From the Guidelines
Low-level laser therapy (LLLT) or photobiomodulation (PBM) is effective in improving pain and function for patients with low back pain, as supported by high-quality evidence from recent studies. According to the 2022 CDC clinical practice guideline for prescribing opioids for pain, high-quality evidence exists that LLLT improves pain, function, or both for at least 1 month after delivery without apparent risk for serious harm in patients with low back pain 1. This is in line with previous findings that LLLT can decrease pain intensity and result in moderate improvement in function compared to sham laser therapy plus NSAIDs in patients with acute or subacute pain 1.
Key Points to Consider
- LLLT is a noninvasive nonpharmacologic approach that can be used to improve pain and function in patients with low back pain.
- The therapy works by stimulating cellular energy production in mitochondria, potentially enhancing tissue repair and reducing oxidative stress.
- Typical treatments involve sessions of 10-20 minutes several times weekly using devices with wavelengths between 630-850 nanometers.
- Results vary significantly between individuals, and multiple sessions are usually required before seeing benefits.
- While generally considered safe with minimal side effects, LLLT should not replace conventional medical treatments for serious conditions.
Recommendations for Clinical Practice
- Clinicians should consider LLLT as a treatment option for patients with low back pain, particularly those who have not responded to other noninvasive nonpharmacologic therapies.
- Patients should be informed about the potential benefits and risks of LLLT and the importance of multiple sessions for optimal results.
- Clinicians should also be aware of the availability and accessibility of LLLT in their community and refer patients to low-cost services when possible.
- As with any treatment, patients with photosensitivity disorders or taking photosensitizing medications should consult healthcare providers before trying LLLT 1.
From the Research
Effectiveness of Low-Level Laser Therapy (LLLT) or Photobiomodulation (PBM)
- LLLT has been shown to reduce inflammation and edema, induce analgesia, and promote healing in a range of musculoskeletal pathologies 2
- PBM is widely used in clinical therapy and is an effective approach to resist bacterial infection of cutaneous wounds and modulate the wound healing process 3
- The use of red and near-infrared wavelengths in LLLT has been found to promote wound healing, with wavelengths of 635 and 810 nm being effective in promoting the healing of dermal abrasions 4
- LLLT has been found to facilitate superficial wound healing in humans, with a triple-blind, sham-controlled study showing enhanced healing as measured by wound contraction 5
Therapeutic Applications of PBM
- PBM therapy has been investigated to accelerate wound healing in diabetic mice, with a merged red and NIR light source showing potential for improving wound healing 6
- Red and blue LED light has been found to have antibacterial effects and accelerate wound healing in a rat model of refractory wound healing 3
- LLLT has been found to have an indirect healing effect on surrounding tissues, with untreated wounds in subjects treated with LLLT contracting more than wounds in a sham group 5
Mechanisms of Action
- The biological response of wound tissue to LLLT depends on the wavelength employed, with the absorption spectrum of cytochrome c oxidase being a candidate mitochondrial chromophore in LLLT 4
- PBM mediated by red and NIR light suggests that the biological response of the wound tissue depends on the wavelength employed 4