Red Light Therapy for Pain: The Safe and Effective Solution for All Kinds of Aches

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Pain is a natural part of life; it alerts us to damage to the body, and warns us of potential injury. While unpleasant to say the least, it exists to keep us safe and, well, alive, by prompting a response from the body. For instance, when you accidentally touch a hot stove, your pain receptors send a message to your brain, prompting a response - in this case, removing your hand from the stove - and preventing damage to the body. If you’ve burnt yourself, the pain then becomes a reminder to treat the wound to prevent infection. 


In other words, pain, when it does its job, is our friend. However, for many, it’s an invisible enemy. Chronic pain typically occurs when acute pain does not resolve once the initial cause has been resolved. Any pain that lasts more than 12 weeks can be considered chronic. 


High-impact chronic pain, on the other hand, is defined as chronic pain that limits life or work activities on most days or every day. According to the CDC, an estimated 50 million Americans suffer from chronic pain, and 19.6 million suffer from high-impact chronic pain. 


Pain is such a large and complex subject that it is often misdiagnosed or simply unexplained. This can make it difficult to treat. While we’ve made enormous strides in terms of pain management in the last century or two, our comprehension of pain is still relatively rudimentary, and thus so are current treatment options, some of which can have harmful side effects. To wit, in an effort to help alleviate suffering and improve the quality of life of those living with chronic pain, we’ve inadvertently created a whole other public health crisis in the form of opioid abuse. This has left the medical community scrambling to find alternative ways to treat pain - and one of the most promising is red light therapy.


Red light therapy is garnering more and more attention as a treatment for pain not only for its proven efficacy, but for its safety, as well. Contrary to addictive medications, it actually activates your body’s own natural ability to diminish pain. How, exactly, does it do that? It’s not magic or pseudoscience, as we’ll see. But first, let’s talk about pain. 

WHAT ARE THE MAIN TYPES OF PAIN?

There is some discrepancy out there about just how many types of pain there are and even what they are. We’ve found the most comprehensive and inclusive to be the following:

  • Nociceptive pain: This is described as pain caused by the stimulation of nociceptive nerve endings (the receptors that detect and transmit sensations when you touch a hot stove, say). Although this type of pain is often conflated with acute pain, it’s important to note that chronic pain can be nociceptive as well. Nociceptive pain can be a characteristic of arthritis, for example.

  • Neuropathic pain: This type of pain is caused by damage or disease affecting the nervous system. It’s often described as a shooting or burning pain. It’s a common symptom of multiple sclerosis, neuralgia, and diabetes, to name a few. (Many people consider fibromyalgia to be neuropathic, however, it technically does not qualify, as it is caused by a dysfunction of the nervous system rather than damage.)

  • Functional or primary pain: This category refers to pain for which there is no obvious origin. In other words, when the pain is the condition rather than a symptom of something else. It can include nonspecific low back pain, primary headache, IBS, fibromyalgia, and many other conditions that are complex and difficult to understand.


Some in the medical community have begun using the term nociplastic pain to refer to functional or primary pain, as it considers that there is a pathophysiological explanation, namely that it arises from altered nociceptive pain. This change in terminology can be empowering to patients who often feel that they’ve been tossed into the catch-all drawer of pain diagnoses.


It’s important to remember that there is considerable overlap between these pain categories, often resulting in complex combinations of both diagnoses and treatments. 

COMMON PAIN CONDITIONS

Listing pain conditions is complicated, as there are innumerable illnesses and disorders for which pain is a secondary symptom. But for our purposes, namely how red light therapy can treat pain, we’ve compiled a short list of some of the most common conditions that cause pain. We'll come back to this and the clinically-proven benefits of red light therapy for each later on

  • Rheumatoid arthritis

  • Osteoarthritis

  • Cancer pain

  • Dysmenorrhea (menstrual pain/cramps)

  • Fibromyalgia

  • Headache/migraine

  • Low back pain

  • Neuropathic pain

  • Post-surgery pain

  • Post-trauma pain

A BRIEF HISTORY OF MODERN PAIN TREATMENT

As we’ve stated, pain is a naturally, albeit unwelcome, part of life. Humans have therefore been attempting to alleviate pain since time immemorial. Here’s a bird’s eye view at humanity’s progress toward the remedies for pain we use today.


