Overview

Living with any type of neuropathy can be extremely challenging and affects quality of life in many different ways. Neuropathy simply refers to damage to nerves that carry signals to and from the brain and spinal cord to other parts of the body. Different neuropathies can present varying symptoms, but generally, patients with neuropathies experience:

• Burning
• Stabbing
• Electric-shock-like pain
• Tingling, numbness, or weakness

For many, symptoms worsen at night, disturbing sleep and reducing the quality of life. In diabetes, nerve damage in the feet and legs is especially common and can sometimes lead to serious complications such as ulcers.

Traditional treatments often involve painkillers or prescription drugs. Although these help some people, they mainly provide only partial relief and often cause side effects. Because of this, researchers have been looking for safer, more effective alternatives. A promising alternative is low-level laser therapy (LLLT), which is gaining popularity because of its favourable attributes and its efficacy.

What is Neuropathy?

Neuropathy simply means damage to the nerves that carry messages between the brain, spinal cord, and the rest of the body. ¹ When they don’t work, they cause the aforementioned symptoms, severely impacting one’s quality of life.

There are many possible causes. Diabetes is one of the most common, with about half of people living with diabetes developing some form of nerve damage in their feet or legs over time.² Other causes include certain medical treatments like chemotherapy,² physical injuries or trapped nerves,^{2, 3} and infections.³ In some instances, the cause is unknown.³

The symptoms can understandably be very distressing. Many people describe their pain as burning, stabbing, or electric shock-like, which is typically felt in the feet and hands.^4,5,6 Others report tingling or numbness,^2,6 loss of sensation in the feet is common among diabetes patients,⁵ increasing the risk of wounds and infections, due to not noticing burns, for example. This can sometimes lead to more serious complications, such as ulcers or even amputation.^4,6

In some cases, muscles may feel weak, and balance and coordination can also be affected.² Pain often worsens at night, meaning patients’ sleep is often disrupted. ⁴

Many of the usual medications for neuropathy have side effects like drowsiness or confusion,⁷ which can make day-to-day functioning even harder than it already is.

Current Treatments and Their Limitations

Managing neuropathy usually means monitoring the cause and treating the symptoms,⁵ in particular, the pain. For people with diabetes, this often means keeping blood sugar levels under control,⁷ with small changes in diet, regular exercise, and education about foot care helping to mitigate the symptoms.

Doctors may prescribe certain drugs initially targeted at epilepsy or depression,⁴ however, they frequently produce unsatisfactory results.⁸ Painkillers, including strong opioids, are often prescribed, but show varying degrees of effectiveness across individuals.⁹ Over-the-counter anti-inflammatory drugs (like ibuprofen) are broadly considered ineffective in neuropathic pain.^4,9 Additionally, none of these treatments addresses the underlying problem, which is nerve damage.¹⁰ 

Alternatives to medication include physical therapy. Gentle exercises and physiotherapy,¹¹ or treatments such as acupuncture,¹² and electrical stimulation therapies,^10,13 can sometimes bring some relief.

Despite all these possibilities, conventional treatments have big challenges:

• Limited effectiveness: Painkillers and other drugs only work well in about a third of patients³
• Unwanted side effects: Many of the medicines cause drowsiness, confusion, or unsteadiness, further complicating everyday life¹⁴
• Treating symptoms, not the cause: Current drugs may reduce pain, but don’t target the cause or prevent the nerve damage from worsening

Because of these limitations, there’s a growing need for more effective and safer alternatives. Researchers are now exploring low-level laser therapy (LLLT): a non-invasive treatment that may not only reduce pain but also ameliorate nerve damage.

What is low-level laser therapy (LLLT)?

Laser therapy is a treatment that uses gentle beams of light to ease pain and help the body heal itself. LLLT uses very low energy light in the red and near-infrared spectrum,^2,3 which is directed at the affected body part: the light stimulates the cells’ natural biochemical processes, encouraging repair.^3,5 Doctors have been using this type of therapy for decades to treat a variety of long-lasting pain conditions.

