What is the role of infrared red therapy light in managing muscle pain?

Infrared Red Light Therapy for Muscle Pain Management

Infrared red light therapy has limited evidence supporting its effectiveness for muscle pain management, with low-quality evidence showing some benefit only when combined with NSAIDs for acute or subacute low back pain. 1

Evidence for Infrared Red Light Therapy

The American College of Physicians' clinical practice guideline on noninvasive treatments for pain indicates that:

• Low-level laser therapy (LLLT), which includes infrared red light therapy, combined with NSAIDs showed some effectiveness in decreasing pain intensity and moderately improving function compared with sham laser therapy plus NSAIDs in patients with acute or subacute low back pain 1
• However, this evidence is classified as low-quality, suggesting limited reliability
• For chronic low back pain and other musculoskeletal conditions, evidence was insufficient to determine the effectiveness of laser therapy 1

First-Line Treatments for Muscle Pain

Instead of infrared red light therapy, guidelines recommend:

1. Nonpharmacologic approaches:

   • Exercise therapy (moderate-quality evidence) 1
   • Motor control exercise for spinal muscles (low-quality evidence) 1
   • Tai chi (moderate-quality evidence for pain reduction at 3-6 months) 1
   • Yoga (low-quality evidence for short-term pain reduction) 1

2. Pharmacologic treatments:

   • NSAIDs (moderate-quality evidence) 1
     • Oral NSAIDs (WMD, −0.93 cm on a 10-cm VAS scale) 1
     • Topical NSAIDs (WMD, −1.02 cm) 1
   • Acetaminophen (moderate-quality evidence) 1
   • Muscle relaxants for acute muscle spasm (limited evidence) 1, 2

Treatment Algorithm for Muscle Pain

1. Acute muscle pain (0-4 weeks):

   • First-line: NSAIDs (oral or topical) and/or acetaminophen 1
   • Second-line: Consider short-term muscle relaxants for spasm component 1, 2
   • Adjunct therapies: Ice for first 24-48 hours, then heat therapy 3

2. Subacute muscle pain (4-12 weeks):

   • Continue appropriate pharmacotherapy
   • Begin structured exercise program
   • Consider LLLT only as an adjunct to NSAIDs if pain persists 1

3. Chronic muscle pain (>12 weeks):

   • Exercise therapy (cornerstone of treatment) 1, 4
   • Consider multimodal approach with:
     • Cognitive behavioral therapy 4
     • Sleep hygiene optimization 4
     • Antidepressants (amitriptyline, duloxetine) for persistent pain 1, 4

Practical Considerations and Caveats

• Infrared light therapy devices are widely marketed but have limited scientific support for muscle pain
• If using LLLT, it should be considered an adjunct to evidence-based treatments, not a primary therapy
• Beware of claims about "detoxification" or "cellular repair" from light therapy devices, as these lack robust scientific evidence
• For persistent muscle pain, consider underlying causes (strain, inflammatory conditions, referred pain) rather than focusing solely on symptomatic treatment 5, 6
• Muscle strains typically improve with conservative management including rest, ice, compression, and NSAIDs 3

Special Populations

• For older adults, topical NSAIDs may be preferred over oral to minimize systemic side effects 4
• In patients with fibromyalgia, a condition with chronic widespread muscle pain, standard LLLT has not shown significant benefit over other therapies 1
• For athletes with acute muscle injuries, early mobilization after the initial rest period (24-48 hours) is recommended over prolonged rest 3, 7

In conclusion, while infrared red light therapy may have a limited role as an adjunctive treatment when combined with NSAIDs for certain types of muscle pain, it should not be considered a primary or standalone treatment given the current state of evidence.