In the Stone Age, people believed that pain was sent from the gods. Pain relief tactics included ritual animal sacrifice or other religious offerings.


Ancient Egyptians used electric eels to relieve pain - a precursor to some electric stimulation methods used today.


Anthropologists have discovered evidence throughout history and across many cultures of trepanation, or the process of drilling a hole in a person’s skull. It had many purposes, one of which likely included pain treatment.


Somewhere around 400 BC, Hippocrates recommended the use of willow bark, which contains salicylic acid, the active ingredient in aspirin. There is evidence of its use as far back as 4,000 BC, however. 


The Chinese began using acupuncture around 100 BC.


In the Middle Ages, the use of herbs became popular for the treatment of pain. Some were applied topically, while others were ingested. And the more herbs, the better, presumably in the likelihood that at least one would work. 


By the 1600s, opium was the pain treatment du jour in the West, thanks to the British occupation of India. In 1680, apothecary Thomas Sydenham created laudanum, a tincture composed of opium, sherry, and herbs. 


The use of laudanum and other opiates, including heroin and morphine, skyrocketed in the 1800s, leading to America’s first opiate epidemic around the time of the Civil War.  


The use of opiates waned considerably in the 1900s, due to advances in medicine leading to less need for pain relieving medication, as well as the introduction of Aspirin, the first Non-steroid anti-inflammatory drug (or NSAID) in 1897. Other NSAIDs such as ibuprofen (Advil) and Naproxen (Aleve) came along in the 1950s and beyond. Acetaminophen (Tylenol) - not an NSAID - was also created in the 1950s. 


In the 1980s and 1990s, pharmaceutical companies waged a campaign to convince medical professionals that prescription opioids carried a very low addiction risk. This led to a sharp uptick in opioid prescriptions throughout the 1990s and well into the 2000s, causing an epidemic that we’re still dealing with today.

THE OPIOID CRISIS AND THE FUTURE OF PAIN MANAGEMENT

The current opioid epidemic has occurred in three waves. The first wave began in 1991 and was characterized by a sharp increase in deaths directly resulting from overprescription of opioid drugs. The second wave began sometime around 2010 in the form of an increase in deaths from heroin abuse, as a crackdown of prescription opioids after the first wave made them harder to come by. The third wave started around 2013, characterized by an increase in deaths related to synthetic and illicitly-manufactured opioids such as fentanyl. 


While the numbers are starting to go down, the problem is far from over. In 2019, 9.7 million Americans over the age of 12 misused a pain medication prescription. Drug overdoses are also the leading cause of death among people under 50 in the U.S., and two-thirds of all drug overdose deaths in 2018 were opioid-related. In fact, from 1999 to 2018, more than 232,000 people have died from overdoses involving prescription opioids, with 15,000 deaths in 2018 alone. 


Despite what we now know, in 2017, more than half of Americans had received an opioid prescription. The main problem is the lack of effective alternatives; we can’t simply cut off pain medication prescriptions that people have been relying on for years without a new plan for pain management. This leaves health care professionals in a tough position. 


Given that this is a public health issue with far-reaching societal consequences, there is an urgent need to establish plans at the governmental level to solve the opioid crisis, and one of the steps is to prioritize safe, effective, non-addictive strategies for the management of chronic pain. And red light therapy is quickly heading to the forefront.  


Let’s take a look at what red light therapy is and how it can help alleviate pain safely, naturally, and most importantly, effectively. 

WHAT IS RED LIGHT THERAPY?

The spectrum of light is composed of wavelengths of energy from different light sources. It is measured in nanometers, with each nanometer representing a different wavelength. The visible light spectrum ranges from 380nm to 780 nm. Red light therapy actually refers to a combination of red and near-infrared (NIR) light, and is in fact more commonly called photobiomodulation or low-level light therapy in scientific literature.


While red light is part of the visible light spectrum at around 625-700nm, near-infrared light is just outside the realm of visible light at approximately 780-3,000nm (these boundaries can change slightly depending on who you ask). 


Just as other wavelengths of light can affect your body in various ways - we’ve all experienced sunburn from UV lights, for instance, and been told to put down our blue-light-emitting devices before bed - red and near-infrared light also acts on the body, in some pretty fascinating ways, as we’ll see.  


