Is infrared therapy effective for treating muscular pain?

Infrared Therapy for Muscular Pain

Infrared therapy has limited evidence supporting its effectiveness for muscular pain, with superficial heat showing more established benefits for acute low back pain and other musculoskeletal conditions.

Evidence for Infrared Therapy

Low-Level Laser Therapy (LLLT)

• Low-quality evidence shows that a combination of low-level laser therapy and NSAIDs can significantly decrease pain intensity and moderately improve function compared with sham laser therapy plus NSAIDs in patients with acute or subacute low back pain 1
• For chronic low back pain, three higher-quality trials found laser therapy superior to sham for pain or functional status up to 1 year after treatment 1
• Limited evidence suggests infrared laser therapy may increase pain threshold at trigger points, with effects observed both at treated points and non-treated trigger points on the opposite side of the body 2

Superficial Heat

• Moderate-quality evidence supports that heat wrap therapy moderately improves pain relief (at 5 days) and reduces disability (at 4 days) compared with placebo for acute low back pain 1
• Low-quality evidence shows that combining heat with exercise provides greater pain relief and improved function at 7 days compared with exercise alone in patients with acute pain 1
• Heat wrap therapy has been shown to provide more effective pain relief and improved function compared with acetaminophen or ibuprofen after 1-2 days 1

Infrared-Emitting Materials

• Recent research (2023) suggests that nonthermal infrared light delivered via patches, fabrics, and garments containing infrared-emitting bioceramic minerals may have positive effects on muscular cells, muscular recovery, and reduced inflammation and pain 3
• Proposed mechanisms include upregulation of endothelial nitric oxide synthase, increased nitric oxide bioavailability, anti-inflammatory effects, and reduction in oxidative stress 3

Comparative Effectiveness

• A 2020 study comparing contrast therapy using infrared and cryotherapy versus contrast bath therapy found that infrared and cryotherapy produced more significant changes in blood flow and had similar effects on muscle tone and pain threshold 4
• A 2006 pilot study on experimentally induced muscle soreness found no statistically significant analgesic effects of LED infrared therapy, though there was a general trend toward pain reduction 5

Recommendations for Muscular Pain Management

First-Line Approaches

1. Superficial heat application (heat wrap, heated blanket) for acute musculoskeletal pain 1
2. Exercise therapy - moderate-quality evidence shows that exercise results in small improvements in pain relief and function compared with no exercise for chronic pain 1
3. NSAIDs - recommended for limited periods (up to one week) for musculoskeletal pain 1, 6

Second-Line Approaches

1. Low-level laser therapy - may be considered as an adjunct to other treatments, particularly when combined with NSAIDs 1, 7
2. Manual therapy - including manipulation and stretching for muscle tension 6
3. Massage therapy - may be offered to decrease pain intensity in specific conditions 1

For Chronic Musculoskeletal Pain

• Consider motor control exercise (MCE) which focuses on restoring coordination, control, and strength of muscles that control and support the spine 1
• Psychological therapies and multidisciplinary rehabilitation may be beneficial 1
• Tricyclic antidepressants or SNRIs (such as duloxetine) may be considered for patients who don't respond to initial treatment 6

Clinical Considerations and Caveats

• Infrared therapy should be considered as part of a multimodal approach rather than as a standalone treatment
• The quality of evidence for infrared therapy specifically is generally low to moderate
• Heat therapy appears to have better evidence than infrared light therapy for pain relief
• Adverse events with infrared therapy are minimal, with only transient skin reactions reported 1
• Avoid prolonged use of NSAIDs due to potential gastrointestinal, renal, and cardiovascular side effects 6
• Opioids should only be prescribed as a last resort and for very limited duration 6

In clinical practice, superficial heat application has more established evidence for pain relief in musculoskeletal conditions than specific infrared light therapy, though emerging evidence suggests potential benefits from infrared-emitting materials that warrant further investigation.