Understanding the Power of PBMT in Osteopathy

What Is PBMT?

Photobiomodulation Therapy (PBMT), also known as high-power laser therapy, utilises specific wavelengths of light to stimulate a photochemical response within tissues. The EMS DolorClast® Laser delivers pulses at 905 nm, a wavelength chosen for its ability to penetrate deeply into muscle, tendon, fascia, and joint tissues without being absorbed by blood or melanin. This interaction with cell structures promotes healing.

1. Boosting Cellular Energy

Light is absorbed by mitochondria (the “power stations” of your cells). This leads to short bursts of ATP (energy), nitric oxide (which improves blood flow), and controlled bursts of reactive oxygen species (ROS). Together, these act as pro-healing signals that help tissue recover faster (Hamblin, 2017).

2. Calming Inflammation

Inflammation is a key driver of chronic pain. PBMT reduces the activity of pathways such as NF-κB and enzymes like COX-2, which drive the production of inflammatory chemicals (TNF-α, IL-1β, PGE₂).

In a randomised, placebo-controlled trial, low-level laser therapy (904 nm, 5.4 J/point) significantly reduced peritendinous prostaglandin E₂ in patients with aggravated Achilles tendinitis, showing a direct anti-inflammatory effect (Bjordal et al., 2006).

3. Reducing Pain Signals (Photoneuromodulation)

PBMT can “quiet down” overactive pain nerves. Laboratory work has shown that laser therapy reduces firing in pain-sensing neurons. In a classic study, soft-laser irradiation decreased firing frequency in 60% of tested heat nociceptors within one minute, and in all nociceptors after 3–10 minutes, with the effect plateauing after 5 minutes (Mezawa et al., 1988). This helps explain why patients often feel pain relief soon after treatment.

4. Improving Blood Flow

By increasing nitric oxide production, PBMT helps blood vessels relax, improving circulation. This brings oxygen and nutrients to the area while carrying away waste products, creating a better environment for repair.

5. Supporting Tissue Repair and Remodelling

PBMT activates fibroblasts—cells responsible for producing collagen and rebuilding connective tissue. Over time, this helps tendons, ligaments, and fascia regain strength and structure.

6. Helping the Immune System Finish the Job

PBMT influences immune cells like macrophages, encouraging them to switch into a healing mode. This helps clear out damaged tissue and complete the inflammation process in a controlled way (Hamblin, 2017).

At the cellular level, photons absorbed by mitochondrial chromophores (particularly cytochrome-c oxidase) increase ATP production, enhance nitric oxide release, and reduce oxidative stress. These changes create a pro-healing environment that encourages tissue repair and modulates inflammation (Hamblin, 2017).

High-Powered Laser Therapy Auckland

Benefits of EMS DolorClast® High-Powered Laser Therapy in Osteopathic Practice

For osteopaths treating a wide range of musculoskeletal conditions, PBMT provides measurable benefits:

• Fast pain relief – reduces nociceptor sensitivity and inflammatory mediators (Enwemeka et al., 2017).

• Anti-inflammatory effect – downregulates the NF-κB and COX-2 pathways, thereby lowering cytokines such as TNF-α and IL-1β.

• Tissue repair stimulation – promotes fibroblast activity and collagen remodelling, vital for tendon and fascia recovery.

• Improved circulation – enhances local blood flow, supporting oxygenation and nutrient delivery.

• Safe and non-invasive – suitable for acute and chronic conditions without pharmacological risks.

  
  

What Conditions Can We Treat with PBMT?

The EMS DolorClast® High-powered Laser is well-suited for a wide range of musculoskeletal problems that osteopaths commonly treat, making it ideal for osteopathic care. At Movement Mechanics, we use it for:

• Plantar fasciitis and heel pain

• Achilles tendinopathy (mid-portion and insertional)

• Hamstring or gluteal tendinopathy

• Neck and back pain associated with muscular or joint dysfunction

• Shoulder osteoarthritis and rotator cuff-related pain

• De Quervain’s tenosynovitis (inflammation of the tendons on the thumb side of the wrist, common in new parents and manual workers)

• Dupuytren’s contracture (fibrous thickening of the palmar fascia affecting hand movement and grip)

• Nerve-related musculoskeletal pain (e.g., neuromas, entrapments)

• Joint inflammation and osteoarthritis-related pain

  
  

EMS DolorClast® High Power Laser Kenn Osteoarthritis

Why Combine Laser Therapy with Shockwave Therapy?

At Movement Mechanics, we often combine PBMT with shockwave therapy (radial or focused) to maximise results within an osteopathic treatment plan.

• High-powered Laser Therapy prepares the tissue by reducing pain and oxidative stress, allowing higher therapeutic dosing during shockwave sessions.

• Shockwave therapy (ESWT) then stimulates angiogenesis, collagen remodelling, and mechanotransduction—further accelerating healing (Rhim et al., 2024).

• Together, they complement hands-on osteopathic techniques, addressing both local pathology and the broader mechanical contributors to dysfunction.

  
  

This combination is supported by research showing that laser pre-conditioning can improve the effectiveness of ESWT, allowing higher treatment doses to be delivered safely (Schmitz et al., 2020). This integrative approach means patients benefit not just from pain relief, but from a restored capacity for movement and function, a cornerstone of osteopathy. For patients who prefer a gentler approach, high-power laser therapy can also be used as a stand-alone treatment, particularly for acute pain and inflammation.

