Low-Level Laser Therapy (LLLT) works on various tissues through bio-stimulation mechanisms, providing benefits such as anti-inflammatory, analgesic, and healing/regenerative effects. The radiation emitted by low-intensity therapeutic lasers influences the metabolism of target cells, generating bio-stimulatory effects that manifest in cellular and vascular processes, directly related to cellular regeneration.

In practice, low-intensity laser radiation enhances the biological processes of homeostasis, resulting in an accelerated response to the usual phenomena of regulatory and regenerative functions of the organism. Additionally, this technique can correct the body's biological response when it is no longer functioning properly due to various reasons, such as lifestyle or diseases.

The biological action triggered by low-intensity laser radiation occurs when the energy from photons is absorbed by intracellular components, creating a slight thermal imbalance (a subtle warming that goes unnoticed), which alters the concentration of calcium ions (Ca2+). This, in turn, stimulates oscillations in Ca2+ concentration and the propagation of waves in the cytosol, activating processes related to calcium.

Notable effects include:

- Increased synthesis of DNA and RNA;

- Improved redox potential of mitochondria and in the synthesis and storage of ATP;

- Release of nitric oxide (NO);

- Release of reactive oxygen species;

- Altered cellular response to hormones;

- Regulation of exocytosis;

- Maintenance of Ca2+ levels in the Golgi complex, mediated by the action of Ca2+-ATPase, which is essential for the regulation of secretion and cellular communication.

These effects impact various biological processes, including:

- Microcirculation;

- Inflammatory processes;

- Neurohumoral regulation;

- Tissue repair;

- Immune system activity;

- Endocrine system function;

- Spasmolytic action;

- Reflex responses in different organs and systems.

In addition to the chemical potential arising from essential processes in cellular organisation—such as ionic exchanges and proton transfers in mitochondria—these phenomena manifest as electromagnetic forces. Physiologically, we can observe these manifestations, for instance, in cardiac muscle contraction, blood flow, digestion, and nerve impulse transmission.

It is important to remember that we are constantly exposed to electromagnetic fields around us, stemming from the cosmos, as well as from electrical and electronic machines and equipment—and that each individual generates their own electromagnetic field. In some situations, depolarisations may occur that need to be repolarised to maintain or restore a healthy state.

Thus, the nature of low-level laser therapy (LLLT) as an electromagnetic source induces a change in the electromagnetic field of cells, stimulating the body's capacity for self-regulation and self-recovery, resulting in tissue and functional regeneration, which implies the correction of pathological conditions.

The mechanism that initiates the biological reactions triggered by low-intensity laser radiation is of an electromagnetic nature and is comprehensive, meaning it is not specific to certain types of cells, but acts on all of them. This activates the energy centres of the cells exposed to radiation, contributing to the maintenance and homeostatic regulation, while preventing new occurrences of diseases.

When considering this phenomenon as a thermodynamic interaction between LLLT and biological structures, it becomes possible to more easily and reliably predict the treatment outcomes.

Contraindications:

The use of this therapy is contraindicated in cases of decompensated renal, hepatic, cardiac, and psychiatric pathologies, as well as in oncological diseases. There are limitations to the application of the therapy depending on the patient's overall condition, the phase of the pathologies, and other factors.

This type of treatment should be indicated and carried out by a specialist or, at the very least, with their direct involvement.

LASER – Light Amplification by Stimulated Emission of Radiation

The acronym LASER stands for Light Amplification by Stimulated Emission of Radiation, which can be translated as amplification of light through stimulated emission of radiation. The main difference between a laser and a fluorescent lamp, for example, is that in a laser, the "forced" emission of photons occurs due to other photons, functioning as a kind of "replica" of photons, resulting in the amplification of light. Each photon that appears is an exact copy of the photon that originated it, which gives the laser unique characteristics such as coherence, polarisation, and monochromaticity.

Coherence refers to the propagation of photons in the same direction and with the same frequency.

Polarisation refers to the symmetry in the distribution of the orientation of the intensity vector of the electric or magnetic field in the electromagnetic wave in relation to the direction in which it propagates.

Monochromaticity is the property of radiation with a specific frequency or wavelength. More precisely, it is the characteristic of radiation that has a sufficiently narrow spectral width to emit only a single colour, in contrast to sunlight, which encompasses the entire spectrum of visible colours.

The emission of low-intensity laser radiation generates an electromagnetic wave, which represents a change in the state of the medium or field, propagating through space at a finite velocity. This wave is characterised by the following parameters:

• Frequency: a physical quantity that indicates the number of oscillations per second (its unit of measurement is the hertz – Hz).

• Wavelength: the distance the wave travels during one cycle (its unit of measurement is the nanometre – nm).

• Power: the amount of energy emitted per unit of time (its unit of measurement is the watt – W).

Opioids: Understanding Opiates

Opiates, also known as opioids, are substances that, as the name suggests, are derived from opium.

Definition of Opiates

Opiates can be both natural, extracted from the poppy known as *Papaver somniferum*, and synthetic, which are generally made from opium. There are several options for opiates used in medicine, among which the following stand out:

- Morphine: frequently used to treat severe pain and anxiety;

- Codeine: used for mild pain and as an effective cough suppressant;

- Thebaine: employed in pain management, converted into naloxone, which acts as a morphine antagonist;

- Papaverine: a spasmolytic and vasodilator;

- Noscapine: known for its antitussive and antipyretic properties.

