Does adding laser therapy to exercise improve chronic lower back pain?
A sham-controlled trial in 148 adults found little added benefit from photobiomodulation alongside exercise.
Exercise is commonly recommended for persistent lower back pain, but some clinics offer additional treatments intended to improve its effects. One is photobiomodulation, sometimes called low-level laser or light therapy. Specific wavelengths of light are applied to the body in the hope of influencing cellular activity and reducing pain.
A randomised trial published on 12 October 2026 asked whether adding this treatment to motor-control exercise provided better results than exercise with a sham light treatment.
The researchers recruited 148 adults aged 18–65 with non-specific lower back pain lasting at least three months. Seventy-four were allocated to each group. Both groups received 12 sessions over six weeks. Allocation was concealed, participants, therapists and assessors were blinded, and the results were analysed by intention to treat.
At six weeks, the between-group difference in pain was only 0.4 points on a 0–10 scale in favour of active light treatment (95% confidence interval: 1.2 points better to 0.4 points worse). Disability differed by 0.7 points on the 24-point Roland–Morris questionnaire (95% confidence interval: 2.4 points better to 0.9 points worse). Neither finding established a clinically important additional benefit.
Blood levels of prostaglandin E2, a substance involved in inflammatory processes, also showed no clear between-group difference. Results remained broadly similar through 12 months of follow-up, and no treatment-related adverse events were reported.
What does this mean for patients?
This is useful evidence because the sham treatment and blinding reduce the likelihood that expectations alone explain any difference. The findings suggest that adding photobiomodulation to motor-control exercise provides little extra benefit for chronic non-specific lower back pain.
The study does not show that exercise is ineffective: both groups received the same exercise programme. Nor can it rule out effects with different light-treatment protocols or in particular subgroups. For now, patients should be cautious about paying extra for laser therapy on the assumption that it substantially improves rehabilitation outcomes.
Original research
Journal of Physiotherapy, published online 12 October 2026. Read the original study →