Class IV Laser Therapy for Pain Management Pain Management through Class IV (High Power) Laser Therapy

Laser therapy is emerging out to be an effective and budget-friendly treatment intervention for pain management because it is a non-invasive, speedy, and painless method of pain relief [1]. According to Journal of lasers in medical sciences, the concept laser therapy for pain management is based on the use of laser light energy to reduce pain and inflammation by accelerating the healing of damaged tissues, relaxing muscles, and stimulating regeneration of the nerve [2]. This series of actions is characterized by the wavelength ad energy of the laser energy used for the pain relief at the target site. Wavelength and laser power define a laser’s ability to penetrate the human body. When it enters the infrared spectrum and the wavelength exceeds 800 nm, laser energy is usually penetrated in the body tissues like X-rays, but it requires a certain amount of energy to reach the desired depth into a tissue [2].

Laser therapy is used to treat pain and inflammation related to the following medical conditions:

  1. Tendonitis
  2. Pain in the neck and shoulders
  3. Lumbar back pain
  4. Knee pain
  5. Dislocations
  6. Elbow pain
  7. Headaches
  8. Hip pain
  9. Inflammation
  10. Joint pain
  11. Neurogenic pain
  12. Sciatica
  13. Sprains and strains
  14. Pain in the ankles.
  15. Plantar fasciitis
  16. Bursitis
  17. Trigger points
  18. Upper back pain
  19. Wrist pain
  20. Post-surgical pain


Types of Lasers used in Pain Management

Two types of lasers power can be used in physical therapy, which are named Class 3 and Level 4 power. The power of a Class 3 laser is less than 500 milliwatts (mW), whereas the power of a Class 4 laser is greater than 500 mW. Class 3 laser is called cold laser as it is used for low-intensity laser therapy and Class 4 laser therapy is referred to as high power laser therapy that is a more effective laser therapy for pain management [3].

Most neuromuscular diseases respond to higher laser power and higher doses depending on the power and time, where the best results can be obtained with a 30-watt or higher laser which comes under the category of class IV high power laser therapy. A 10-minute treatment with a 30-watt laser provides 18,000 joules of energy, which has analgesic effects, significant anti-inflammatory and healing properties [3].



Class IV laser treatment

The class IV laser therapy is a non-invasive, fast, and drugless alternative that is clinically proven to provide relief to chronic pains by improving the body’s natural healing abilities. Laser therapy is very useful for patients who need to recover faster, especially in terms of muscle healing. Class IV laser is an effective treatment that can penetrate damaged or diseased tissue using high-energy laser light [3].

Cells usually respond to light waves positively, especially when the body is in the healing phase. A class IV laser therapy works by exploiting the photobiostimulation phenomenon and the response of the cells to laser energy of a specified wavelength. The class IV lasers deliver intense amounts of light to a body that causes the cells in a body to produce more energy in the form of ATP (Adenosine Triphosphate) [3, 4].

Laser Therapy Sessions Required for Pain Management

The laser is painless and fast, and each session of this therapy takes not more than 5-10 minutes, after which a patient can feel the immed

Mechanism of Action of Class IV Laser

A class IV laser penetrates in the diseased or damaged tissue with powerful energy to accelerate healing in the painful area. This results in increased blood flow at the affected area so that it can attract more nutrients that are required for the complete healing process. Class IV of laser energy light causes the body to produce ATP, thereby increasing the production of cells energy and ATPs and the increased amount of ATP energy boost the DNA / RNA activity, increased production of collagen, reduced inflammation, and increased efficiency of cell regeneration and healing process [4].


Features of Class IV Laser Therapy

The class IV laser is effective for pain management because of its following actions.

  1. Weakens the sensitivity of the nerves by reducing bradykinin (a chemical that causes pain).
  2. Normalize ion channels in the cells of the affected region.
  3. Releases endorphins (the body’s pain reliever hormone)
  4. Releases encephalin (analgesic effect producing hormone)
  5. Accelerate cell reproduction and growth in the muscles, ligaments, and tendons
  6. Accelerate nerve regeneration.
  7. Formation of new capillaries in damaged tissues to speed up the healing process
  8. Removing trigger points
  9. Reducing scar tissue formation
  10. Increased production of collagen
  11. Increased production of stem cells [5]


What Painful Areas can be treated by High Power Laser Therapy?

High-powered laser therapy is most commonly used in physical therapy and chiropractic clinics to relieve pain in the neck, back, or joints as pain in these areas is often treated quickly with lasers. The laser is also effective in reducing pain in the inflamed areas especially in peripheral neuropathy, capsulitis, tendonitis, sprains, stress, bursitis and, repetitive sports injuries. Although there is no specific area that responds faster to lasers, a response to laser therapy varies from patient to patient as everyone has different medical conditions [2, 4].


iate effects, but it can differ from patient to patient. However, the maximum time to feel its effects is 18-24 hours after the treatment whereas long-term effects of laser therapy can be observed after three to five sessions of treatment. Most commonly, Patients feel relief in pain after one or two treatment sessions, however, five or more sessions may be needed to relieve the chronic pains and prolonged diseases. The more chronic and prolonged the injury is, the more laser therapy sessions will be needed [1, 5].


  1. White PF, Lazo OL, Galeas L, Cao X. Use of electroanalgesia and laser therapies as alternatives to opioids for acute and chronic pain management. F1000Research. 2017;6.
  2. Ezzati K, Laakso EL, Salari A, Hasannejad A, Fekrazad R, Aris A. The beneficial effects of high-intensity laser therapy and co-interventions on musculoskeletal pain management: a systematic review. Journal of lasers in medical sciences. 2020;11(1):81.
  3. Brusciano L, Gambardella C, Terracciano G, Gualtieri G, di Visconte MS, Tolone S, Del Genio G, Docimo L. Postoperative discomfort and pain in the management of hemorrhoidal disease: laser hemorrhoidoplasty, a minimal invasive treatment of symptomatic hemorrhoids. Updates in surgery. 2020 Sep;72(3):851-7.
  4. White PF, Zafereo J, Elvir-Lazo OL, Hernandez H. Treatment of drug-resistant fibromyalgia symptoms using high-intensity laser therapy: a case-based review. Rheumatology international. 2018 Mar;38(3):517-23.
  5. White PF, Cao X, Elvir Lazo L, Hernandez H. Effect of high-intensity laser treatments on chronic pain related to osteoarthritis in former professional athletes: a case series. J Mol Biomark Diagn. 2017;8(343):2.

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