EMS DolorClast® High Power Laser Device

Evidence Behind Laser Therapy in Musculoskeletal Care

The effectiveness of PBMT in treating various conditions is well-documented. Here are some key findings:

• Heel pain (plantar fasciitis): PBMT significantly reduces pain scores and improves function compared to placebo (Alayat et al., 2017).

• Tendinopathies: Laser therapy enhances collagen synthesis and tendon healing in both preclinical and clinical studies (Tumilty et al., 2010).

• Dupuytren’s contracture: PBMT has been reported to reduce palmar fascia stiffness and improve finger extension when combined with manual therapies (Khanna et al., 2021).

• De Quervain’s tenosynovitis: Early studies and case reports suggest both PBMT and shockwave reduce pain and improve grip function in this condition (Sayed et al., 2020).

• Combined PBMT + ESWT: Studies show pre-treatment with a 905 nm high-power laser increases shockwave therapy effectiveness, enabling deeper energy delivery with reduced discomfort (Schmitz et al., 2020; EMS DolorClast data).

  
  

EMS DolorClast® High Power Laser Plantar Fasciopathy

Why Osteopaths Are Uniquely Positioned to Use PBMT

Osteopathy views the body as an interconnected unit, with muscles, tendons, fascia, joints, and neural systems all influencing one another. PBMT strengthens this approach by:

• Targeting both acute and chronic inflammation

• Facilitating tissue repair in overuse syndromes

• Supporting whole-body integration when combined with manual osteopathic care, exercise rehabilitation, and patient education

  
  

At Movement Mechanics, we utilise EMS DolorClast® technology, a globally recognised, evidence-backed system, to ensure our patients access the most advanced musculoskeletal therapies available in Auckland.

Final Word: A Modern Tool in Traditional Hands

Photobiomodulation Therapy with the EMS DolorClast Laser offers a modern, scientifically validated way to reduce pain, accelerate healing, and improve function. When delivered in the hands of an osteopath trained to treat the whole musculoskeletal system, PBMT becomes more than just a technology; it’s part of a holistic plan to restore balance, mobility, and quality of life.

If you’re looking for laser therapy or shockwave therapy in Auckland and want care that addresses the root cause of pain, not just the symptoms, book a consultation today and experience evidence-based osteopathy with cutting-edge technology.

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Jonathan Hall *M.Ost, BAppSci (Human Biology), PGCertHSc (Acupuncture), GradDipHeal*

Jonathan Hall is the founder and principal Osteopath at Movement Mechanics Osteopathy. Jonathan specialises in Shockwave Therapy and Western medical acupuncture. A fully qualified Osteopath registered with OCNZ, PNZ, PAANZ and ACC, Jonathan also founded Auckland Shockwave Therapy to help bring evidence-based Shockwave treatment to New Zealand using the industry-leading EMS Radial Shock Wave device.

Contact Us: hello@movementmechanics.nz

Book an appointment with Jonathan here.

References

Alayat, M. S., Elsodany, A. M., & El Fiky, A. A. (2017). Long-term effect of high-intensity laser therapy in the treatment of plantar fasciitis: a randomized controlled trial. Lasers in Medical Science, 32(2), 535–542.

Bjordal, J. M., Couppe, C., Chow, R. T., Tuner, J., & Ljunggren, E. A. (2006). A randomised, placebo controlled trial of low level laser therapy for activated Achilles tendinitis with microdialysis measurement of peritendinous prostaglandin E₂ concentrations. British Journal of Sports Medicine, 40(1), 76–80. https://doi.org/10.1136/bjsm.2005.020842

Enwemeka, C. S., Parker, J. C., Dowdy, D. S., Harkness, E. E., Sanford, L. E., & Woodruff, L. D. (2017). The efficacy of low-power lasers in tissue repair and pain control: a meta-analysis study. Photomedicine and Laser Surgery, 32(4), 215–223.

Hamblin, M. R. (2017). Mechanisms and applications of the anti-inflammatory effects of photobiomodulation. AIMS Biophysics, 4(3), 337–361. https://doi.org/10.3934/biophy.2017.3.337

Mezawa, S., Iwata, K., Naito, K., & Kamogawa, H. (1988). The possible analgesic effect of soft-laser irradiation on heat nociceptors in the cat tongue. Archives of Oral Biology, 33(9), 693–694.

Khanna, A., Gougoulias, N., & Maffulli, N. (2021). Emerging evidence in Dupuytren’s disease management: conservative and minimally invasive options. International Orthopaedics, 45(3), 639–648.

Rhim, H. C., Park, Y., Lee, S. M., & Huh, J. (2024). Use of extracorporeal shockwave therapy for athletes: A systematic review. British Journal of Sports Medicine, 58(5), 289–297.

Sayed, R. K., Abd El-Maksoud, G. M., & Khafagy, A. H. (2020). Effect of low-level laser therapy in De Quervain’s tenosynovitis: A randomized controlled trial. Journal of Physical Therapy Science, 32(1), 48–53. https://doi.org/10.1589/jpts.32.48

Schmitz, C., et al. (2020). Improving outcomes of extracorporeal shock wave therapy by laser preconditioning: Clinical pilot data. Journal of Clinical Orthopaedics and Trauma, 11(6), 1082–1087.

Disclaimer: This content is for educational purposes and is not a substitute for professional medical advice.

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