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1. At the moment of injury: Chemicals are released from damaged cells, triggering the inflammation process. Blood vessels at the injury site become dilated; blood flow increases to carry nutrients to the site of tissue damage. 2. Within hours of injury: White blood cells (leukocytes) travel down the bloodstream to the injury site where they begin to tear down and remove damaged tissue (via lymphatic drainage), allowing other specialized cells to start developing scar tissue. Cell proliferation and modeling occurs at this point. 3. Within days of injury: Scar tissue is formed on the skin or inside the body as the proliferation and modeling continue. The amount of scarring may be proportional to the amount of swelling, inflammation, or bleeding within. In the next few weeks, the damaged area will regain a great deal of strength as scar tissue continues to form. 4. Within a month of injury: Scar tissue may start to shrink, bringing damaged, torn, or separated tissues back together. However, it may be several months or more before the injury is completely healed. Pathology of Pain Pain is a universal experience. Nearly one-third of people will experience chronic pain at some point in their lives. Chronic pain affects 50 million Americans, according to the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). This costs the country $125 billion or more each year in treatment, disability compensation and lost productivity. Pain is the major reason for a patient to seek healthcare. For this reason JCAHO now lists pain as the “Fifth Vital Sign,” along with pulse, blood pressure, temperature and respiration rate. Yet only an estimated one in four Americans with chronic pain receives proper treatment. Clinical pain results from the stimulation of nerve endings, or nociceptors. This stimulation is most often caused by traumatic injury or disease affecting peripheral tissues. Pain signals are then sent along to the spinal cord and up to the brain where it is consciously recognized. Examples include skin cuts, bruises, arthritis and bone fractures. Pain can also arise from direct injury or disease of the nerves leading to the spinal cord, to the spinal cord itself or to the brain. This is called neuropathic disease. Examples include carpal-tunnel syndrome, migraines, and fibromyalgia. Light Therapies and Tissue Healing One of the beneficial characteristics of light therapy is that it has the ability to promote and enhance healing, not just treat symptoms. The irradiation by infrared light triggers the natural repair mechanisms carried out by the body. Several of the mechanisms of action for light therapy that work to alleviate pain and inflammation also play an important role in tissue healing. Wound healing progresses through stages of inflammation, proliferation, remodeling and maturation. Light therapy has been demonstrated to impact each of these phases in beneficial ways. Light therapy can provide the following beneficial impacts in both open surface wounds and closed connective or soft tissue injuries: 1. Enhanced leukocyte infiltration. Light therapy stimulates activity involving neutrophils, monocytes and lymphocytes. These white blood cells play key roles in clearing out damaged cells. 2. Increased macrophage activity. Light therapy accelerates macrophage activity in phagocytosis, growth factor secretion and stimulation of collagen synthesis. Increased neovascularization. The significant angiogenesis that occurs with laser therapy promotes revascularization with subsequent improvement in perfusion and oxygenation. Endothelial cell regeneration is accelerate7 3.PDF Image | Mechanisms of Action for Infrared Light on Tissue Healing
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