Red light therapy, for its part, is a therapeutic treatment in which red and NIR light is diffused into the skin via light-emitting diodes (LED). These wavelengths penetrate all the way to the mitochondria of the cell. 


Mitochondria are cellular organelles in which all your body’s energy is produced, in the form of adenosine triphosphate (ATP). Sometimes, whether due to age, illness, or a variety of other factors, the system lags and ATP production slows. Exposure to red and NIR light creates a biochemical reaction within the mitochondria, allowing it to use oxygen more efficiently to create ATP. The result of this optimization of ATP synthesis is that the body’s tissues and organs are able to function more optimally as well. 


But how can improved functioning at the cellular level help with pain relief? It does so in several ways. 

WHAT ARE THE MECHANISMS THAT ALLOW RED LIGHT THERAPY TO HELP RELIEVE PAIN?

Red light therapy improves cellular function

We’ve already touched on this, but what does this mean for pain relief? 


A major source of pain is injury or illness. And many injuries and illnesses heal themselves over time. It doesn’t happen magically - the body is working hard at the cellular level to repair damage and fight disease. However, when the cells are functioning suboptimally, this ability to heal is hindered. 


By increasing ATP production, red light therapy bolsters your body’s natural ability to heal injuries and battle illness. To use the example of sports, research has shown red light therapy to accelerate healing post-injury and to speed up return to play (you can read more about red light therapy and sports/fitness here). 

Red light therapy improves blood flow

Research has found red light therapy to induce angiogenesis, which is the formation of new blood vessels. It also triggers the release of nitric oxide (NO), a natural vasodilator. This increase in the number and size of capillaries allows for more oxygen and nutrients to reach affected tissues. It also allows for a more efficient elimination of waste and toxins, which can further accelerate the healing process.


Increased circulation also helps relax muscles, promotes flexibility and movement, and breaks up scar tissue, all of which can alleviate pain. 

Red light therapy reduces inflammation

Increased ATP production and improved blood flow is known to help reduce inflammation by speeding up the healing process. 


Another way red light therapy reduces inflammation is by altering the macrophages of the cell. Macrophages are organisms that detect, engulf, and eliminate dead cells and pathogens (disease-causing organisms). There are two types of macrophage phenotypes, M1 and M2. M1 has a pro-inflammatory effect, while M2 diminishes the inflammatory response and repairs damage. Research has found that red light therapy may change the macrophage phenotypes from M1 to M2, thus reducing inflammation and promoting healing . 

Red light therapy triggers hormesis

Somewhat counterintuitive on the surface, hormesis is the process of temporarily causing stress to a system in order to provoke a response. In this case red light therapy causes mild temporary oxidative stress. Oxidative stress is an imbalance between free radicals and antioxidants in the body. Long term, it can lead to a variety of ailments and diseases, most notably cancer. In small doses, however, it can be beneficial by jump-starting the body’s natural defenses. In other words, the body overcompensates for this temporary stress by activating the body’s healing complex, strengthening the affected tissue and ultimately relieving pain. 

Red light therapy increases collagen

Collagen is the body’s most abundant protein. It’s the major building block in all types of tissue, providing it with structure and robustness. Collagen production naturally diminishes with age, which partly explains why it might take you longer to recover from a muscle tear or broken bone than it would have twenty years ago. 


There is a wealth of research demonstrating red light therapy’s effectiveness in increasing collagen. In fact, red light therapy is commonly used for the cosmetic treatment of wrinkles, sagging skin, wounds, and scars. This same stimulation of collagen production can be applied to other tissues, including bones, joints, and other internal organs, to promote quicker healing of injuries which cause pain. 

THERAPEUTIC BENEFITS OF RED LIGHT THERAPY ON PAIN MANAGEMENT, AND PAIN RELIEF: A RESEARCH-BASED OVERVIEW

Let’s take this opportunity to go back to our list of common pain conditions and see what the research specific to these conditions has gleaned to date. 

Rheumatoid arthritis (RA)

A 2005 review of the literature on red light therapy and rheumatoid arthritis found the treatment to be effective in reducing pain as well as duration of morning stiffness, and for increasing joint flexibility. 


Another review published in 2020 analyzed the efficacy of red light therapy on a range of inflammatory, musculoskeletal, and autoimmune diseases. Researchers concluded it to be a promising treatment for RA, and that it “could play a major role in attenuating the immune response that leads to joint destruction and debilitation”.

