Laser Treatment for Neuropathy – Is It Effective?

Peripheral neuropathy is defined as injury and dysfunction of the smaller nerves that extend from the spinal cord to other areas of the body.  This condition can occur as the result of trauma, an autoimmune disorder, an infection, or chemotherapy.  In these situations, there is inflammation or a direct toxic effect on the nerves.  However, the most common cause of peripheral neuropathy are Types I and II diabetes mellitus.  It affects 50 percent of  people with this medical condition.  Although diabetes is associated with high blood sugar levels, it is unclear as to why this causes nerve damage.  Reduced blood flow and oxygen supply to peripheral nerves may play a role.  When peripheral neuropathy develops, its symptoms can become life-altering. 

The symptoms of peripheral neuropathy typically begin in the hands or feet, then progress to the arms and legs.  They include:

  • numbness or tingling
  • burning sensation
  • pain triggered by normal activities
  • decreased or increased touch sensation
  • muscle weakness
  • balance problems

Unfortunately, researchers have not discovered a way to reverse the effects of neuropathy.  Nerves consist of a central body, an axon through which impulses travel, and nerve endings.  These nerve endings, called ,dendrites directly attach to muscles, skin, and other organs.  Although the central body and axon may undergo some amount of regeneration, the dendrites cannot repair themselves.  Any damage and resulting symptoms are likely to be permanent.  For this reason, steps should be taken to prevent the worsening of peripheral neuropathy once initial signs are present.   For individuals with diabetes, the most preventative measure is to maintain normal blood glucose levels in order to slow the progression of neuropathy.

Conventional Methods for Managing Neuropathy

Although peripheral neuropathy cannot be reversed, there are a variety ways to manage the symptoms.  These methods can help make day to day life a little more bearable.

Because pain is a frequent and frustrating problem, medications that mitigate pain are commonly recommended.  This may include over-the-counter acetaminophen or ibuprofen.  It is important to take appropriate doses of these medications, and at the recommended frequency, to prevent adverse effects on the stomach, liver and kidneys.  However, the pain of peripheral neuropathy can become so severe that prescription medications are often necessary.

Topical creams can reduce neuropathic pain without causing systemic side effects.  These include lidocaine patches and  capsaicin cream, among others.  Capsaicin is derived from chili peppers, and is thought to alleviate pain by reducing a chemical in the nerve axon that transmits pain signals.  It also blocks pain receptors in the areas over which the cream is applied.  However, its effectiveness wanes over time.

Other treatment options include antidepressants, anti-seizure medications, transcutaneous nerve (TEN) stimulators, and physical therapy.  These work in different ways to reduce pain, and are prescribed only after extensive evaluation by primary care doctors and specialists.  Figuring out which of these treatments will work best often depends on the type and severity of the pain as symptoms can vary from person to person.

Aside from the aforementioned treatments, some studies suggest that certain laser treatments can reduce neuropathic pain. But, which are truly beneficial?

How Does Laser Treatment for Neuropathy Work?

Lasers have been used for a variety of medical purposes for some time.  For example, some types of lasers are used to cut precise incisions along delicate parts of the body, such as the eyes.  In the 1960s, studies found that low level lasers may improve the pain and discomfort of peripheral neuropathy.  However, current studies have found the efficacy of low level lasers to be inconsistent.

The most popular form of laser therapy used for neuropathic pain is cold laser treatment.  The process is painless, and administered several times per week.  It is felt to stimulate partial nerve regeneration by increasing blood circulation around the affected areas.  As a result, it is purported to decrease neuropathic pain and discomfort.  However, as stated previously, damaged dendrites cannot be repaired.

In contrast, deep tissue laser therapy has been shown to effectively reduce neuropathic pain.  It uses laser wavelengths of 600 to 1100nm to cause a biochemical reaction within nerves and surrounding tissues that reduces pain and promotes healing.  Treatments are done two to four times per week for eight to 30 weeks.

What Else Do Studies Say?

Laser treatment of peripheral neuropathy is fairly new, and we’re just beginning to understand how it provides relief from neuropathic pain.  However, despite the lack of in-depth understanding, existing studies point to the same conclusion:  some laser treatments are more effective than others.

A 2012 study measured pain management used a screening survey that quantified the level of neuropathic pain experienced by each participant.  Based on their findings, low level laser therapy significantly reduced pain in those with Type 2 diabetes.  Similar findings were noted in a study conducted in 2011.

Another study published in 2017 indicated that low level laser therapy could improve sensory function in individuals with peripheral neuropathy.  However, variations in the treatment regimens, and the lack of a specific treatment protocol affected successful outcomes.

More recently in 2021, a systematic review of multiple clinical trials concluded that low level laser therapy had no effect on pain reduction for some diabetic patients.

Based on this research, it appears that deep tissue laser therapy is more effective in reducing the pain of peripheral neuropathy.  It is hoped that this promising method will become the standard of care for relieving neuropathic pain.

Who Provides Laser Treatment for Neuropathy?

Pain management specialists perform laser treatments for peripheral neuropathy, not neurologists or neurosurgeons.  At pain management centers, doctors, physician assistants, and nurse practitioners provide a variety of options for managing pain.  They can customize a treatment plan for each individual which can include laser treatments.

However, because of the limited research on the use of lasers for peripheral neuropathy, it may not be covered by your health insurance.  As it can be quite expensive, ranging from $125 to $175 USD per session, this treatment option may not be affordable for everyone.

Low Level Laser Treatment at Home

There are a variety of low level laser treatment devices on the market sold for use at home.  The use of home medical lasers isn’t recommended by health authorities, and many of these devices do not have FDA approval.  Medical and non-medical lasers are classified from ranges I to IV.  A class IV laser is 100 to 1000 times stronger than a class I laser.  If it has been evaluated by the FDA, any laser above class I comes with a safety precaution label, and are intended for professional use only.

Often, retailers will request some sort of proof of your condition, or clearance from a certified laser therapy provider before allowing you to purchase higher class lasers.  Improper use of a higher class laser can result in eye and skin injuries.  There may be non-FDA class III and IV lasers available for purchase without all of the “red tape.”  However, it is likely unsafe to use these devices without the guidance of a medical professional.

In Closing

Peripheral neuropathy can negatively impact your independence and quality of life.  It may even have serious emotional and psychological effects.  However, there are ways this condition can be managed.

In addition to oral and topical treatments, speak to your doctor about alternative therapies such as deep tissue laser treatments.  Include a discussion about the safety and efficacy of home laser treatment products.  Your physician will determine what is the best treatment plan for your individual needs.

Leah Alexander, MD, FAAP

Dr. Alexander began her pediatric career at Elizabeth Pediatric Group of New Jersey in 2000, and has practiced at Pediatricare Associates of New Jersey since 2005. After graduating from Kalamazoo College and Michigan State University College of Human Medicine, she completed her pediatric training at Overlook and Morristown Memorial Hospitals. She is board certified in General Pediatrics. In addition to pediatrics, Dr. Alexander pursued her interest the culinary arts with study at the French Culinary
Institute. In 2007, she opened Global Palate, LLC, catering small group events for six years. Dr. Alexander has also been a professional writer and editor since 2018, engaging in a variety of medical editing and writing projects.