94789-431-8
  16. Moskvin S.V., Geynits A.V., Khazov M.B., Fedorishchev I.A. Lasherphoresis of hyaluronic acid and laser anti-cellulite programs in cosmetology (LASMIK® technology). – M.–Tver: Triada, 2010. – 96 p. ISBN 978-5-94789-416-5
  17. Moskvin S.V., Geynits A.V., Kochetkov A.V. Laser-vacuum massage LASMIK® in medicine and cosmetology. – M.–Tver: Triada, 2014. – 160 p. ISBN 978-5-94789-640-4
  18. Moskvin S.V., Gorbani N.A. Laser-vacuum massage. – M.–Tver: Triada, 2010. – 72 p. ISBN 5-94789-168-9
  19. Moskvin S.V., Khadartsev A.A. EHF-laser therapy. – M.–Tver: Triada, 2016. – 168 p. ISBN 978-5-94789-746-3
  20. Moskvin S.V., Kisselev S.B. Laser therapy for joint and muscle pain. – M.–Tver: Triada, 2017. – 216 p. ISBN 978-5-94789-787-6
  21. Moskvin S.V., Kochetkov A.V. Effective Techniques of Low Level Laser Therapy. – M.–Tver: Triada, 2017. – 88 p. ISBN 978-5-94789-771-5
  22. Moskvin S.V., Konchugova T.V. Substantiation of the use of laser-phoresis of biologically active substances // Questions of balneology, physiotherapy and exercise therapy. – 2012. – № 5. – P. 57–63.
  23. Moskvin S.V., Nasedkin A.N., Osin A.Ya., Khan M.A. Laser therapy in pediatrics. – Moscow: EKSMO, 2010(1). – 479 p. ISBN: 978-5-699-41460-4
  24. Mufaged M.L., Ivanchenko L.P., Moskvin S.V. Laser therapy in urology. – Tver: Triada, 2007. – 132 p. ISBN 978-5-94789-254-3
  25. Nasedkin A.N., Moskvin S.V. Laser therapy in otorhinolaryngology. – M.–Tver: Triada, 2011. – 208 p. ISBN 978-5-94789-469-1


About the Author

Sergey V. Moskvin – Doctor of Biological Sciences, PhD of Technical Sciences, Leading Researcher of The Federal State-Financed Institution “State Scientific Centre of Laser Medicine under the Federal Medical Biological Agency” of Russia, Moscow, author of more than 550 scientific publications, including more than 55 monographs and 35 copyright certificates and patents;

e-mail: 7652612@mail.ru,