Cold Laser Therapy Overview

What is Cold Laser Therapy?
A non-heating pain-free therapy, cold laser therapy makes use of intense beams of pure light from specific wavelengths. These wavelengths activate localized energy cells to promote healing and decrease inflammation as well as provide relief from acute and chronic pain.
Cold laser therapy has a bio-stimulating effect to enhance the natural cell activity in the body, speeding up the healing process, and improving on a cellular level, helping to repair muscle tissues. It is versatile and can be used on many different chronic and acute conditions while serving as an additive in conjunction with other modalities or manual therapies. There is no radiation associated with the treatment itself.
Why is it called “Cold” Laser Therapy?
The term “cold” laser comes from the fact that the machine uses low-level light energy, which stays cold and does not emit heat to any body tissues. Other lasers, considered “hot” lasers, such as Intense Pulsed Light Therapy (IPL) use a thermal change in the skin to produce new growth. Cold lasers will help to repair the cells and are non-thermal, meaning they do not need heat to do this.
It is important to note the different classes that lasers fall under. “Cold” falls under class 3 while “Hot” falls under class 4. Class 4 lasers, when used in medical treatments, will burn, cut or vaporize, and are also used in the military or industrial fields. Class 3 lasers are used in many physiotherapy clinics, specifically to help repair muscle tissues.
Benefits of Cold Laser Therapy

image credit BTL Laser
Benefits include:
- Non-invasive: No breaking of the skin, no prolonged recovery time,
- Pain-free: No pain or feeling associated at all while receiving cold laser therapy,
- Non-thermal: No heat is emitted to the body tissues,
- Decreases inflammation: Reduces swelling and redness,
- Able to treat a variety of chronic + acute conditions: Cold laser therapy is versatile in being able to treat a variety of conditions such as muscle strains, tendonitis, arthritis, neck/lower back pain, and tennis elbow among many others
Cold laser therapy can be used on a multitude of different chronic and acute conditions such as:
- Tennis and golfer’s elbow
- Carpal Tunnel Syndrome
- Ligament and tendon strains/sprains/tears
- Osteoarthritis
- Plantar Fasciitis
- Fibromyalgia
- Neuropathic pain
- Tendonitis, tendinopathy, or bursitis
Contraindications
Pregnancy – Pregnant women are recommended not to undergo laser therapy, since its effects on unborn children are not yet known.
Epileptics – Low-frequency visible light may trigger a seizure in photosensitive, epileptic patients.
Cancer – Cold laser therapy should not be used over any suspicious cancerous lesions or carcinoma.
Eyes – There should not be direct lasering of the eyes, as the laser can cause permanent eye damage (eye protection should always be used).
Due to the cold laser being a pain-free, non-heating modality there are no side effects from receiving laser therapy. The only disadvantage to laser therapy is the number of treatments you may need, as most patients do not receive full relief after the initial treatment session. At our clinic, we utilize cold laser therapy as an additive to other modalities, not necessarily on its own.
Cold Laser FAQ
What is the difference between cold laser therapy and red light therapy?
Cold laser therapy and red light therapy are similarly the same thing, they are both considered low level light therapies (LLLT) and both utilize a red light. The long wavelengths stimulate pigment molecules in the mitochondria of skin cells to produce chemicals the body needs for healing and repair, which is why you may see red light therapy being used by medical aestheticians to treat skin appearance such as acne, wrinkles, and scarring.
Is low level laser therapy (LLLT) the same as cold laser?
Low level laser therapy is a broad term used to categorize lasers that have a low level of lightwaves emitting from them (ex: cold laser therapy, red light therapy).
Can cold lasers damage the eyes?
In the case that there is even a remote chance of a light beam reflecting or directly hitting your eye, laser safety glasses need to be worn as a safety precaution due to the intense beams of light laser machines give off. Permanent eye damage can happen if not wearing the proper safety glasses.
How often can you do cold laser?
Cold laser therapy has a cumulative effect, therefore it is generally best to receive laser twice a week for the duration of your treatment.
Does cold laser penetrate bone?
Bones, along with muscle and other soft tissues, are transparent to certain laser lights which means the laser light can safely penetrate it. Depending on the dosage and the output power of the laser machine, low level light therapy can stimulate cellular metabolism, as well as increase the synthesis of proteins. All of these changes contribute to bone regeneration.
Does Cold Laser Therapy Work?
Continuing research on cold laser and red therapy is showing promising results. https://pubmed.ncbi.nlm.nih.gov/28987080/ this review of literature on low level laser therapy concludes “Many studies have demonstrated analgesic and anti-inflammatory effects provided by photobiomodulation in both experimental and clinical trials”.
What to Expect During a Cold Laser Treatment
As there is no heat or pain associated with this treatment, you will not feel anything while the laser machine is turned on and operating. Should your physiotherapist feel that cold laser is beneficial for the injury you are coming in for, they will place our handheld laser head directly on the affected area. Depending on the injury, they will select the wavelength suitable for you and adjust the intensity level. Infrared clusters of blue and red light will penetrate into the tissues for a number of minutes, beeping to notify once the laser is done.
Before starting the machine, laser safety glasses will be given and need to be worn during the duration of treatment. Multiple areas can be lasered during one session.
