Mar. 31, 2025
This guide was created to combat some of the misinformation on the web about cold lasers and PhotoBioModulation (PBM). This is a straight-forward and comprehensive guide to cold lasers and high dosage lasers, ranging from low-cost home systems to high-end systems for practitioners. You can use this guide in conjunction with our therapy laser comparison table to see most of the major players in the cold laser market and how they compare based on specifications and prices. There are over clinical studies and hundreds of books, videos, and other resources showing the effectiveness of laser therapy that you can search using the Laser-Therapy.US research tool. There are currently over 300,000 health care providers using cold lasers in their practice and over 750,000 laser users. Laser therapy is not an "experimental" therapy as insurance companies often say when they deny a claim for a laser.
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Even though most traditional MDs stay away from laser therapy, it is widely used by chiropractors, acupuncturists, physical therapists, herbalists, functional medicine specialists, vets, dentists, podiatrists and many other health care providers that focus on root cause of health care problems (like mitochondrial malfunctions) as opposed to focusing on the symptoms. Although lasers are not a cure-all, there should be little doubt that cold lasers are effective in treating a wide variety of problems. The majority of therapeutic lasers are used to treat damaged tissue and structural (bone, joint, and ligament) problems but the use of laser therapy to treat trigger points, acupoints, and lymph nodes is rapidly growing. Cold lasers are FDA registered for pain reduction, inflammation reduction, and increasing blood flow.
The main 3 specifications that people use to compare systems are:
1. Power:
Power is measured in milliwatts [mW] for class 1 to 3b systems and watts [W] for class 4 systems.
2. Wavelength
Wavelength is measured in nanometers [nm]. Each wavelength interacts with cells differently.
3. Pulsing
Some systems are continuous wave [CW] only, meaning that the laser is on 100% of the time. Some are pulsing only. Better systems are both. Some problems are best solved with pulsing
and some problems are best solved with CW. As problems get more complex, pulsing becomes more critical.
These variables control the quality of light and how it travels though, and reacts with, tissues. Dosage is the measure of total light energy put into the tissue. It is measured in Joules. Many people also care about the warranty, service and training associated with the laser. Please call for these specifics about each option.
In general, a laser's ability to successfully treat a wide variety of conditions is mostly based on output power at an appropriate wavelength, with some contribution added from pulsing.
In general, the addition of pulsing to laser therapy reduces how quickly you build up the energy dosage. For a fixed treatment time, the addition of pulsing makes up for the lower dosage and then some. The best option is to set the laser on pulsing and increase the treatment time to achieve the same dosage. Most of the body of scientific research in this area is focused on dosage (which is the total energy put into the treatment area). There is less emphasis on using exotic wavelengths and pulsing frequencies, although there is still some evidence of its' importance as well.
Based primarily on Dr. Hamblin's research and publications, we prefer 800nm to 860nm for nervous system and vascular issues. Followed by 600nm to 660nm, 980nm is the preferred option for pain control, and 905nm is preferred for blood work and other situations when safety is the highest priority. At this point, it appears that all the wavelengths are appropriate for treating structural or cellular damage.
Much of the misinformation about cold lasers is related to power levels and how they affect the safety and effectiveness of the product. Low power laser manufacturers have lots of ways to justify why their product is the best, but the overall market agrees that power is the single most important factor in determining the efficacy of cold lasers. With the exception of some class 4 lasers (which might have the capability to burn tissue if used incorrectly), more power is better because it allows practitioners to give patients higher dosage when it is appropriate. Many laser manufacturers have a doctor on staff who can write a recommendation letter to make sure that each buyer is getting proper supervision and training.
Lasers come in classes
1 through 4:
Class 1 lasers can be purchased for use at home on humans, and they have a maximum power of 5mW continuous per diode. Class 1b allows lasers to be up to 500mW but they still can not cause eye damage unless the bean is refocused. Several
manufacturers make higher power lasers that qualify as a class 1 or 2 by pulsing the laser. Just don't waste your time buying anything that looks like a laser pointer.
Class 3b lasers are designed for practitioners, but can also be purchased for use at home. Class 3 lasers must be less than 500mW per laser diode continuous output. Several
manufacturers have higher power units that use multiple diodes that have TOTAL power level in the class 4 range, but they are safe enough to qualify as a
class 3b device because they have less chance of eye damage and no chance of tissue heating damage. Many laser manufacturers have a doctor on staff who can write a recommendation letter to meet the requirements, so they can sell you a laser.
