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Pain and inflammation
Published on
February 3, 2026

Photobiomodulation and Chronic Pain: A Systematic Review of Randomized Controlled Trials

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This systematic review included 14 randomized clinical trials evaluating photobiomodulation in adults with chronic pain. The majority of the trials reported a significant reduction in pain intensity, particularly in fibromyalgia and neuropathies, but no pooled estimate was provided.

What this study measured

The authors searched five databases—PubMed, Embase, Scopus, LILACS, and MEDLINE—for articles published between September 2015 and September 2025. Only randomized clinical trials comparing a photobiomodulation protocol to a placebo, sham treatment, or conventional care were included.

The primary outcome measure was pain intensity. Secondary outcome measures included function, quality of life, and the occurrence of adverse events. The protocol is registered in PROSPERO (CRD420251140711).

Key Findings

Fourteen studies were included. The conditions covered are fibromyalgia, peripheral neuropathies, orofacial pain, and musculoskeletal pain.

  • 14 randomized clinical trials were included.
  • Four major types of chronic pain are represented: fibromyalgia, peripheral neuropathies, orofacial pain, and musculoskeletal pain.
  • Research period covered: September 2015 through September 2025, across 5 databases.
  • Most studies report a significant reduction in pain with photobiomodulation, with a more pronounced effect in fibromyalgia and neuropathies.
  • Functional improvements and an enhanced quality of life have been observed only in some studies.
  • The incidence of adverse effects is described as low.
  • No meta-analysis was conducted: the abstract does not include any mean differences, confidence intervals, or pooled quality scores.

How photobiomodulation works for this indication

The mechanism remains hypothetical. Red and near-infrared light are thought to be absorbed by mitochondrial cytochrome c oxidase, which would increase ATP production in the exposed tissues. This metabolic boost would be accompanied by a modulation of oxidative stress and local inflammatory mediators, as well as an effect on tissue perfusion. In nerve-related pain, an effect on nociceptive conduction is also being discussed. These explanations are offered as hypotheses and are not tested in this review.

Limits You Should Know

The main limitation is the heterogeneity of the technical parameters: wavelength, energy density, duration, and number of sessions vary from one study to another. The authors note that this variability compromises the standardization of results and prevents broader recommendations. The duration of follow-up is also described as limited, leaving open the question of whether the effect is sustained over time.

The results are not consistent. The authors note that most trials show a reduction in pain, which implies that some do not. Improvements in function and quality of life are observed only in a subset of the studies. Finally, with 14 trials spanning four categories of pain, each subgroup is based on a small number of studies, and no quantitative estimate of the overall effect is available.

What This Means in Practice

Photobiomodulation appears to be a complementary approach for chronic pain that is difficult to control using conventional methods, with a tolerance profile described as favorable. It is not a substitute for prescribed pain medication or for investigating the cause of the pain. The authors call for multicenter studies with standardized protocols before any definitive clinical recommendations can be made. It is advisable to discuss any personal treatment plan with the physician managing the pain.

Frequently Asked Questions

Does photobiomodulation provide relief from fibromyalgia?

In this review of 14 randomized trials, fibromyalgia is among the conditions for which pain reduction is most clearly reported. However, the abstract does not provide any numerical values, mean differences, or confidence intervals. The findings are therefore encouraging but not quantified.

How many sessions are needed?

The abstract does not specify any treatment protocol. This is precisely what the authors identify as a weakness in the field: technical parameters vary from one trial to another, making it impossible to establish a standard treatment regimen. They call for multicenter studies with a harmonized protocol.

Are there any side effects?

The authors report a low incidence of adverse effects in the included trials, which supports the method’s safety profile. No specific rates are provided in the abstract, and the duration of follow-up in the trials is considered limited. This does not replace the need for medical advice.

Reference

Ferreira LMA, Oliveira ABC, Mendes JJB, Costa GV, Silva IR, et al. Photobiomodulation in chronic pain: a systematic review of randomized clinical trials. Frontiers in Integrative Neuroscience, 2026;20:1717372. PMID 41710353. DOI 10.3389/fnint.2026.1717372. https://pubmed.ncbi.nlm.nih.gov/41710353/

This summary is provided for informational purposes only and does not constitute medical advice. Photobiomodulation is not a substitute for prescribed treatment. Consult a healthcare professional.