December 18, 2018
Physical therapist aiding a patient

Cold Laser Therapy: Does It Work?

by Berkeley Wellness  

Cold laser therapy—also called low-level or near-infrared laser therapy—uses low-level light energy to treat a wide array of conditions, ranging from sprains, tendinitis, back pain, and arthritis to temporomandibular disorder (chronic jaw pain), carpal tunnel syndrome, diabetic neuropathy, fibromyalgia, and leg ulcers. Used by some physical therapists, physiatrists, chiropractors, and occupational therapists, it is different from conventional “hot” laser surgery. The FDA has cleared more than two dozen cold laser devices, including some sold on the Internet for home use, for the temporary relief of pain, which means only that they are safe, not necessarily that they are effective. The therapy is noninvasive and painless; no serious side effects have been reported.

It’s not clear how cold laser therapy might work, but it may have anti-inflammatory effects, help repair connective and other tissues, and release pain-relieving endorphins.

Overall, though, it’s hard to draw firm conclusions because many of the studies have been small, short in duration, and not well-controlled. Plus, there are differences in the devices and how the treatment is delivered in terms of dosage, wavelength, duration, where on the body it is applied, and technique. Cold lasers may work for one condition but not another, and only in some people—and their effect may depend on the degree of injury.

Though cold laser therapy may provide some temporary relief for some types of pain, it may not affect the underlying ailment or be any more effective than other types of heat delivery, according to DeviceWatch.org, a project of Quackwatch.org (however, these devices actually give off little heat). In their coverage policies, both Cigna and Aetna note that there’s little or no conclusive evidence that cold laser therapy is effective for anything. Even in research suggesting some promise for the therapy in treating conditions such as carpal tunnel syndrome, chronic neck or back pain, and diabetic ulcers, the evidence has been limited and conflicting, and it’s hard to know how much any apparent benefit is due to a placebo effect.

Bottom line: If you have tendinitis or other musculoskeletal pain, work with a physical therapist, who may use cold laser therapy among other treatments. Some health insurance policies cover it when it’s provided by a health-care professional for certain ailments. Whether it adds much to the benefits of traditional physical therapy—ice, heat, exercise, and massage, for example—is unclear. Lastly, don’t count on getting the same benefit from self-treatment as you might from having it done by an experienced, trained professional. Home devices, which can cost hundreds of dollars and are often touted as a cure for nearly everything, may not have the power to do much of anything.

Also see TENS for Pain?