Class 4 lasers are any laser that has one or more laser beams with an output of 500mW or more (Avant tested their system to prove that they can deliver class 3b safety out of 700mW diodes.
Class 4 lasers between 0.5 watt and 104 watts can do damage to the eye or tissue if improperly
used. This danger is easily eliminated with training. The FDA has softened the standards so that Class 4 lasers can be sold for home use. They can be
purchased without any restrictions for use on pets and horses but need a prescription for home use on humans. Some laser manufacturers have a doctor on staff who can train new owners on how to get the best results with their laser.
The best lasers offer multiple wavelengths. This gives you more flexibility in treating a wider range of problems.
The next factor to consider is pulsing frequency and/or continuous wave operation. A laser can be turned on and off quickly to pulse the laser or it can sweep (operate at a constantly changing pulse frequency). Companies like Erchonia use extremely low power lasers (less than 20mW) and claim that all the" heavy lifting" is done with the pulsing and not the dosage. There is also a theory that the cells can become acclimated to any type of continuous input including continuous wave lasers and the pulsing helps keep the body from becoming desensitized to the laser therapy.
Continuous Wave (CW) light is best for getting higher dosages quickly so companies like Apollo make only CW lasers. They say that no one knows what the best pulsing frequency is, so why waste your time guessing and increasing the treatment times? More expensive lasers do both because sometimes you want the maximum dosage to give people an immediate improvement in their symptoms and sometimes you are OK with a lower dosage if you can get a stronger stimulation effect in the cells. Some conditions can take months of treatments, so some people might give up if they don't see an immediate improvement and stop the therapy. To prevent quitting, many practitioners start out the therapy routine with a higher dosage and then bring it down over time. Lasers with both continuous wave and pulsed wave allow practitioners and home users to optimize each treatment protocol based on the condition and the patient's expectations.
A recent summary study of laser therapy research by Huang et al. came to the conclusion that pulsing is best for most applications, except nervous system therapy.
There are a handful of other things to consider as well. This includes the quality of training (we offer the best in the industry), support literature, and the depth of their protocol library. Practitioners often put a high value on flexibility and power while home owners want an easy to use and safe product. If you are looking at a system on sketchy websites (that can cost less $), you might want to read our article about laser scams and questionable products.
In general, more powerful lasers provide faster results and shorter treatment times, so it can be good to buy as much power as you can afford.
Class 4: If you are a practitioner who is concerned about faster recoveries and shorter treatment times, and you have a structured environment, start looking at the class 4 lasers like the ReGen Laser, ATPmax or EVOlaser. These are elite lasers that offer high dosages and/or quick treatment times. This system have multistep internal protocols so it is really easy to get amazing results your first day with the laser. If you are a practitioner who wants a simple, yet powerful laser, with no risk of tissue heating, look at the Apollo desktop. These types of systems can be overkill for laser acupuncture, except the Apollo which offers an optional 500mW pinpoint probe and point finder.
If you are looking for a hands-free class 4 systems, the ReGen Laser, ATPmax and the EVOLaser offer hands-free options.
Class 3: The best overall value in class 3 lasers are the Avant portables. They blow away the competition (like Erchonia™) based on the specifications; Avant systems do everything well. The Avant Lasers offer RED, Violet and IR wavelengths, both pulsing and CW output, and both broad and pinpoint treatments in one compact package. Another great handheld option is the PowerMedic Pro laser. Their acupuncture probe is one of the best options because it is optimized for that application. For a desktop class 3 system, consider the Chattanooga Vectra Genisys (professionals only). Chattanooga is somewhat of an industry standard in PT and they make multi-modality systems. For unattended treatments, consider the Avant with a stand. We also sell the legendary ML830™.
Class 1, 2 & 1m: If safety is a high priority, the TerraQuant/MR4 series laser are a great option.. There are more TerraQuant lasers in the world than all the other brands put together. Because they use super-pulsing technology, they have higher peak power level than you can normally get in a sub-3b class laser. Remember to stay away from anything that looks like a laser pointer, as these systems are typically limited to 5mW and deliver such a tiny dosage that most people would consider them worthless. Class 1m lasers are limited to 500mW (the same as a class 3b) but cannot cause eye damage unless the laser is focused through a lens. Therefore, a class 1m can be about 100 times stronger than a class 2 or class 1.
View all the major brands on the market
We know it can be confusing. If you need help, please call us at 1-800-388-. We will be happy to answer any question about therapy lasers and we can make specific recommendations based on your needs.
