Beyond the Scalpel: Using Light to Rethink Recovery and Reduce Pain

Educational

By Dr. Scott Sigman, Orthopedic Surgeon and Chief Medical Officer, OrthoLazer

Orthopedic recovery has long been rooted in a blend of surgical precision and traditional pain management. But as the medical community continues to grapple with the opioid crisis and the long-term effects of inflammation and chronic pain, it is time we revisit how we help patients heal.

One tool that is shifting the paradigm is photobiomodulation therapy (PBMT), also known as laser therapy. This safe, evidence-based approach uses near-infrared light delivered by a medical laser to penetrate deep into tissue, where it stimulates cellular activity, accelerates recovery, and reduces pain, without the risks associated with opioids or repeat corticosteroid injections.

Why This Moment Matters

The FDA recently issued significant changes to opioid labeling requirements, highlighting the real and growing risks of misuse, even with short-term use (1). These updates emphasize that:

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

For orthopedic surgeons, this is not just a regulatory update. It is an opportunity to lead. We are often on the front line of post-op pain management. Whether it is 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.

Consider this: a CDC study found that even a one-day opioid prescription carries a 6% chance of continued use a year later (2). A 10-day supply raises that risk to 13% (2). A 30-day supply means nearly one in three patients may still be taking opioids a year later (2). These numbers are staggering, and they underscore why opioid-naïve patients should be offered safer alternatives from the start.

How PBMT Works

PBMT uses specific wavelengths of near-infrared light to stimulate healing at the cellular level. This light penetrates the skin and underlying tissues, where it is absorbed by enzymes in mitochondria, triggering a regenerative cascade:

Increased ATP production (cellular energy)
Release of anti-inflammatory proteins such as interleukin-10
Improved blood flow
Activation of fibroblasts for soft tissue repair

The result is less swelling, less pain, and faster healing without the risks associated with opioids or invasive procedures.

What the Evidence Shows

Recent research continues to validate PBMT’s clinical value:

A systematic review of 48 clinical trials found that high-intensity laser therapy significantly reduced inflammation and improved mobility across musculoskeletal conditions, outperforming low-level laser and placebo treatments (3).
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 (4).
In a post-operative study, patients receiving PBMT reported greater pain relief and functional gains than those treated with ultrasound or TENS (5).

These findings reinforce what we see daily in our practices. Patients who use PBMT, whether post-surgically or as part of a conservative treatment plan, recover faster, experience less pain, and can return to activity with greater confidence.

Integrating PBMT Into Orthopedic Care

While PBMT has become a core part of our orthopedic protocols at OrthoLazer, its benefits extend far beyond orthopedic surgery. Sports medicine physicians, chiropractors, pain management specialists, and physical therapists are also using this noninvasive, evidence-based modality to reduce inflammation, accelerate tissue repair, and improve patient function across a wide range of musculoskeletal conditions.

The ability to integrate PBMT seamlessly into both conservative care plans and post-operative recovery makes it a valuable tool for multiple specialties committed to improving mobility and reducing pain without relying solely on medication.

At OrthoLazer, we have made PBMT a core part of our protocols. From conservative treatment plans to post-operative recovery, laser therapy is integrated at every stage.

For example, a knee replacement patient with significant bruising and swelling after surgery experienced dramatic improvement after six PBMT sessions over two weeks, far exceeding typical recovery expectations.

Patient-reported outcomes back this up:

97% of post-op patients would use PBMT again
98% would recommend it to friends or family
100% were satisfied with their care
93% felt it was worth the out-of-pocket cost

The Path Forward

The FDA’s updated guidance reinforces what many of us have long believed: safe, effective, noninvasive therapies need to be part of the conversation from the start. Pain management should never be one-size-fits-all.

PBMT is not just about reducing opioid use. It is about equipping patients with tools that support their goals, bodies, and futures. As orthopedic providers, sports medicine physicians, chiropractors, and other clinicians, we can lead the way in reshaping recovery by combining clinical expertise with evidence-based, noninvasive therapies that put patient safety first.

When it comes to patient recovery, precision matters. So does giving patients every advantage to heal quickly, safely, and fully.

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.
Shah A, Hayes CJ, Martin BC. Characteristics of Initial Prescription Episodes and Likelihood of Long-Term Opioid Use — United States, 2006–2015. MMWR Morb Mortal Wkly Rep 2017;66:265–269. http://dx.doi.org/10.15585/mmwr.mm6610a1.
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.
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/.
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.