Natural opiates are obtained through direct extraction from the poppy capsule. These substances generate effects similar to the opioids produced by the body, such as endorphins and enkephalins, which are neurotransmitters fundamental for cellular communication in the nervous system. The main indications for the use of these drugs include relief of severe pain and reduction of anxiety.

Effects of Opiates

Opiates work by decreasing the activity of the central nervous system (CNS), providing analgesia and hypnosis, and suppressing cough and respiratory centres, resulting in reduced heart rate and blood pressure. However, they can lead to chemical dependence due to the sense of euphoria they promote. Discontinuation of use leads to a difficult withdrawal process, with symptoms that may include:

- Nausea and vomiting;

- Diarrhoea;

- Cramps;

- Abdominal pain;

- Tearing;

- Nasal discharge;

- Among others.

These signs can persist for up to 12 days.

Tolerance

The clinical effectiveness of opiate use can be compromised by the development of tolerance, which consists of a decrease in analgesic effect. This may lead to hyperalgesia, or an exaggerated response to pain, and/or allodynia, which is the perception of pain in normally painless stimuli. This, in turn, results in the need to increase the dose, causing side effects such as:

- Chronic pain related to decreased physical activity;

- Respiratory depression;

- Constipation;

- Cognitive difficulties;

- Medication dependence;

- Psychosocial complications.

Solutions

Therefore, it is essential to seek new approaches that address the underlying cause of pain. In this context, the Power Clinic offers treatments with medical laser therapy, specifically low-level laser therapy (LLLT), which can reduce or eliminate pain and associated anxiety, promoting the functional recovery of patients both physically and mentally. This naturally leads to a reduction or, ideally, a cessation of the use of non-steroidal anti-inflammatory drugs (NSAIDs), opiates, and corticosteroids.

The Centre for Evidence-Based Medicine (CEMBE) conducted a meta-analysis of four studies from health system databases in Canada and Europe, aimed at assessing the true risk of acute myocardial infarction (AMI) associated with the regular use of non-steroidal anti-inflammatory drugs (NSAIDs). The results indicated that all analysed NSAIDs were associated with an increase in the risk of AMI.

Understanding Pain

Pain is an unpleasant experience of an emotional or physical nature, recognised as a mechanism for defence and survival. It acts as an alert for the body, signalling the presence of some anomaly in one or more areas. It is estimated that approximately 80% of medical consultations are motivated by the sensation of pain.

Classification of Pain

Pain can be categorised according to its duration, thus dividing it into:

- Acute: Characterised by its short duration, it usually disappears once the underlying cause is treated or resolved. It is often well-localised.

- Chronic: Lasting more than three months, where the intensity is not directly related to the event that caused it, and in many cases, the origin may be unknown.

Regarding its neurophysiological classification, pain can be divided into:

- Nociceptive: Resulting from the activation of nociceptors by painful stimuli, which may be mechanical, thermal, or chemical, subdivided further into:

- Somatic: Made worse by movement and generally relieved at rest; it may have a musculoskeletal, joint, or postoperative origin.

- Visceral: Arises from the distension of hollow organs, typically poorly localised and may be accompanied by nausea, vomiting, or sweating.

- Non-nociceptive: Not dependent on painful stimuli, which can be classified into:

- Neuropathic: Resulting from injury or dysfunction of the Central or Peripheral Nervous System.

- Psychogenic: When it is not possible to identify a nociceptive or neuropathic mechanism.

How Can Medical Laser Therapy Relieve Pain?

Low-level laser therapy (LLLT) stimulates the body’s cells, promoting the release of nitric oxide into the bloodstream and adjacent tissues. This process causes the relaxation of cells in the arteries, veins, and lymphatic vessels.

With muscle relaxation, blood vessels dilate, resulting in a significant increase in circulation. As a result, the body can more effectively address the affected area, accelerating the replacement of damaged cells through increased RNA and DNA synthesis.

Furthermore, LLLT boosts the production of adenosine triphosphate (ATP), which transports energy to the cells and contributes to the generation of endorphins, favouring prolonged pain relief.

Laser radiation consists of a combination of electromagnetic waves of invisible (infrared) and visible (red and blue) light. Infrared light, with its longer wavelength, has the capacity to penetrate more deeply into soft tissues.

Consequently, infrared light is found to be more effective in treating bones, joints, and deep muscles. The combination of the two types of light has been shown to facilitate pain relief and accelerate the healing process through the following mechanisms:

- Increased blood circulation;

- Reduction of pain;

- Stimulation of endorphin production, providing long-term relief;

- Decreased swelling through increased lymphatic system activity;

- Stimulation of ATP release, which supplies energy to the cells;

- Rapid replacement of damaged cells, promoting an increase in RNA and DNA synthesis.

ILIB is an innovative therapy that uses low-intensity laser applied intravenously. The technique stimulates cellular regeneration, improves blood circulation, and enhances the immune system. It is indicated for treating inflammation, strengthening overall health, and improving well-being. The procedure is safe, painless, and effective, helping to reduce oxidative stress levels in the body, thus promoting greater vitality and quality of life.

The infrared therapy uses infrared light to promote deep heating of the tissues, which helps relieve muscle pain, improve blood circulation, and accelerate cellular recovery. The infrared heat penetrates deeper layers of the skin, providing muscle relaxation and assisting in the relief of chronic pain. Additionally, it contributes to the detoxification of the body, stimulating metabolism and enhancing overall health.