Laser Therapy Applications in Musculoskeletal Pain Management

Laser therapy has emerged as a versatile modality for treating a wide spectrum of musculoskeletal pain conditions. By delivering coherent light at specific wavelengths and power densities, both low-level laser therapy (LLLT) and high-intensity laser therapy (HILT) stimulate photochemical and photothermal processes in tissues. These processes may enhance mitochondrial activity, modulate inflammatory mediators and promote microcirculation, thereby reducing pain and accelerating tissue repair. Clinical applications span nonspecific low back pain, osteoarthritic knee pain, shoulder tendinopathies and enthesopathies of the elbow and heel. Protocols differ in wavelength (commonly 600–1,100 nm), dose (ranging from a few joules up to several tens of joules per centimetre squared) and pulse characteristics, tailored to depth and target pathology. Devices can be handheld or integrated into physiotherapy practice as adjuncts to exercise, manual therapy and ergonomic interventions. The global uptake has been driven by favourable safety profiles, non-invasiveness and the potential to reduce reliance on pharmacological analgesics. While efficacy varies according to treatment parameters and patient characteristics, consensus is growing around standardised protocols and outcome measures to optimise clinical benefit and reproducibility.

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Laser Therapy Applications in Musculoskeletal Pain Management publication trend

The graph below shows the total number of articles in laser therapy applications in musculoskeletal pain management across all publications each year (not limited to Nature Index journals).

Technical terms

Low-level laser therapy (LLLT): Delivery of low-power laser irradiation (typically <500 mW) that induces photobiomodulation without generating appreciable heat.

High-intensity laser therapy (HILT): Application of higher-power laser beams (often >500 mW) producing both photobiomodulatory and photothermal effects to reach deeper tissues.

Photobiomodulation: Cellular response to non-ionising light, leading to enhanced mitochondrial respiration, nitric oxide release and modulation of inflammatory pathways.

Visual analogue scale (VAS): Unidimensional measure of pain intensity on a continuous line, usually 0–10 cm, widely used in clinical trials.

Oswestry Disability Index (ODI): Questionnaire assessing the degree of disability and functional impairment in patients with low back pain.

References

1. High-Intensity Laser Therapy for Musculoskeletal Disorders: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Journal of Clinical Medicine (2023).
2. High-Intensity Laser Therapy (HILT) as an Emerging Treatment for Vulvodynia and Chronic Musculoskeletal Pain Disorders: A Systematic Review of Treatment Efficacy. Journal of Clinical Medicine (2022).
3. A Randomized Comparative Study between High‐Intensity and Low‐Level Laser Therapy in the Treatment of Chronic Nonspecific Low Back Pain. Evidence-based Complementary and Alternative Medicine (2020).