Osteoarthritis

A 2017 review found red light therapy in conjunction with prolotherapy (a regenerative injection treatment for chronic musculoskeletal pain) is an effective approach to treating osteoarthritis. In fact, the authors of the study recommend this combination of treatment to healthcare professionals as a safe alternative to long-term opioid prescription.


A 2019 meta-analysis on the effectiveness of red light therapy on osteoarthritic knee pain and disability determined that the treatment significantly reduced pain compared to placebo. They also found a significant reduction in disability. These results were maintained during follow-ups up to 12 weeks later. Researchers also noted that no adverse effects related to the treatment were reported.

Cancer pain

One of the unfortunate side effects of cancer treatment is pain. In fact, for some, the pain is so great that it impels them to stop treatment altogether. One of the most common - and debilitating - side effects is oral mucositis (OM), the inflammation and ulceration of the lining of the mouth. 


In a systematic literature review published in 2019, researchers promote the use of red light therapy to prevent OM in patients undergoing cancer treatment. 


Another 2019 review found the treatment to significantly improve OM in patients undergoing chemotherapy, finding it to have both preventative and healing effects. 


In a 2016 study, researchers tested the efficacy of red light therapy on chemotherapy induced OM in children. Of the 123 subjects included in the study, 62 children received 4 consecutive days of red light therapy treatment, while the remaining 61 received a placebo treatment. They found the red light therapy patient to have significantly reduced pain, regardless of whether lesions disappeared or not. 


Burning mouth syndrome (BMS) is another common side effect of cancer treatment, although it can often occur in healthy adults, and is particularly common among postmenopausal women. A 2017 review of the literature on red light therapy and BMS concluded that the treatment appears to be effective in reducing pain associated with the condition. 


Finally, another study published in 2019 looked at the therapeutic benefits of red light therapy on a number of oral symptoms caused by cancer treatment, including OM and burning mouth sensation. Researchers determined that red light therapy “can be safe, time-saving, and a promising approach for the management of the oral complications due to cancer therapy and the quality of life of cancer patients”.


Lymphedema, a buildup of lymph fluid under the skin causing painful swelling, is another common symptom associated with cancer. It may be caused by the cancer itself or it can be a side effect of treatment. One 2015 meta-analysis found red light therapy to significantly reduce limb volume and pain in women with breast cancer, more so than other treatments. 


A similar review was conducted in 2017. An analysis of 11 studies revealed red light therapy to be effective for short-term limb volume and circumference reduction as well as pain reduction in breast cancer patients. 

Dysmenorrhea

While most people with periods experience menstrual pain occasionally, for about 5% to 10% the pain is severe enough to significantly disrupt their lives. Red light therapy could be an effective solution, according to recent research. 


In one 2012 randomized, double-blind study, 31 women were recruited, 21 of whom were administered red light therapy treatment for 20 minutes a day during the 5 days leading up to their period. The remaining 10 were given a placebo. While the control group only showed a slight temporary reduction, the treatment group showed an 83% drop in pain. The pain reduction remained significant after 6 months. A similar study from the same year showed red light therapy to be effective at reducing menstrual pain when applied to acupuncture points. 


A 2015 literature review confirms the effectiveness of red light therapy at treating menstrual pain when applied to acupuncture points, as well as when combined with exercise. 


Finally, a randomized, double blind study from 2015 assigned 44 women to a red light therapy treatment group and 44 others to a placebo group. The treatment group showed a significantly greater reduction in pain than the control group, with no adverse effects. 

Fibromyalgia

Fibromyalgia is notoriously difficult to treat. Fortunately, red light therapy is emerging as a useful therapeutic tool for the management of symptoms. In a 2014 clinical trial, 20 patients were divided into two groups. One received three red light therapy treatments over four weeks, while the other was given a placebo. Results showed a significant reduction of all symptoms (except for number of tender points) in the treatment group compared to the placebo group. 


Researchers did see a reduction in the number of tender points in a 2018 systematic review. They also noted a significant reduction in Fibromyalgia Impact Questionnaire (FIQ) scores (the FIQ is an instrument used to assess the health status of people with fibromyalgia).