How it works for Neuropathy

Although researchers are still learning exactly how it works, laser therapy appears to support healing in several important ways:

• Boosting circulation: Laser light can improve blood flow in the treated area.^2,4 This is especially important in people with diabetes, where poor circulation often makes nerve damage worse
• Calming inflammation: The therapy helps reduce the body’s overactive immune response, lowering chemicals that cause swelling and irritation⁶
• Helping nerves repair themselves: The light energy increases the cells’ ability to produce energy (ATP), which is vital for nerve health.¹⁵ It may also encourage the growth of supportive cells and protective coverings (myelin) around nerves.⁶ At the same time, it reduces oxidative stress (cell damage) and triggers the release of natural pain relievers called endorphins.¹⁵

By targeting these processes, laser therapy doesn’t just help to mask the pain; it may actually help nerves recover and function better.

Safety and Patient Experience

One of the biggest advantages of laser therapy is its safety and comfort.

• It’s completely non-invasive, meaning no needles or surgery are necessary
• The treatment is painless: most people don’t feel anything at all⁵
• Side effects are very rare and usually mild, such as a temporary tingling sensation, which subsides after treatment¹⁶

Evidence and Research So Far

So far, research into LLLT for neuropathy looks very promising, although it is still in the early stages. Most studies have focused on diabetic nerve damage, nerve problems caused by injury or surgery, and Carpal Tunnel Syndrome (CTS).

In these studies, patients usually receive a series of treatments where gentle red or infrared light is applied to the painful area (such as the feet, hands, or wrists) over several weeks. Doctors then assess how much the pain improves and evaluate whether the nerves are working better.

Key Findings

Across many studies, patients have reported encouraging results:

• Less pain: People described big reductions in burning, stabbing, and “pins and needles” feeling. In one study, average pain scores dropped from around 6.5 out of 10 to just over 1 after treatment⁵
• Better nerve function: Tests show that nerves can send signals faster and stronger after LLLT. ⁶ Some studies also found improvements in touch, vibration, and overall sensation^5,17
• Improved blood flow: Laser therapy appears to boost circulation,⁵ helping tissues and nerves get the nutrients they need to heal
• Overall symptom relief: Patients scored better on clinical tools that measure the severity of neuropathy, showing broad improvement beyond just pain relief⁷

LLLT has been investigated in several types of neuropathies:

• Diabetic peripheral neuropathy (DPN) – The most common focus, with many trials showing improvements in pain, nerve function, and quality of life^2,5,7
• Trauma-related neuropathy – For example, nerve problems after surgery or injury
• Carpal Tunnel Syndrome (CTS) – Some studies suggest laser therapy helps, especially in mild cases,¹⁶ though results are mixed

In short, early evidence shows that adding LLLT to standard care may provide extra relief for many patients. While it’s not a miracle cure, it stands out as a safe and non-invasive option worth further exploration.

Risks, Limitations, and Unknowns

Although LLLT offers many strengths, some limitations and uncertainties that should be taken into consideration:

• Effectiveness varies: One large trial found no significant improvement in diabetic neuropathy symptoms compared with a placebo,¹⁸ demonstrating inconsistency among findings
• Not a guaranteed cure: In some cases, LLLT seems to help only mild conditions, while moderate or severe cases show little or short-term improvement
• Unclear best settings: Researchers have not yet agreed on standardised laser parameters. Different studies use different types of lasers, strengths, wavelengths, and numbers of sessions. Too little light may have no effect, while too much might actually reduce the benefits³

The success of LLLT seems to depend on factors like the type of laser used, treatment settings, and severity of the condition: there is no universal protocol yet. More large, high-quality trials are needed before doctors can ascertain exactly how well it works and under the optimal conditions.

Summary

• Neuropathy is challenging, and current treatments aren’t perfect
• Laser therapy offers hope as a safe, non-invasive option
• Research is still in progress, but early results are encouraging