Red Light Therapy vs. Class IV Laser Used in Therapy: What the Evidence Really Says
By Dr. John Mishock, PT, DPT, DC
As musculoskeletal rehab continues to move away from opioids and toward non-invasive pain management, photobiomodulation (PBM) has become a serious clinical tool rather than a fringe modality. At one end of the spectrum are lower-power “red light”/LED systems, often used in spas and anti-aging clinics. At the other end are higher-power Class IV lasers that can deliver therapeutic doses to deeper joint and body tissues in minutes, used by professional sports teams and high-end orthopedic sports medicine clinics. Below, I will review the best evidence comparing Red light therapy to Class IV laser therapy.
How do red light and Class IV Laser work?
Photobiomodulation (PBM) refers to the use of red or near-infrared (NIR) light (typically 600–1100 nm) at non-thermal doses to modulate cellular function—reducing pain and inflammation and promoting tissue repair. The core mechanisms include: Absorption of photons by mitochondria (the energy producers of the cell), which increases energy (ATP) production. The PBM also improves microcirculation (nitric oxide release), reduces inflammation (Downregulation of pro-inflammatory cytokines), and reduces pain (modulation of nociceptor activity). ScienceDirect+1 Critically, both Red light LEDs and lasers can produce PBM effects when the wavelength, power density, dose (J/cm²), and treatment time are within the therapeutic window. The device type isn’t magic by itself; dose and delivery matter most.
What is the difference between Red Light LED Therapy and Class IV Lasers?
In most clinical and consumer contexts, “red light therapy” means: light source is an LED panel or pad (often 630–660 nm red, sometimes 800–880 nm NIR). The power density at the skin is typically lower (often <50–100 mW/cm² for consumer devices). The beam of light is a non-coherent, broad beam for a large treatment area. The use pattern is frequent, with longer sessions often at home or in a spa.
Class IV (high0intensiy) laser therapy—often marketed as “high-intensity laser therapy (HILT)”—is defined by higher output power. (7-30 Watts). The wavelengths are longer (810-1064 nm) and coherent, with the ability to target damaged or painful tissue. The higher power allows faster delivery of therapeutic energy and potentially greater penetration into deeper joints and muscle tissue, working at the cause of the pain in the shoulders, knees, hips, feet, neck, and low back within a short treatment time. Class IV lasers have very strong scientific evidence for the effectiveness of treating musculoskeletal disorders, with over 150 high-quality trials.
The Bottom Line between Red Light Therapy and Class IV Lasers?
Red light/LED therapy and low-level laser have legitimate evidence for pain reduction and improved function in several chronic musculoskeletal conditions. Class IV (high-intensity) laser therapy offers two key advantages: stronger research data vs sham and other conventional modalities in high-value musculoskeletal conditions. Class IV lasers also have the ability to efficiently deliver therapeutic doses to deeper muscles, joints, and spinal tissues within typical outpatient time constraints.
The Future of Laser Therapy at Mishock PT
As we continue to expand our evidence-based treatment options, Mishock Physical Therapy & Associates is excited to introduce Class IV Laser Therapy as part of our advanced pain management and rehabilitation services in the near future. Our clinical team will be offering high-intensity laser therapy for musculoskeletal pain, inflammation, soft-tissue injuries, neuropathy, and post-surgical recovery, allowing patients to benefit from the deeper tissue penetration and faster treatment times supported by current research. If you are looking for non-invasive pain relief, accelerated healing, and cutting-edge rehabilitative technology, our upcoming Class IV Laser Therapy services will provide an effective, science-backed solution to help you move better and recover faster. Stay tuned for launch dates and availability at our Mishock PT locations.
We can help!
If pain is limiting you from doing the activities you enjoy, give Mishock Physical Therapy a call: locations in Gilbertsville (610-327-2600), Skippack (610-584-1400), Phoenixville (610-933-3371), Boyertown (610- 845-5000), Limerick (484-948-2800) at www.mishockpt.com or request your appointment by clicking here.
Dr. Mishock is one of only a few clinicians with doctorate-level degrees in both physical therapy and chiropractic in the state of Pennsylvania. He has also authored two books; “Fundamental Training Principles: Essential Knowledge for Building the Elite Athlete”, “The Rubber Arm; Using Science to Increase Pitch Control, Improve Velocity, and Prevent Elbow and Shoulder Injury” both can be bought on Amazon or train2playsports.com.
