Class IV laser therapy — sometimes called high-intensity laser therapy or photobiomodulation — uses specific wavelengths of light to stimulate cellular processes involved in healing and pain modulation. Unlike surgical lasers that cut tissue, therapeutic lasers deliver energy at wavelengths and intensities that produce biological effects without damaging tissue.
How it works
Laser light penetrates several centimetres into tissue and is absorbed by cellular components — particularly cytochrome c oxidase in the mitochondria. This absorption:
- Increases cellular ATP production (energy for tissue repair)
- Modulates inflammatory mediators
- Increases local blood flow
- Stimulates fibroblast activity for tissue repair
- Modulates pain signalling through nerve pathways
Conditions with strong laser therapy evidence
- Achilles tendinopathy
- Rotator cuff tendinopathies
- Tennis and golfer's elbow
- Plantar fasciitis
- Osteoarthritis pain (knee, hand)
- Post-surgical tissue healing
- Chronic neck and back pain
- Neuropathic pain conditions
- Wound healing
What a treatment feels like
The handpiece is moved slowly over the treatment area. Most patients feel a mild warmth. Sessions typically last 5-15 minutes depending on the area being treated. There's no pain and no post-treatment restriction on activity.
How many sessions
Acute injuries often improve within 3-6 sessions. Chronic conditions may need 8-12 sessions for full benefit. Response is progressive — cumulative effect builds over the treatment course.
Safety and contraindications
Class IV laser therapy has a strong safety profile. Contraindications include:
- Direct treatment over active cancer
- Pregnant abdomen (though other areas are fine)
- Direct eye exposure (protective eyewear is worn)
- Certain photosensitizing medications
- Active bleeding
How it fits with other treatments
Laser therapy is rarely a standalone treatment — it works best as part of a broader plan that includes hands-on therapy, corrective exercise, and lifestyle modification. As an adjunct, it can accelerate healing and reduce pain more effectively than either approach alone.
Compared to shockwave therapy
Both are valuable modalities with overlapping applications. Shockwave is often preferred for chronic tendinopathies (calcific tendinitis, plantar fasciitis, tennis elbow). Laser is often better tolerated in more acute or sensitive conditions. Sometimes we use both in the same treatment plan for complementary effects.
If you have a chronic tendon issue, arthritis pain, or a stubborn soft tissue condition, ask about laser therapy at your next visit. It's one of the more effective tools in our kit.