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Laser therapy is a versatile modality that can be used to treat many equine conditions. Through a process called photobiomodulation, laser therapy is able to target damaged cells to reduce pain and inflammation while promoting healing and increased circulation. Treatments are fast, non-invasive, and easy to administer, but most importantly, they are effective.
 
Veterinarians can use laser therapy to treat a range of disorders, either as a sole treatment option or as an adjunct to other complementary modalities. It can also be used to treat conditions of varying severity and difficulty. When pain and inflammation are present, laser therapy should be considered as part of the treatment protocol
 
To illustrate how versatile and effective this modality can be for the equine practitioner, here are 5 tough conditions that respond well to laser therapy, along with recommended treatment protocols for each:
1. Digital flexor tendon injuries

Injuries to the digital flexor tendons are common in equine athletes.  One of the primary goals when treating these injuries is to reduce the associated pain and inflammation. If these two factors can be address quickly, recovery will be accelerated.
 
If laser therapy is used immediately following the injury, the formation of scar tissue is minimized, healing is accelerated and the return to competition shortened. If laser therapy is not applied until the injury has reached a chronic stage, scar tissue will have already formed and the prognosis for the return to competition becomes guarded.
 
For acute digital flexor tendon injuries, 10 J/cm2 is a recommended dose. The veterinarian should deliver approximately 7,000 J to both the affected area and the immediately surrounding tissue. Contact application and placement of the tendons through a passive range of motion exercise through flexion and extension of the leg should be employed to reduce tension on the tendon and facilitate better energy delivery to the deeper structures. 15 watts is a typical power setting for this protocol as one can easily deliver the recommended treatment in 7-8 minutes. Treatments should be given daily for several days and then 3-4 times per week until resolution.
 
For chronic digital flexor tendon injuries, the same dosage may be used, but the power of the laser may be turned down and the treatment time extended to deliver the energy more slowly. Passive range of motion should again be used to maximize results. Treatments should then be delivered twice a week until the condition has sufficiently resolved, with periodic maintenance sessions as necessary.
2. Back pain
 
Back pain is another common condition. The cause of pain can be difficult to pinpoint, and therefore difficult to treat. Sometimes the pain is caused by direct trauma to the back, while other times it is a secondary or tertiary problem from a distal disorder. Laser therapy is a great option for treating back pain as it not only can be used to treat the pain itself, but can also stimulate healing within the tissues as well.
 
For example, consider a horse being presented with back pain secondary to a lesion within the digital flexor tendon structures. Laser therapy would be an ideal treatment option in this case because you can treat the secondary pain and inflammation in the back, as well as promote healing of the lesion within the tendon.  This provides a holistic treatment approach to the case that will allow a faster recovery.
 
For acute back conditions, the recommended dosage is 10-12 J/cm2. The back is a large area, so more energy is required to produce a therapeutic effect - between 14,000 – 16,000 J total is ideal. A higher power setting of 15 W is also recommended to keep the treatment time limited to 22 minutes. Treatment should be continued 3-4 times per week until resolution.
 
For chronic back pain, treatments should be administered 2-3 times per week until the condition has sufficiently resolved. In order to maximize energy delivery and minimize treatment time, the condition should be treated as acute in terms of dosage and power level. The back is a very large treatment area, so using a high power (like 15 W) allows for treatment of the entire area in a manageable time period.
 
3. Pharyngitis
 
Pharyngitis in horses can be an acute or chronic condition. In either case, laser therapy can be used in conjunction with traditional treatments to reduce the associated inflammation and pain.
 
When the pharyngitis is a result of an infection, the laser can be used in conjunction with antimicrobial medications to help ease the swelling of the tissues while the medication is working to combat the underlying infection. More specifically, since horses with this condition often have difficulty swallowing and/or breathing, applying laser therapy will enable the horse to recover faster than would be possible when only administering antimicrobial medications.
 
In the case of a chronic upper respiratory condition, laser therapy will reduce the initial inflammation, and since laser therapy is cumulative in effect, administering subsequent treatments will not allow this inflammation to reoccur.  There are no side-effects or performance restrictions with laser therapy, so treatments can be done as often as needed.
 
In acute and chronic cases of pharyngitis, 8-10 J/cm2 is recommended, for a total of about 4,000 J. When delivering the dose, it is ideal to apply with a contact method and move the handpiece throughout the throat latch.  Raise and lower the head of the patient during application and this will allow a more thorough saturation of the target tissues. To deliver the entire dose quickly, in about 5 minutes, 15 W should be used. Treatments should be administered as needed for each individual case.
 
4. Stifle injuries
 
The stifle is the largest and weakest joint in the equine athlete. It is also a complicated biomechanical anatomical structure that receives constant stress. As such, injuries to the area are common and can be difficult to pinpoint and effectively treat. Ideal treatment of the stifle should include not only the joint itself but all of its supporting soft tissue structures. Laser therapy provides a quick and effective reduction in pain and inflammation within these tissues.
 
In severe cases when surgery is required, laser therapy should be used post-operatively to accelerate healing. For chronic stifle conditions, like osteoarthritis, laser therapy can be used to not only manage pain and inflammation, but it will also slow down the deterioration of the joint.
 
For acute and chronic stifle conditions, it is very important to treat both the stifle and surrounding structures.  A dose of 9-11 J/cm2 is a recommended, for a total of about 12,000 J. To quickly treat such a large area, 15 W is a good power setting, allowing the attending therapist to deliver the full dose in 16 – 17 minutes. It is very difficult to place this area through a passive range of motion during treatment. If the condition is acute, administer treatments daily for 3-4 treatments, and then 2-3 times per week. If the condition is chronic, treatment every other day for the first week or two is ideal, followed by maintenance sessions 2-3 times per week.
 
5. Strained semimembranosus and semitendinosus muscles
 
As two of the primary muscles used for propulsion in the equine athlete, the semimembranosus and semitendinosus muscles are susceptible to many injuries. Injuries to this area not only significantly impact the horse’s athletic performance, but can also lead to sustained secondary lamenesses when not adequately addressed.
 
When a horse has injured either of these muscles, they will exhibit varying degrees of lameness. It is therefore important to employ a therapy method that will restore normal function and a return to competition as quickly as possible. Additionally, laser therapy has the added effect of increasing circulation, therefore it can be applied prior to competition to help prevent re-injury to the area and maximize athletic performance.
 
The recommended dosage for treating injured semimembranosus and semitendinosus muscles is 9-11 J/cm2, for a total of about 10,000 J. The hip and thigh region contain both superficial and deep structures, and comprise a large treatment area, so 15 W is a good power setting to cover the area quickly and ensure adequate energy is reaching the deeper target structures and musculature. These structures should always be treated with a contact hand piece as this in itself provides a mechanical range of motion to the muscle tissues. A 14-minute session at 15 W will yield a full dose, and which should be repeated daily for several days and then every other day until the condition is resolved.
 
 

5 Difficult-to-Treat Equine Conditions That Respond Well to Laser Therapy