If you are dealing with muscle or joint pain, you may have heard about laser therapy as a non-invasive treatment option. But does therapeutic laser therapy actually help with pain?
Research suggests that it can.
Therapeutic laser therapy, often discussed in the research literature as photobiomodulation therapy (PBM), low-level laser therapy (LLLT), or high-intensity laser therapy (HILT), has been studied for a variety of musculoskeletal conditions.
Clinical research has found potential benefits for pain and, in some cases, function and range of motion. However, the results depend on the condition being treated, the type of laser used, the treatment dose, and how the therapy is combined with other rehabilitation strategies.
For patients, the most important takeaway is this:
Laser therapy may help manage pain, but it works best as part of a comprehensive physical therapy program rather than as a replacement for active rehabilitation.
What Is Laser Therapy in Physical Therapy?
Therapeutic laser therapy uses specific wavelengths of light to deliver energy to targeted tissues.
The broader therapeutic concept is often called photobiomodulation.
Unlike surgical lasers that are designed to cut, remove, or intentionally damage tissue, therapeutic lasers are used at parameters intended to produce biological effects without causing tissue destruction.
Depending on the device and treatment parameters, therapeutic laser may use red, near-infrared, or other wavelengths.
The specific wavelength, power, energy, treatment time, and application technique all influence how the light interacts with tissue.
This is important because laser therapy is not one single treatment protocol.
Different devices and treatment parameters can produce different biological and clinical effects.
How Can Laser Therapy Help With Pain?
Researchers believe photobiomodulation can influence several biological processes involved in pain and tissue response.
Potential mechanisms that have been investigated include changes in:
- Cellular signaling
- Mitochondrial activity
- Inflammatory pathways
- Oxidative processes
- Nerve signaling
- Local circulation
- Pain sensitivity
However, the exact mechanisms are complex and are still being investigated.
It is therefore more accurate to say that laser therapy may influence biological pathways involved in pain and tissue recovery rather than claiming that it simply "removes inflammation" or "heals damaged tissue."
Can Laser Therapy Help Muscle Pain?
Research has investigated laser therapy and photobiomodulation for several types of muscle-related pain.
These include:
- Muscle soreness
- Myofascial pain
- Exercise-related muscle pain
- Muscle injuries
- Trigger-point-related pain
- Sports-related musculoskeletal pain
The results vary depending on the condition and treatment parameters.
One area that has received considerable attention is myofascial pain, including pain in the neck and surrounding musculature.
A systematic review and meta-analysis of 13 randomized controlled trials involving 556 patients found that low-level laser therapy significantly reduced pain in people with myofascial neck pain. Improvements were also found in pressure pain sensitivity and some measures of range of motion, although disability did not significantly improve.
This suggests laser therapy may be useful for symptom management, but reducing pain does not necessarily mean that the underlying movement or strength problem has been completely resolved.
Can Laser Therapy Help Joint Pain?
Laser therapy has also been studied extensively for joint pain.
One of the best-researched examples is knee osteoarthritis.
A 2024 systematic review and meta-analysis published in Physical Therapy examined 10 randomized placebo-controlled studies involving 542 people with knee osteoarthritis.
The researchers found that photobiomodulation significantly reduced pain at rest compared with placebo. However, all of the included studies had unclear or high risk of bias, and the researchers rated the certainty of the evidence as very low. They concluded that PBM may complement other recommended treatments but should not be considered a stand-alone treatment based on the current evidence.
Another systematic review examining low-level laser therapy combined with exercise for knee osteoarthritis found improvements in pain but did not find significant improvements in knee range of motion, muscle strength, or overall knee function compared with exercise plus placebo laser.
This is an important distinction.
Laser therapy may help reduce pain without automatically restoring strength or function.
That is why exercise and progressive rehabilitation remain important.
Can Laser Therapy Help With Neck Pain?
Neck pain is another area where laser therapy has been studied.
A large systematic review published in The Lancet included 16 randomized controlled trials involving 820 patients and found that low-level laser therapy reduced pain in both acute and chronic neck pain populations compared with placebo. The researchers reported that the benefits could persist beyond the immediate treatment period in some studies.
More recent research has also examined high-intensity laser therapy.
A 2023 systematic review and meta-analysis of eight randomized controlled trials found moderate-quality evidence that high-intensity laser therapy improved pain and certain cervical range-of-motion measures in people with neck pain. The authors concluded that HILT may be considered an adjunctive treatment.
A larger 2024 systematic review included 20 studies and found that high-intensity laser therapy reduced neck pain and disability and improved cervical extension. However, the overall certainty of evidence was considered low because of study heterogeneity and risk of bias.
What About Shoulder Pain?
Photobiomodulation has also been studied for shoulder conditions.
A 2024 comprehensive review evaluated 36 clinical studies involving photobiomodulation for shoulder and neck pain. The authors found evidence of potential benefits across several shoulder and neck conditions, while also highlighting differences in treatment protocols and study designs.
