Red Light Therapy for Pain

PainExam Podcast Show Notes Red Light Therapy (Photobiomodulation) for Pain Evidence, Mechanisms, and Clinical Applications Host: Dr. David Rosenblum Red light therapy, also known as photobiomodulation (PBM) or low-level laser therapy (LLLT), is an emerging non-invasive treatment modality increasingly used in pain medicine, rehabilitation, and regenerative medicine practices. In this episode of the PainExam Podcast, Dr. Rosenblum reviews the mechanisms, clinical evidence, indications, and safety considerations surrounding photobiomodulation therapy for pain. Red and near-infrared wavelengths stimulate mitochondrial activity, increase ATP production, reduce inflammatory mediators, and promote tissue healing. These physiologic effects may translate into analgesic benefits for a variety of musculoskeletal and neuropathic pain conditions. Clinical research suggests potential benefit in temporomandibular disorders, chronic neck pain, and inflammatory oral conditions, though results vary due to differences in dosing parameters and treatment protocols. Despite these limitations, PBM has a favorable safety profile and is increasingly being integrated into multimodal pain management strategies. Key Topics Covered • What is photobiomodulation therapy (PBM) • How red and near-infrared light interact with mitochondria • Mechanisms of analgesia and tissue repair • Evidence from clinical trials in TMD, neck pain, and oral inflammatory pain • The biphasic dose response (Arndt-Schulz law) • Safety profile and contraindications • How PBM may integrate with regenerative pain medicine Mechanism of Action Photobiomodulation works primarily through stimulation of mitochondrial chromophores, particularly cytochrome c oxidase. This leads to: • Increased ATP production • Modulation of inflammatory cytokines • Increased angiogenesis and tissue repair • Reduced oxidative stress These effects may improve pain, inflammation, and healing in certain musculoskeletal conditions. Evidence Discussed in This Episode Temporomandibular Disorders Randomized trial demonstrating improvements in pain and mandibular function with red light therapy. De Carvalho et al., Pain Research and Treatment (2019) https://onlinelibrary.wiley.com/doi/full/10.1155/2019/8578703 Chronic Neck Pain Clinical trial demonstrating improvements in pain scores and pressure pain thresholds after photobiomodulation therapy. Chen et al., Lasers in Medical Science (2022) https://link.springer.com/article/10.1007/s10103-022-03540-0 Oral Pain and Dental Inflammation Randomized study demonstrating reduced pain and improved healing following PBM treatment. Almeida et al., BMC Oral Health (2023) https://link.springer.com/article/10.1186/s12903-023-02784-8 Who May Benefit From Photobiomodulation? Red light therapy may be considered as an adjunct treatment for: • myofascial pain • cervical spine pain • temporomandibular disorder • tendinopathy • peripheral neuropathy • musculoskeletal injury recovery Safety and Contraindications Photobiomodulation has a very favorable safety profile. Reported adverse effects are rare and usually mild: • transient erythema • warmth at treatment site • headache • eye irritation without proper protection Precautions include: • avoiding direct retinal exposure • avoiding treatment over malignancy • avoiding application over the uterus during pregnancy • caution in photosensitive disorders Resources For Patients Seeking Treatment Learn more about integrative and regenerative pain treatments including PRP, ultrasound-guided injections, and advanced pain therapies: AABP Integrative Pain Care & Wellness https://www.AABPpain.com For Pain Physicians and Advanced Practice Providers Training in ultrasound, interventional pain procedures, and pain board preparation: NRAP Academy CME Education https://www.NRAPpain.org