Laser Therapy: A Non-Invasive, Painless and Cost-Effective Therapy for Pain

Laser Therapy: A Non-Invasive, Painless and Cost-Effective Therapy for Pain

Over my 25 years working in the chiropractic profession laser therapy has really evolved. Laser therapy started with Class I small red pens under five milliwatts and today at the other end of the spectrum we have very potent Class IV laser over 500 milliwatts.

Pain is the most common reason for physician consultation in the United States. One out of three Americans is affected by chronic pain annually. The number one reason for missed work or school days is musculoskeletal pain. Currently accepted therapies consist of non-steroidal anti-inflammatory drugs, steroid injections, opiate pain medications and surgery, each of which carries their own specific risk profiles. What is needed are effective treatments for pain which have an acceptably low risk-profile. For over forty years, low level laser (light) therapy (LLLT) … has been shown to reduce inflammation and edema, induce analgesia, and promote healing in a range of musculoskeletal pathologies.
— Howard B. Cotler, et al, The Use of Low Level Level Laser Therapy (LLLT) for Musculoskeletal Pain

LLLT, sometimes also referred to as low level light therapy or photobiomodulation (PBM), is a low intensity light therapy. The effect is photochemical not thermal. The light triggers biochemical changes within cells and can be compared to the process of photosynthesis in plants where the photons are absorbed by cellular photoreceptors, thereby triggering chemical changes.

In short, laser light has the ability to stimulate healing at the cellular level injured cells which causes injured cells to metabolize more quickly than they normally would. It is that metabolism which accelerates the healing process.

With LLLT we apply specific wavelengths of light energy that are capable of penetrating tissue to be absorbed by the cells. Sufficient energy must be delivered to the target tissue to trigger a response.

LLLT involves use of a near-infrared laser operating at a wavelength of 600 to 1,000 nanometers and at various power levels. Class IIIB lasers operate at less than 500 milliwatts and Class IV lasers operate at more than 500 milliwatts. These lasers are designed to produce no heat which is why LLLT is sometimes called cold laser therapy. We use both Class IIIB and Class IV LLLT at Wagner Chiropractic.

While many are unable to differentiate the beneficial effects between Class IIIB and Class IV systems, Class IV is able to apply therapeutic doses over larger surface areas and in shorter periods of time.

The basic effects of LLLT are bio-stimulative, regenerative, analgesic and anti-inflammatory.

The following conditions are documented to respond well to LLLT treatment:

  • acute tendon and ligament injuries

  • bone density issues

  • carpal tunnel syndrome

  • cervical or lumbar radiculopathy (pinched nerves)

  • chronic regional pain syndrome

  • chronic rotator cuff problems

  • epicondylitis (1)

  • fibromyalgia

  • frozen shoulder

  • knee arthritis and knee issues

  • muscular back pain

  • neck and back pain

  • neuropathy syndromes

  • osteoarthritis and thoracic bursitis

  • plantar fasciitis (2)

  • post-surgical pain

  • plantar fasciitis(2)

  • rheumatoid arthritis

  • sprains, strains

  • tendinitis, tendinopathy

  • whiplash injury

With LLLT, we find at Wagner Chiropractic that we are able to offer a dramatic range of motion increase to and decrease of pain in the affected/injured area. This finding is not exclusive to our practice alone.

A 2009 report in the Lancet finds that LLLT reduces neck pain.

The American Physical Therapy Association recommends that clinicians use LLLT to relieve pain and stiffness for patients who have achilles tendinopathy(3).

The Cochrane Library published research in 2014 which focused on patients with frozen shoulder. The patients in the study who received LLLT experienced less pain than those in the placebo-controlled group.

LLLT is a non-invasive, painless and cost-effective therapy for pain:

With the predicted epidemic of chronic pain in developed countries, it is imperative to validate cost-effective and safe techniques for managing painful conditions which would allow people to live active and productive lives. Moreover the acceptance of LLLT (which is currently being used by many specialties around the world) into the armamentarium of the American health care provider would allow for additional treatment options for patients. A new cost-effective therapy for pain could elevate quality of life while reducing financial strains.
— Howard B. Cotler, et al, The Use of Low Level Level Laser Therapy (LLLT) for Musculoskeletal Pain

Of course, chiropractors must be properly trained for use of all LLLT, especially Class IIIB and IV. At Wagner Chiropractic we are fully trained for all LLLT and have been using it for over 15 years with successful results.

  1. a type of musculoskeletal disorder that refers to an inflammation of an epicondyle (a protuberance above or on the condyle [a rounded protuberance at the end of some bones, forming an articulation with another bone] of a long bone, especially either of the two at the elbow end of the humerus [arm])

  2. a disorder of the connective tissue which supports the arch of the foot (also known as tendinitis or tendinosis)

  3. a type of tendon disorder that results in pain, swelling, and impaired function



John M. Eisenberg Center for Clinical Decisions and Communications Science. “Treatment Options for Rotator Cuff Tears.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, 29 Oct. 2010,

Cotler, Howard B. “The Use of Low Level Laser Therapy (LLLT) For Musculoskeletal Pain.”, U.S. National Library of Medicine National Institutes of Health, 9 June 2015,