Updated: May 27
Laser therapy for Achilles tendonitis or tendinopathy may or may not provide short-term pain relief, but it’s unlikely to produce long-term relief and recovery. This article explains why this is and points you to the correct approach for Achilles tendon injury treatment. Remember, if you need more help with an Achilles injury, you're welcome to consult one of our team via video call.
The terms tendinitis, tendonitis, tendinosis, and tendinopathy mean the same thing for all practical purposes, and we use these interchangeably in our articles.
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What is laser therapy for Achilles tendonitis/tendinopathy?
Laser therapy for Achilles injuries is also called low-level light therapy or cold laser. This is because it is not the type of laser that produces heat, nor the type that is used in laser surgery. So, you won’t feel any heat while it is being used on you.
The theory behind the treatment is that the laser light shines into your injured tissue and reduces inflammation, thereby providing pain relief and stimulating healing.
Why laser therapy likely won’t heal your Achilles tendinopathy
Usually, we use the terms “tendonitis” and “tendinopathy” interchangeably, but in this instance, there is a difference that matters.
The term tendonitis used to be favoured, but nowadays tendinopathy is deemed to be more correct. This is because “-itis” means that there is inflammation involved in the injury process. However, lately it has been shown that very few cases of ongoing Achilles pain actually have inflammation, and therefore “tendinopathy” is more correct because it refers more broadly to the structural changes inside your injured tendon, which may or may not include a bit of inflammation.
Because the healing effect of laser therapy is thought to mainly work by reducing inflammation, it is unlikely to influence the healing process for the vast majority of ongoing Achilles injuries.
This is backed up by quite a few research studies as well as by systematic reviews (where they look at the aggregate results of a group of high-quality research studies).
These studies and reviews have found that the outcomes for patients who have had laser treatment combined with traditional Achilles tendon rehab were not significantly different than for patients who have only had the traditional rehab.
Achilles tendon laser treatment might provide temporary pain relief
I do know anecdotally from personal experience with patients on whom I have used laser therapy that some of them say their painful tendon feels somewhat less tender right after the session than before the session.
That’s great, but if a patient were to come in to see me week after week or month after month for laser therapy, it won’t change anything that’s going on inside the tendon to make it more robust or to help them get back to their usual sport or daily activities.
So, laser therapy may help you if your Achilles tendon is feeling quite tender in the moment, but it isn't something that's going to give you long-term relief.
Use this approach for Achilles tendon recovery rather than laser therapy
Tendons consist mostly of collagen fibres that are arranged in parallel to each other. The fibres are grouped in many bundles that are also parallel to each other. This is what makes a tendon so strong.
In a tendinopathy, the structure of some of the fibres, maybe even in just one of those bundles, become disorganised, so now the tendon is not as strong as it should be. This then causes pain if you’re still expecting the tendon to perform like when it was 100% healthy.
Research has shown that the best treatment for this type of Achilles injury is to strengthen the collagen fibres around the injured ones with targeted exercise. This makes the tendon more robust overall so that you can get back to doing your sport or other activities without pain.
At Treat My Achilles, we combine the concept of relative rest with a personalised tendon-strengthening exercise programme. This means that we figure out how to keep you as active as possible while avoiding activities of the type or intensity that would increase your tendon pain.
You can read more about relative rest for Achilles pain here, and this article explains our approach to strengthening exercises for Achilles rehab.
How we can help
Need more help with your Achilles injury? You’re welcome to consult one of the team at TMA online via video call for an assessment of your injury and a tailored treatment plan.
We're all UK Chartered Physiotherapists with Master’s Degrees related to Sports & Exercise Medicine. But at Treat My Achilles we don't just value qualifications; all of us also have a wealth of experience working with athletes across a broad variety of sports, ranging from recreationally active people to professional athletes. You can meet the team here.
About the Author
Martimbianco, A.L.C., Ferreira, R.E.S., Latorraca, C.D.O.C., Bussadori, S.K., Pacheco, R.L. and Riera, R., 2020. Photobiomodulation with low-level laser therapy for treating Achilles tendinopathy: a systematic review and meta-analysis. Clinical Rehabilitation, 34(6), pp.713-722
Arora, N.K., Sharma, S., Sharma, S. and Arora, I.K., 2022. Physical Modalities with Eccentric Exercise are no better than Eccentric Exercise alone in the treatment of Chronic Achilles Tendinopathy: A Systematic Review And Meta-Analysis. The Foot, p.101927
Nogueira AC Jr, Júnior Mde J. The effects of laser treatment in tendinopathy: a systematic review. Acta Ortop Bras. 2015 Jan-Feb;23(1):47-9. doi: 10.1590/1413-78522015230100513. PMID: 26327796; PMCID: PMC4544521
Cotler HB, Chow RT, Hamblin MR, Carroll J. The Use of Low Level Laser Therapy (LLLT) For Musculoskeletal Pain. MOJ Orthop Rheumatol. 2015;2(5):00068. doi: 10.15406/mojor.2015.02.00068. Epub 2015 Jun 9. PMID: 26858986; PMCID: PMC4743666
Van Der Vlist, A. C., et al. (2021). "Which treatment is most effective for patients with Achilles tendinopathy? A living systematic review with network meta-analysis of 29 randomised controlled trials." British Journal of Sports Medicine 55(5): 249-256.