Here are a few reasons to buy from ColdLasers.Org Brick and MortarLaser therapy (photobiomodulation, or PBM) is one of the fastest-growing modalities in chiropractic and in many other health care disciplines. As recently as 15 years ago there was little understanding of the mechanism behind photobiomodulation. But now thanks to the work of top researchers around the world, use of PBM science and the laser therapy device is rapidly advancing.
With a better understanding of laser mechanisms comes a better understanding of the optimal parameters for effective laser therapy treatments. laser therapy device equipment manufacturers that are implementing the latest laser therapy science and research into their devices and protocols will continually be improving clinical outcomes.
Want more information on Cold Laser Therapy Device? Feel free to contact us.
Investing in a therapeutic laser is a big decision for today’s chiropractor. There are many options on the market and oftentimes conflicting advice regarding laser parameters. But diligent laser equipment research pays off.
Ryan Lucas, DC, of Gaylord, Mich., said, “I am continually impressed with the various conditions that I have been able to help people with that they otherwise would have suffered with for years. This impresses me weekly even after using laser for 10 years.”
The first questions to ask when buying a laser therapy device should be about the company itself:
Questions should also be asked about warranty, service and repairs, and availability of loaner equipment, if needed. A therapy laser company should be devoted to advancing laser therapy science and offering various educational resources.
A reputable therapy laser company should be able to provide prompt clinical support from fellow clinicians experienced in treatment delivery, case management and laser safety. This clinical support should be included in the laser price — with no extra charges.
“My laser company has outstanding customer service and support. I have been using their lasers for more than 12 years and they have never let me down,” said Reed Lerman, DC, of Manahawkin, N.J.
The next questions to ask are about the laser equipment itself:
Next we move to the internal specifications of the laser device:
The important specifications for effective laser therapy treatments are as follows: wavelength, power, power density, treatment time, and mode of delivery (continuous wave versus pulsed modes of delivery).
Wavelength determines depth of penetration and the chromophores that will most readily absorb the laser photons. Most therapy lasers can emit multiple wavelengths simultaneously, with some offering “wavelength selectability,” which will turn on or off selected wavelengths.
The next generation of laser therapy device will be able to deliver multiple wavelengths at various power levels. This will further improve clinical outcomes.
Power correlates to the brightness of the laser light, and power density measures the concentration of the laser light. A higher-powered therapy laser can deliver more light to deeper tissues and can deliver a therapeutic dosage to a larger volume of tissue than a lower-powered laser. Therapeutic lasers utilize power density orders of magnitude lower than that of surgical lasers.
When it comes to power, beware of the American adage, “If some is good, then more is better,” as lasers with too much power can create liability issues.
The best therapeutic lasers can deliver laser light in multiple modes. This means the laser light could be constantly on or pulsing on/off at varying frequencies. This targets different tissue types in the patient and elicits different physiological responses from the tissues.
Certified laser therapist Suzanne Agliata advises, “Choose a laser that makes it easy to replicate any treatment.”
Laser therapy treatments must be delivered directly to the skin, as laser will not pass through clothing. Treatments are best delivered as an active procedure, with the laser therapist directly applying the laser to the patient. Unattended laser devices do not save on staffing expenses, as someone must be in the room monitoring the patient. Failing to do so opens the door to injury complaints and liability.
The physiological effects of laser therapy are reduced pain, modulated inflammation and enhanced tissue healing. Treatments are non-invasive and have virtually no side effects.
Jim Hoyt, DC, of Missouri Valley, Iowa, reports, “It’s the next best thing to a ‘magic wand!’ I could not practice without it and still deliver the best care possible.”
The final and perhaps most important consideration in purchasing a laser device is return on investment. After all, the most expensive piece of equipment is the one that you do not use — regardless of the cost.
Make an analysis of the number of patients and conditions that can be treated every month, and how much you can be reimbursed for those services. Laser equipment companies work with financing companies who can structure different types of loans or leases. One laser company offers a pay-as-you-go system, which allows for product evaluation with no long-term commitment.
Laser therapy is here to stay. It is a proven modality, helping scores of patients with pain and injuries every day. Brenda Medina, DC, of Franklin, Tenn., enthusiastically proclaims, “Laser therapy is a game-changer. I should wear a shirt that says, ‘Let’s laser that!’”
Choosing the right therapy laser will soon have you echoing her words.
If you want to learn more, please visit our website FDA Approved Cold Laser Therapy Device.
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