How LLLT (cold laser) may help fibromyalgia
LLLT works by delivering low-intensity light to tissues. At the cellular level this light may modulate mitochondrial activity, improve microcirculation, reduce local inflammation and influence nerve signalling — processes that can reduce pain sensitivity and support recovery.
In fibromyalgia, where central sensitisation and widespread musculoskeletal tenderness are characteristic, these local and systemic biological effects may reduce the intensity of tender points and improve fatigue when used as part of a comprehensive management plan.
What the evidence says
The most rigorous synthesis to date (a 2019 systematic review and meta-analysis of randomised controlled trials) examined LLLT for fibromyalgia and reported statistically significant benefits in:
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Fibromyalgia Impact Questionnaire (FIQ) scores (overall impact)
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Pain severity
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Number of tender points
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Fatigue and stiffness
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Anxiety and depression scores
That review included nine RCTs with a total of 325 participants and concluded that LLLT is an effective, safe and well-tolerated option for fibromyalgia, while noting heterogeneity in laser types, dose and study quality — so individual results may vary.
What to expect from treatment
Typical goals when using LLLT for fibromyalgia are reduced pain intensity, fewer tender points, improved daily function and less fatigue.
LLLT is usually given as a series of short sessions (for example, weekly or multiple times per week for several weeks) and may be offered alone or alongside exercise, pacing strategies and other multimodal therapies.
Important: Protocols (wavelength, power, treatment time and number of points treated) vary. Because fibromyalgia is a complex condition, best outcomes are generally obtained when LLLT is part of an integrated management plan supervised by a health professional.
Safety and side effects
LLLT is non-invasive and is generally reported as safe with few adverse effects in clinical trials. Mild transient effects such as local warmth or temporary increase in sensitivity are occasionally reported.
LLLT should not be used directly over active malignancy. Pregnancy and certain photosensitive conditions require specialist advice — always share your full medical history with your practitioner.
Practical guidance for people with fibromyalgia
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Discuss with your clinician: Ask your GP, specialist or pain clinic whether LLLT might fit your personalised care plan.
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Ask about device and protocol: Check what device will be used, how many sites will be treated, session length and total number of sessions.
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Combine with active care: LLLT is most effective when combined with graded exercise, sleep optimisation, stress management and other therapies.
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Track outcomes: Use pain scales, fatigue ratings or FIQ items to measure benefit over time.
Addressing scepticism — a fair view
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Steel-manning the sceptic: It’s reasonable to be cautious — trials have used different lasers, doses and small samples, and fibromyalgia is highly variable, so a one-size-fits-all claim would be misleading.
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Feel–Felt–Found: Many people feel frustrated because previous treatments offered limited relief. Others have felt the same scepticism about light therapy. What they found — when LLLT was delivered within a structured care plan and monitored — was measurable reduction in pain and tenderness, and sometimes improved energy and sleep.
Why some clinicians choose pulsed LLLT devices
Pulsed-mode devices are popular because they allow delivery of therapeutic light energy while giving micro-breaks that may reduce heating and allow deeper tissue interaction.
If you’re exploring devices, see Pulse Laser Relief — Pulsed Low Level Laser Therapy for clinical information and product specifications.
Limitations and next steps in research
While the meta-analysis provides encouraging evidence, limitations include variable trial quality, small sample sizes and inconsistent treatment parameters. Larger, well-designed RCTs are needed to define the optimal dose, frequency and long-term benefit.
Takeaway
LLLT (cold laser / photobiomodulation) is a promising, low-risk adjunct for some people with fibromyalgia. Randomised trials show reductions in pain, tender points and fatigue compared with placebo.
It is not a cure, but when integrated into a multidisciplinary plan it can be part of a sensible strategy to improve symptoms and quality of life. Talk to your treating team to see whether it’s appropriate for you.
References:
Yeh SW, Hong CH, Shih MC, Tam KW, Huang YH, Kuan YC. Low-Level Laser Therapy for Fibromyalgia: A Systematic Review and Meta-Analysis. Pain Physician. 2019 May;22(3):241-254. PMID: 31151332.