Another meta-analysis was conducted in 2019 on randomized controlled trials. Researchers found red light therapy to be effective in significantly reducing pain severity, FIQ scores, number of tender points, stiffness, fatigue, depression, and anxiety in patients with fibromyalgia, compared to patients receiving a placebo treatment. 


Finally, another 2019 meta-analysis on the treatment of pain related to fibromyalgia highlights the importance of permanent pain relief rather than temporarily masking it with medication. The authors point to red light therapy as “the most universal and effective” of all physiotherapeutic methods. 

Headache/migraine

In a 2016 study, 10 women were administered red light therapy as a treatment for headache. Treatment was applied for 34 seconds on tender points of the masseter and temporal muscles. Researchers found a 64% reduction in pain post-treatment. They also noted a significant increase in blood flow in the temporal artery as well as an increase in 5-HT (serotonin) levels. This indicates that red light therapy appears to alleviate headache by regulating blood flow and serotonin levels. 


A 2018 study compared the effects of red light therapy and botulinum toxin (Botox) on chronic migraines. They found both treatments to significantly reduce the number of pain days, acute medication consumption, and severity of pain. Red light therapy was also found to significantly reduce sleep disturbance. 


Another study published in 2019 evaluated the effects of red light therapy on three patients suffering from chronic migraines. The first patient received three treatments over four weeks, the second six treatments over 23 days followed by another four treatments over four weeks, and the third eight treatments over four weeks. Each patient experienced a significant reduction in pain during the course of the treatment, and they all reported being migraine-free at the end. 


Finally, a 2013 study evaluated the effectiveness of red light therapy on chronic rhinosinusitis. Among the symptoms of this condition are facial pain and pressure similar to headache. 10 patients received ten treatments over 4 weeks. Results showed a significant reduction in symptoms after two weeks (39%) and at the end of treatment (46.34%). Results were sustained for 5 months on average post-treatment. 

Low back pain

This is one of the most common pain complaints due to its innumerable causes. It’s also the single leading cause of job-related disability. For this reason, research on the subject is not lacking. 


A 2010 study found red light therapy to be significantly more effective at treating discogenic back pain (pain caused by damaged intervertebral discs) compared to a placebo group. 


A 2015 meta-analysis found red light therapy to be an effective method for relieving pain in patients with nonspecific low back pain (i.e. back pain not attributable to a known pathology). Similar results were noted in a 2016 review, with evidence supporting red light therapy as a beneficial short-term therapeutic intervention. 

Three clinical trials published in 2020 turned up promising evidence of red light therapy’s effectiveness as a treatment. The first study compared a group receiving 12 red light therapy treatments to a group receiving the same number of sham treatments. The treatment group showed significantly greater improvements in pain, spinal range of motion, and functional status after three months compared to the sham group. 


The second study found a combination treatment of red light therapy and Mulligan sustained natural apophyseal glides (SNAGs) to be effective for significantly improving pain, function, and range of motion. 


The third study found low-level laser therapy (red light therapy) to be as effective as high-intensity laser therapy (HILT) for the treatment of nonspecific low back pain, with significant improvements in pain, range of motion, and quality of life. Note that contrary to red light therapy, which can be used at home, HILT may only be used by a qualified therapist in a clinical setting. 

Neuropathic pain

If you’ll recall, neuropathic pain is caused by damage or disease affecting the nervous system. Diabetic neuropathy is the most common and debilitating of the complications caused by diabetes. Symptoms can include numbness, tingling, sharp pain or cramps, and hypersensitivity to touch. One 2012 study found that red light therapy significantly reduced pain and improved electrophysiological parameters and foot skin microcirculation. A similar 2015 study also showed a significant reduction in pain in patients that received red light therapy treatments, as well as an increase in temperature (a common symptom of diabetes is difficulty regulating body temperature).


In a 2016 study, researchers performed an analysis of 14 articles studying the effects of red light therapy on neuropathic pain. They found that all the studies analyzed showed red light therapy to be effective for the reduction and control of neuropathic pain. 


A 2018 literature review analyzed 26 articles studying the effects of red light therapy on peripheral nerve regeneration. Their analysis determined that red light therapy treatment has a beneficial effect on healing nerve lesions, resulting in accelerated nerve regeneration, improved function, reduced pain and inflammation, and increased collagen and blood vessel formation.


