Introduction

In an era where patients expect faster recovery and measurable outcomes, traditional modalities alone may not suffice. Patients are frustrated with 12-16 visit plans of care, and we all know it. When someone walks through the door with an acute disc injury, most clinicians’ hearts sink. Enter Class IV Laser Therapy: a high‑power photobiomodulation technique that enables deeper tissue penetration and accelerated healing. For clinics seeking to stand out, this modality provides both clinical and business advantages. Pain ends today.

Feature: Deep Tissue Penetration & High Output Power

Class IV lasers operate at higher power outputs (10 W to 40 W) and longer wavelengths (e.g., 900 nm-1064 nm), enabling light to reach deeper anatomical structures. In one randomized controlled trial, patients with knee osteoarthritis treated with a 30 W 1064 nm Class IV laser experienced a 44.24% pain reduction compared to 3.93% in the placebo group.¹ Another study comparing high‑intensity vs low‑level laser therapy found superior pain relief and function in the high‑intensity group.² Understanding the differences between Class III and Class IV lasers is vital for providers and business owners to maximize outcomes, profit, and marketing. As clinicians, we need to be able to better answer the question, “How long is this going to take for me to feel better?”

Advantage: Enhanced Tissue Healing, Faster Outcomes

High‑power laser therapy stimulates mitochondrial activity, enhances microcirculation, reduces inflammation, and accelerates collagen synthesis. A systematic review of low‑level laser therapy (~785–904 nm) showed improved pain and functional status in knee osteoarthritis when combined with exercise.³ Class IV lasers extend this principle by delivering optimal doses to deeper tissue, making them ideal for thicker tissues and refractory conditions. A pilot RCT reported sustained pain reduction for up to three months post‑treatment. ⁴ In essence, the higher the output of your laser, the faster and deeper you can penetrate into tissue. However, the dose must fit the patient and the condition, and providers must understand the variables associated with dose so as to quickly maximize patient-centered outcomes.

Benefit: Market Differentiation, Improved Outcomes, Premium Pricing

Offering Class IV laser therapy allows clinicians to quickly and easily distinguish themselves from competitors. Patients seeking non‑invasive solutions recognize laser therapy as a premium, results‑driven option. Better outcomes mean greater satisfaction, more referrals, and stronger financial sustainability. While many clinics are marketing the use of lasers in practice, imagine a marketing campaign linking a better understand of the “how and why” of laser technology with superior outcomes.

Understanding the Evidence

A 2020 meta‑analysis reported significant pain reduction in patients with knee osteoarthritis following high‑intensity laser therapy.⁵ A systematic review comparing ESWT (shockwave) and laser therapy observed promising outcomes for both, with laser therapy showing strong musculoskeletal benefits.⁶ A 2016 RCT further demonstrated that combining Class IV laser with exercise therapy led to significant improvements in pain and function compared to exercise alone.⁷ Collectively, these studies confirm that Class IV laser therapy is both safe and effective for musculoskeletal rehabilitation and is the clear choice for patients seeking faster outcomes compared to conservative and/or standard care. The goal is not to replace standard care; rather the literature advocates multimodal treatment that includes laser therapy to achieve more efficient outcomes.

Implementation Considerations

• Training as a Provider: Proper certification ensures clinicians understand wavelengths, dosing (J/cm²), safety, and device maintenance. The literature is clear – overdosing and underdosing lead to poor outcomes.

• Patient Selection: Who is best suited for Class IV laser? In addition to patients that have received regenerative medicine procedures, patients with degenerative, post-op, and/or chronic pain conditions are optimal candidates!

• Implementation: Combine with manual therapy and graded exercise for maximal benefit. For example, many studies are beginning to combine electric dry needling with red light therapy.

• Marketing and ROI: Promote as “High‑Power Laser Therapy — deeper healing, fewer visits.” Class IV laser will begin to speak for itself. Offer to do a workshop for existing or past patients to educate the public. While the cost of equipment is higher, ROI through premium services is substantial when properly implemented into practice.

Objections & Rebuttals

“Lasers are gimmicks.” — Modern Class IV devices backed by RCTs produce reproducible outcomes. Check out this free Class IV laser lecture to see for yourself.
“Equipment is cost prohibitive.” — With smart service packaging, the device pays for itself through premium pricing. Many companies will work with you on financing. Don’t be afraid to ask questions. “Safety is unclear.” — Proper certification is required to maximize safety; side effects are rare when parameters are understood and respected.

Conclusion

Class IV laser therapy is more than a modality — it’s a pathway to advanced patient outcomes, clinic differentiation, and clinician confidence. To stay ahead of the curve, equip yourself with the knowledge and protocols to deliver efficient and meaningful tissue healing.
Take the next step: Enroll in Torrentia’s Orthobiological Hacker™ Certification and lead the rehab. profession. We will teach you a new paradigm of patient care, which includes exercise, manual therapy, and state-of-the-art technology (i.e., Laser, focused shockwave, multi-waveform technology, non-invasive brain stimulation, etc.) within the framework of regenerative and functional medicine for degenerative and pain related neuromusculoskeletal conditions.

References (AMA Style)

1. Alayat MSM, Elsodany AM, Ali MM. The effectiveness of high-intensity laser therapy in the treatment of chronic knee osteoarthritis: a randomized controlled trial. Lasers Med Sci. 2017;32(6):1289–1295.

2. Santamato A, Solfrizzi V, Panza F, et al. Short-term efficacy of high-intensity laser therapy versus low-level laser therapy in chronic neck pain: a randomized trial. Lasers Med Sci. 2015;30(1):325–332.

3. Kwon DR, Park GY, Lee SU. Effect of low-level laser therapy in patients with knee osteoarthritis: a meta-analysis. BMJ Open. 2019;9(7):e024531.

4. Tashiro Y, et al. Deep tissue laser therapy in knee osteoarthritis: a pilot randomized controlled trial. Photomed Laser Surg. 2018;36(10):547–554.

5. Dundar U, et al. Effectiveness of high-intensity laser therapy in knee osteoarthritis: a systematic review and meta-analysis. Lasers Med Sci. 2020;35(3):531–543.

6. Choi W, et al. Comparison of extracorporeal shockwave therapy and laser therapy for musculoskeletal disorders: a systematic review. J Phys Ther Sci. 2022;34(1):31–38.

7. Alayat MSM, Elsodany AM, Ali MM. Combined exercise and Class IV laser therapy improves knee OA outcomes versus exercise alone. Lasers Med Sci. 2016;31(8):1823–1831.