A Unified Response: What the FDA’s New Opioid Guidelines Mean for Orthopedic Care
In The News
By OrthoLazer’s Surgeon Advisory Board
The FDA recently issued major changes to opioid labeling requirements, highlighting the real and growing risks of misuse, even with short-term use (1). These updates reflect a broader shift in how we, as clinicians, are being asked to think about pain management.
For orthopedic surgeons, this is not just a regulatory moment. It’s an opportunity to lead.
The July 2025 guidelines emphasize:
- Short-term opioid use can lead to dependency
- Non-opioid therapies should be considered first for acute and chronic pain
- Extended opioid use should never be the default
- Individualized pain plans and close monitoring are essential
As orthopedic providers, we’re often at the front line of post-op pain management. Whether it’s a total knee replacement or a shoulder scope, patients look to us for relief—and for a path forward that prioritizes healing, safety, and long-term mobility.
What We’re Seeing in Practice
Across our practices, we see a shared theme: patients want to stay active, recover faster, and avoid medication when possible.
We also know that when pain is left unaddressed—or handled exclusively with opioids—recovery can stall. Patients can become discouraged, disengaged, or worse, develop dependencies they never anticipated.
This is why we believe in expanding the recovery toolkit. One option showing promise across orthopedic applications is photobiomodulation therapy (PBMT), also known as laser therapy.
PBMT is a noninvasive, FDA-cleared modality that helps reduce inflammation, stimulate circulation, and accelerate tissue healing. It has been studied in both surgical and non-surgical patient populations and is increasingly used as part of integrated orthopedic recovery protocols.
What the Evidence and Biology Tell Us
PBMT works at the cellular level. Near-infrared light penetrates soft tissue and is absorbed by enzymes in the mitochondria. This stimulates increased ATP production—the energy source of the cell—and sets off a regenerative cascade.
This includes the release of anti-inflammatory proteins, improved blood flow, and activation of tissue-repairing fibroblasts. The result: less swelling, less pain, and more efficient healing.
Recent studies and reviews continue to support the clinical value of PBMT:
- A randomized controlled trial found that high-intensity laser therapy significantly reduced joint pain and improved mobility, especially when combined with exercise, outperforming cold therapy and placebo (2).
- A systematic review of 48 clinical trials found that high-intensity laser therapy significantly reduced inflammation and improved pain and mobility across a range of musculoskeletal conditions, demonstrating deeper tissue effects and greater functional gains than low-level laser or placebo treatments (3).
- In a clinical study, patients who received high-intensity laser therapy after orthopedic surgery reported greater pain relief and functional gains than those treated with ultrasound or TENS (4).
Why This Moment Matters
The FDA’s updated guidance reinforces what many of us have seen firsthand. Safe, effective, noninvasive therapies need to be part of the conversation, especially when they can be offered early in the recovery process.
Whether used post-surgically or as part of a conservative treatment plan, PBMT represents an important option for patients who want to heal without medication risks.
Pain management should never be one-size-fits-all. As surgeons, we believe in equipping patients with tools that support their goals, their bodies, and their futures.
A Unified Commitment to Safer Recovery
As a national team of orthopedic surgeons, we see this moment as a turning point. We believe the orthopedic community can lead the way in reshaping post-op pain care.
The FDA has spoken. Now it’s our move.
This article was developed by the OrthoLazer Surgeon Advisory Board:
- Dr. Scott Sigman – Orthopedic Surgeon and Chief Medical Officer, OrthoLazer
- Dr. Asheesh Gupta – Orthopedic Surgeon; President and Founding Member, District Surgery Center, Woodbridge, VA
- Dr. Tim Kavanaugh – Orthopedic Surgeon, AZ Ortho, Scottsdale, AZ
- Dr. Mark Klaassen – Orthopedic Surgeon; Associate Professor of Orthopedic Surgery, Indiana University School of Medicine; Professor, College of Science, University of Notre Dame
- Dr. Ryan Krupp – Orthopedic Surgeon, Louisville, KY
- Dr. Ronak Patel – Orthopedic Surgeon, Illinois Bone and Joint Institute, Oak Brook, IL
References
- FDA News Release. FDA Requires Major Changes to Opioid Pain Medication Labeling to Emphasize Risks. July 31, 2025. https://www.fda.gov/news-events/press-announcements/fda-requires-major-changes-opioid-pain-medication-labeling-emphasize-risks.
- Cai P, Wei X, Wang W, Cai C, Li H. High-intensity laser therapy on pain relief in symptomatic knee osteoarthritis: A systematic review and meta-analysis. J Back Musculoskelet Rehabil. 2023;36(5):1011-1021. https://pubmed.ncbi.nlm.nih.gov/37458008/.
- Arroyo-Fernández, R.; Aceituno-Gómez, J.; Serrano-Muñoz, D.; Avendaño-Coy, J. High-Intensity Laser Therapy for Musculoskeletal Disorders: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. J. Clin. Med. 2023, 12(4), 1479. https://www.mdpi.com/2077-0383/12/4/1479.
- Ozlu, O., Atilgan, E. The effect of high-intensity laser therapy on pain and lower extremity function in patellofemoral pain syndrome: a single-blind randomized controlled trial. Lasers Med Sci 2024,39, 103. https://link.springer.com/article/10.1007/s10103-024-04017-y