Another literature review published in 2020 analyzed 13 articles on red light therapy and neuropathic orofacial pain. All studies showed a reduction in pain intensity, leading to the conclusion that red light therapy appears to be effective in treating various neuropathic orofacial conditions. 

Post-surgery pain

In a 2012 study, 60 patients were given either red light therapy treatment of a placebo after a tonsillectomy. Pain and odynophasia (pain when swallowing) were then measured every two hours for 12 hours, and then again at 24 hours. Results showed that those in the treatment group had a greater reduction in pain at each assessment, as well as an overall lower consumption of pain medication. 


Similar studies were conducted in 2014 and 2016, on patients who had undergone tibial fracture surgery and elective cesarean, respectively. In both studies, results also showed a greater decrease in pain and pain medication intake in the treatment group. In the cesarean study, patients in the treatment group also exhibited a significant delay in their first request for pain medication.


In a 2017 study, researchers found red light therapy to significantly reduce pain in patients who have had molar surgery. (For a greater look at the benefits of red light therapy for oral health as well as its applications in dentistry, check out this blog post.)

Post-trauma pain

Traumatic injury is a leading cause of pain, with two of the most common causes being sports injury and traffic accidents. A groundbreaking 2000 study evaluated the effects of red light therapy on 74 patients suffering from pain caused by a variety of sports- or traffic-related injuries. Researchers found that “in addition to accelerated wound healing, the main advantages of LLLT [...] include prevention of side effects of drugs, significantly accelerated functional recovery, earlier return to work, training, and sport competition compared to control group, and cost benefit”. A similar study from that same year yielded comparable results, with 85% of treated subjects experiencing an accelerated recovery process.


Finally, following a 2-year study on the effectiveness and cost-effectiveness of clinical interventions for neck pain and associated disorders, the Ontario Protocol for Traffic Injury Management now includes red light therapy as a recommended treatment for certain types and grades of traffic injury.

Red light therapy for opioid addiction

Opioid dependency is not a pain condition per se, but given its close relationship with pain management, we felt it relevant to include here. 


It appears red light therapy may be effective in regulating opioid cravings, according to this 2020 study. Twenty-two patients experiencing significant opioid cravings were randomly administered either red light therapy treatment or a placebo. The treatment group showed a 51% decrease in cravings after one week compared to 15.8% for the placebo group. The treatment also demonstrated a significant reduction in anxiety and depression after one week compared to the untreated patients. 


A similar study is currently underway. Researchers anticipate a 60% reduction in opioid cravings in the treatment group, as well as a reduction of opioid use of 1.6 times per week. 


As you can see, the research on red light therapy for pain management is more than promising; it’s overwhelmingly positive. But what does all this mean for you? How can you get the therapeutic benefits outlined in the research? We’re happy to say that it’s never been easier, or more affordable.

HOW CAN YOU BENEFIT FROM RED LIGHT THERAPY FOR PAIN RELIEF?

While it’s still a relatively young technology, red light therapy has been available commercially for some time now. Until recently, however, it was mainly administered in a professional setting using industrial equipment. Given that the key to effective red light therapy is frequent, consistent use, this made it a rather inconvenient (particularly for pain sufferers) and expensive therapeutic option. 


Advances in LED technology have made it possible to design and manufacture compact red light therapy devices that are just as powerful and efficient as their industrial counterparts, without the hefty cost. And Rouge Red Light Therapy Panels are among the most powerful and efficient on the market today (read about how Rouge outshines the competition here).


Two salient concerns for pain sufferers are, of course, risk and side effects. The prescription opioid crisis has left a great deal of people worse off than when they started. Patients and healthcare professionals alike may therefore be reluctant to begin a course of treatment that has the potential to cause harm in other areas. 


Fortunately, one of the most impressive aspects of red light therapy is that on top of being effective it has virtually no risks or side effects. None of the studies referenced here turned up any adverse effects, and it is universally considered safe for daily use. 


In fact, Rouge red light therapy devices are FDA-registered as Class-II medical devices specifically for the treatment of pain and stiffness associated with arthritis as well as the relief of muscle spasms and minor muscle and joint aches. 

OTHER HEALTH BENEFITS OF RED LIGHT THERAPY

Because red light therapy works by optimizing your own body’s ability to function more efficiently, it’s effective for treating a vast array of issues. Some of these include: