Evidence Summary: Managing lymphoedema: Low level laser therapy
- Jenni Muscat
- Jan 8
- 2 min read
Overview: Lymphoedema is a condition characterized by the accumulation of lymphatic fluid in tissues, leading to swelling, typically in the limbs. The management of lymphoedema includes various approaches such as compression garments, manual lymphatic drainage (MLD), and exercises. In recent years, Low-Level Laser Therapy (LLLT), also known as photobiomodulation (PBM), has been explored as a potential adjunctive treatment for lymphoedema. LLLT uses specific wavelengths of light to penetrate tissues, aiming to reduce inflammation, promote lymphatic flow, and encourage tissue healing.
Mechanism of Action:
LLLT involves the application of low-intensity light (typically in the red or near-infrared spectrum) to the skin, which is thought to stimulate cellular processes such as:
Increased lymphatic drainage.
Improved cell metabolism and tissue repair.
Reduced inflammation and pain.
Clinical Evidence:
Effectiveness in Reducing Swelling: Multiple studies have investigated the role of LLLT in reducing limb volume and swelling in patients with lymphoedema, particularly after breast cancer treatments or other lymphatic damage.
A systematic review and meta-analysis (2015) concluded that LLLT might significantly reduce limb circumference and improve quality of life in patients with breast cancer-related lymphoedema.
Another study found that LLLT, combined with conventional therapies (e.g., MLD), demonstrated better results in reducing limb volume than either treatment alone.
Reduction in Pain and Inflammation: Several studies have suggested that LLLT can help reduce pain and inflammation associated with lymphoedema. Laser therapy may promote analgesic effects, potentially by modulating the inflammatory process or through the stimulation of endorphins.
Improved Lymphatic Function: Some trials have shown that LLLT may enhance lymphatic function by stimulating lymphatic vessel contraction and improving tissue permeability. This helps facilitate the movement of lymph fluid from the tissues into the lymphatic system, potentially reducing fluid accumulation in affected areas.
Comparative Studies: In some studies, LLLT has been compared with other treatments such as pneumatic compression or MLD. While LLLT alone often showed moderate benefits, the combination of LLLT with other therapeutic methods appears to be the most effective strategy for managing lymphoedema.
Safety and Side Effects: LLLT is generally considered safe when administered by trained professionals. Common side effects are minimal and may include mild skin irritation, redness, or slight discomfort during treatment. The risk of more serious side effects, such as burns or tissue damage, is low due to the low energy used in LLLT.
Limitations of Current Research:
Inconsistency in Protocols: A major limitation in the research on LLLT for lymphoedema is the variation in treatment protocols. Different studies use different light wavelengths, dosages, treatment frequencies, and durations, making it difficult to draw definitive conclusions.
Small Sample Sizes: Many studies have small sample sizes, leading to questions about the generalizability of the results.
Long-Term Effectiveness: While LLLT may provide short-term benefits, there is insufficient evidence to determine its long-term effectiveness in preventing the progression of lymphoedema or providing sustained relief.
Conclusion:
Low-Level Laser Therapy has emerged as a promising adjunctive treatment for managing lymphoedema, particularly in reducing swelling and pain, and improving lymphatic function. However, more robust and well-designed clinical trials are needed to establish standardized treatment protocols, assess long-term effectiveness, and further elucidate the mechanisms by which LLLT works. Until such evidence is available, LLLT can be considered a supplementary therapy in conjunction with established treatments like compression therapy and manual lymphatic drainage.
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