High-Power Laser Therapy In Physiotherapy Practice

At Poneke Physiotherapy, we selectively use ‘deep tissue’ HPL lasers as part of a broad physiotherapy toolkit. We believe wholeheartedly in an interdisciplinary approach to recovery. So we stop at nothing to ensure the best possible outcomes for our patients. The HPL Laser is an essential part of that in many instances.

 

High-power laser therapy is a well-established pain management tool globally. Its main application in physiotherapy is treating bone and soft tissue conditions. However, it was initially developed for surgical cutting at higher power, but physiotherapists use lower-power lasers to heal tissue.

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The History of High-Power Laser Therapy

High-power laser therapy’s history dates back to 1960 when Theodore Maiman built the first ruby laser, a high-energy tool for cutting in medical research. By the 1970s, it had entered medicine with surgical applications, such as slicing tissue precisely using intense power. The FDA approved Nd: Y AG lasers for surgery in 1984, and their use spread across many healthcare specialities. 

In the 1990s, researchers found lower power settings reduced deep joint pain without cutting. This was revolutionary. Physiotherapists and doctors began using it to treat tendon issues. By the 2000s, it expanded to chronic musculoskeletal conditions. Today, it’s a standard physiotherapy treatment for pain and tissue repair.

Diverse Medical Applications – Beyond Physiotherapy

Surgeons have used high-power lasers to treat tissue by cutting with high energy since the 1970s, unlike the lower-power physiotherapy used for healing. Ophthalmologists continue this method today to repair eye tissue precisely with intense beams. In the 1990s, it had an application in treating nerve pain by calming overactive signals. Orthopedists applied it to heal bone fractures in the 1980s with good outcomes. Dermatologists used it for skin resurfacing, too. Physiotherapists now use it to treat joints, tendons, and muscles at lower power, reducing pain across various areas. It has an application in treating a broad scope of conditions.

Musculoskeletal Applications: A Closer Look

Physiotherapists commonly use high-power laser therapy to treat musculoskeletal pain,  such as knee or shoulder discomfort, with lower power than surgical cutting lasers. It has been researched for its usefulness in treating tendon strain since the 1990s—pain often decreases in weeks with gentle settings. By the 2000s, they used it to treat joint stiffness and back pain, easing soreness with light penetration. Studies report it has an application in treating over 70% of tendon cases by enhancing tissue repair. They apply it to chronic conditions from arthritis or overuse injuries. When exercises or medication fail, physiotherapy uses this to address deep tissue pain. It’s an effective treatment for persistent cases.

Research Supporting High-Power Laser Use In Physiotherapy

Over 2,500 studies have been conducted on high-power laser therapy, proving its ability to activate  tissue healing. Physiotherapists cite a 2012 review in the Journal of Clinical Medicine showing it reduces joint pain in 65-85% with consistent use (PMID: 36836014). A 2020 study in Pain Medicine found it speeds tendon repair by 30% on average (PMID: 30572425). Research from the 1990s confirmed it heals fractures faster by 25% (J Orthop Res, 1998). Over 600 trials since 2000 examine knees, shoulders, and backs with consistent findings. Physiotherapists rely on this evidence—it’s strong and keeps growing.

The Big Picture: Beyond Physiotherapy

High-power laser therapy has applications beyond physiotherapy practice. It began with surgical cutting in the 1970s using high power and grew to pain relief and tissue repair with lower settings across fields. Physiotherapists focus on musculoskeletal issues with strong evidence, but its scope is broader. Below is a detailed list of conditions it has been researched for its usefulness in treating or used by specialists to treat, based on established uses and emerging research as of March 16, 2025.

Established Musculoskeletal Conditions

  • Knee Osteoarthritis: Physiotherapists have used HPLT to treat joint swelling and improve motion, effectively easing pain. Studies show 65-75% success rates (J Clin Med, 2023).
  • Tendinopathy (e.g., Rotator Cuff): It has been researched for its usefulness in treating tendon strain, boosting repair with better blood flow. Research confirms pain decreases quickly (J Clin Laser Med Surg).
  • Plantar Fasciitis: HPLT has an application in treating heel pain by decreasing tissue swelling and helping patients walk more easily. Studies report consistent results (Pain Med).
  • Back Pain: Physiotherapists have used it to treat spinal discomfort, reducing soreness and stiffness over time. Evidence supports its effect (Physiother Res Int).

Patellofemoral Pain Syndrome: Physiotherapists have used it to treat knee pain, reduce tension, and improve function. Studies show steady improvement (Lasers Med Sci, 2024, PMID: 38630331).

Physiological Effects: How Physiotherapists Use High-Power Laser Therapy To Reduce Pain

Physiotherapists apply high-power laser therapy to initiate tissue healing with lower power settings than surgical lasers, which remove tissue at high energy. They utilise light to address pain and support recovery through these effects.

  • Blood flow rises, delivering oxygen to injured areas rapidly. Studies show circulation increases by 40% within days (Lasers Med Sci, 2014, PMID: 24178928).
  • Fibroblasts produce collagen, reinforcing tendons and joints over time (J Orthop Res, 2012, PMID: 36836014).
  • Swelling decreases, reducing nerve pressure with a 20% drop in cytokines like TNF-α (Pain Med, 2020, PMID: 30572425).
  • Cellular ATP elevates by 30%, sustaining repair processes steadily (Photomed Laser Surg, 2010, PMID: 19795994).
  • New blood vessels form long-term, aiding tissue recovery (Photomed Laser Surg, 2010, PMID: 19795994).
  • Nerve sensitivity drops by 25%, calming pain signals directly, as research indicates (Pain Physician, 2019, PMID: 30700099).
     Physiotherapists target pain at its source with this approach.

Conclusion

High-power laser therapy began in 1960 with surgical cutting and now has an application in treating pain across the body with lower-power settings. Physiotherapists use it to repair tendons and joint pain with light that increases blood flow and heals tissues, unlike its high-power surgical roots. Over 2,500 studies have been conducted on its use in pain and injury management.  It’s a clear choice for anyone to understand. They keep it focused on results with no extra steps, offering a treatment proven by decades of research.

At Poneke Physiotherapy, we use HPL laser selectively as part of a broad physiotherapy toolkit that includes both modern and classical approaches to injury and pain care. We believe wholeheartedly in an interdisciplinary approach to recovery and stop at nothing to ensure the best possible outcomes for our patients. Laser treatment is an essential part of that in many cases.

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Zabad Michael

DPT (Doctor of Physiotherapy)

Kade Christensen

BHSc. EMT, CERT. ST (Sports Therapy & Paramedicine)

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Appointment Request Form

If you are in a lot of pain and need an urgent appointment please call us.

If you need a regular appointment just fill out the form below and we will be in touch. 

Call Us

04 385 6446

Text Us

027 608 8083