This is particularly important because "shoulder pain" is not one diagnosis.
Shoulder pain may result from:
- Rotator cuff-related pain
- Tendinopathy
- Osteoarthritis
- Adhesive capsulitis
- Muscle-related pain
- Post-surgical conditions
- Cervical or nerve-related problems
Laser therapy may be appropriate for some patients but not others.
A physical therapist should first determine why the shoulder hurts before deciding whether laser therapy is appropriate.
Can Laser Therapy Help With Back Pain?
High-intensity laser therapy has also been studied for low back pain and other spinal conditions.
A systematic review and meta-analysis of 12 studies found that high-intensity laser therapy significantly improved pain and disability compared with control treatments in patients with musculoskeletal disorders. The largest improvements were reported in neck and back pain subgroups.
However, an important consideration is that low back pain has many different causes.
Laser therapy does not address every potential contributor to back pain.
For example, a patient's symptoms may also be influenced by:
- Muscle weakness
- Reduced mobility
- Poor load tolerance
- Movement patterns
- Nerve sensitivity
- Training errors
- Work demands
- Sleep
- Stress
- Previous injury
A complete physical therapy evaluation is therefore important.
Does Laser Therapy Reduce Inflammation?
You may see laser therapy described as an "anti-inflammatory" treatment.
There is laboratory and clinical evidence suggesting photobiomodulation can influence inflammatory signaling and biological processes associated with inflammation.
However, saying that laser therapy simply "gets rid of inflammation" is an oversimplification.
Inflammation is a normal biological process that can be beneficial in certain stages of healing.
The goal of rehabilitation is not necessarily to eliminate inflammation completely. Instead, treatment should address the patient's symptoms and underlying condition while supporting appropriate tissue recovery and function.
Does Laser Therapy Speed Up Healing?
Laser therapy is frequently marketed as a way to accelerate tissue healing.
There is biological research supporting potential effects on cellular activity and tissue responses. However, the strength of clinical evidence varies considerably depending on the tissue and condition being treated.
Therefore, it is more accurate to say that laser therapy may support certain biological processes associated with tissue recovery rather than promising that it will make every injury heal faster.
For patients recovering from an injury, factors such as appropriate loading, nutrition, sleep, circulation, and progressive rehabilitation also play important roles.
Is Laser Therapy the Same as Red Light Therapy?
They are related, but the terms are not necessarily interchangeable.
Photobiomodulation is the broader therapeutic concept involving specific wavelengths and doses of light.
Red light therapy typically refers to treatment using red wavelengths.
Near-infrared light is also commonly used in photobiomodulation because these wavelengths can penetrate tissues differently than visible red light.
Therapeutic lasers can deliver specific wavelengths and energy levels with greater control than some consumer LED devices.
Therefore, research involving one type of light device should not automatically be assumed to apply identically to every red light or laser device.
What Is Class IV Laser Therapy?
Class IV laser therapy refers to a classification of therapeutic laser devices based on their power output.
These higher-powered therapeutic lasers can deliver energy to tissues at treatment parameters that differ from lower-powered laser systems.
Class IV lasers are sometimes used in physical therapy for musculoskeletal conditions, including pain and mobility-related problems.
Importantly, the term "Class IV" describes the laser safety classification, not a guarantee that the treatment will be more effective than every lower-powered laser.
Treatment effectiveness depends on factors such as:
- Wavelength
- Power
- Energy delivered
- Irradiance
- Treatment area
- Treatment duration
- Treatment frequency
- Diagnosis
- Individual patient characteristics
Does More Laser Power Mean Better Results?
Not necessarily.
One of the most important concepts in photobiomodulation is treatment dosage.
The biological response to light depends on multiple factors, including wavelength and energy delivered.
There is not one universally effective laser dose for every condition.
Research on musculoskeletal laser therapy has demonstrated substantial variation in treatment parameters, making it difficult to directly compare results between studies.
This is one reason evidence-based laser therapy should be individualized rather than based simply on the idea that "more power is better."
Can Laser Therapy Replace Exercise?
No.
This is perhaps the most important point for patients.
Laser therapy may help reduce symptoms, but pain reduction alone does not necessarily restore:
- Strength
- Balance
- Mobility
- Coordination
- Power
- Endurance
- Movement control
- Sport-specific ability
For example, a patient with knee osteoarthritis may experience less pain following laser therapy. But they may still need strengthening and functional exercises to improve their ability to walk, climb stairs, squat, or participate in recreational activities.
Similarly, an athlete with muscle pain may benefit from laser therapy while still needing progressive loading before safely returning to sport.
The goal is not simply to make the pain go away.
The goal is to help the patient return to normal movement and function.
How Is Laser Therapy Used in Physical Therapy?
Laser therapy is typically most useful when incorporated into a larger rehabilitation program.
A physical therapist may first perform an evaluation to determine:
- What is causing the patient's symptoms?
- What tissues may be contributing to the problem?
- What movements or activities are limited?
- What is the patient's current strength and mobility?
- Is laser therapy appropriate?
- What other interventions are needed?
If laser therapy is selected, it may be combined with:
- Therapeutic exercise
- Strength training
- Mobility exercises
- Manual therapy
- Neuromuscular re-education
- Balance training
- Movement retraining
- Sport-specific rehabilitation
Laser therapy can then be reassessed based on changes in pain, movement, and function.
What Does Laser Therapy Feel Like?
Many patients experience little or no discomfort during therapeutic laser treatment.
Depending on the device and settings, patients may feel:
- Mild warmth
- Gentle pressure from the applicator
- Little to no sensation
The experience varies depending on the device, treatment area, and treatment parameters.
Laser therapy should not be thought of as a treatment that needs to hurt in order to work.
Is Laser Therapy Safe?
Therapeutic laser treatment is generally considered non-invasive and well tolerated when appropriately administered.
However, lasers can cause eye injury if used improperly, so appropriate eye protection and safety procedures are important.
Laser therapy may also be inappropriate for certain patients or treatment areas. A physical therapist or other qualified healthcare professional should determine whether it is appropriate based on the patient's medical history and the specific device being used.
Patients should always tell their clinician about relevant medical conditions, medications, recent procedures, and other health considerations before treatment.
What Does the Research Actually Say?
Overall, the research on laser therapy is promising but condition-specific.
Systematic reviews have reported improvements in pain for conditions including neck pain, knee osteoarthritis, and other musculoskeletal disorders. However, the certainty of evidence varies, and some reviews have identified limitations involving study quality, treatment parameters, and differences between protocols.
For example:
- Knee osteoarthritis: PBM may reduce pain, but the certainty of evidence is currently very low.
- Neck pain: Both low-level and high-intensity laser therapy have demonstrated potential benefits for pain, with some evidence also supporting improvements in range of motion.
- Myofascial neck pain: LLLT may reduce pain, although improvements in disability are less consistent.
- Musculoskeletal pain overall: Reviews of high-intensity laser therapy report improvements in pain and disability, but the quality of the underlying evidence varies.
This is why a responsible physical therapy approach should not promise that laser therapy will "cure" pain.
Instead, it should be considered one evidence-informed tool within a larger treatment strategy.
The Bottom Line
Yes, laser therapy may help with certain types of muscle and joint pain.
Research supports potential pain-relieving effects of photobiomodulation and therapeutic laser therapy for several musculoskeletal conditions, including some types of neck pain, knee osteoarthritis, myofascial pain, and other musculoskeletal disorders.
However, the evidence is not equally strong for every condition, and treatment parameters matter.
Laser therapy should therefore not be viewed as a replacement for exercise or comprehensive physical therapy.
At Core Performance Physical Therapy, therapeutic laser can be incorporated into an individualized rehabilitation program when appropriate. Depending on the patient's needs, laser therapy may be combined with strengthening, mobility training, manual therapy, movement assessment, and functional or sport-specific rehabilitation.
The goal is not simply to treat pain. The goal is to help you move better, build strength, and get back to the activities that matter to you.
Frequently Asked Questions About Laser Therapy
Can laser therapy help muscle pain?
Research suggests that photobiomodulation may reduce pain associated with certain muscle and myofascial conditions. Results vary depending on the diagnosis and treatment parameters.
Can laser therapy help joint pain?
Yes. Laser and photobiomodulation therapy have been studied for several joint conditions, including knee osteoarthritis. Research suggests it may reduce pain in some patients, although the certainty of evidence varies.
How does laser therapy reduce pain?
Researchers believe photobiomodulation may influence cellular signaling, inflammatory processes, nerve activity, and other biological pathways associated with pain. The exact mechanisms are still being investigated.
Does laser therapy heal injuries?
Laser therapy may influence biological processes associated with tissue recovery, but it should not be marketed as a guaranteed way to accelerate healing. Appropriate rehabilitation, progressive loading, and other factors remain important.
Does laser therapy hurt?
Most patients experience little or no discomfort. Some therapeutic lasers may produce mild warmth during treatment.
How many laser therapy sessions will I need?
There is no universal number of sessions. Treatment frequency and duration depend on the diagnosis, treatment parameters, response to therapy, and overall rehabilitation plan.
Is Class IV laser therapy the same as photobiomodulation?
Class IV laser therapy is one way of delivering therapeutic laser energy. Photobiomodulation is the broader therapeutic concept involving specific wavelengths and doses of light.
Can laser therapy replace physical therapy exercises?
No. Laser therapy is generally best used as an adjunct to active rehabilitation rather than a replacement for strengthening, mobility, and functional exercise.
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