Same-Week Appointments at Balance Foot & Ankle
Three board-certified podiatric surgeons. 950K+ YouTube subscribers. 1,123+ five-star reviews. Howell & Bloomfield Hills, Michigan.
Medically Reviewed | Dr. Tom Biernacki, DPM | Board-Certified Podiatric Surgeon | Balance Foot & Ankle, Michigan
Quick Answer: MLS laser therapy uses dual-wavelength infrared light (808nm and 905nm) to reduce inflammation, stimulate tissue repair, and decrease pain in the foot and ankle. Most patients require 6–10 sessions. It is FDA-cleared, non-invasive, and particularly effective for plantar fasciitis, Achilles tendinopathy, and neuropathy.
How MLS Laser Therapy Works
MLS (Multiwave Locked System) laser therapy delivers two synchronized infrared wavelengths — 808nm (continuous wave) and 905nm (pulsed wave) — simultaneously to affected tissue. The 808nm wavelength targets hemoglobin and water molecules to reduce inflammation, while the 905nm wavelength penetrates deeper to stimulate mitochondrial activity and accelerate cellular repair. The synchronized delivery amplifies both effects while minimizing the thermal energy that could damage tissue.
At the cellular level, MLS laser stimulates cytochrome c oxidase in the mitochondrial respiratory chain — the fundamental mechanism of photobiomodulation. This leads to increased ATP production, accelerated collagen synthesis, enhanced circulation, reduced prostaglandin synthesis (lowering inflammation), and direct modulation of pain signal transmission through C-fiber and Aδ-fiber activity reduction.
Conditions Treated with MLS Laser
Plantar fasciitis: MLS laser is among the most effective non-surgical treatments for chronic plantar fasciitis, with multiple studies demonstrating 70–85% reduction in pain after a course of treatment. The laser targets the fascia insertion and the inflammatory cascade driving morning heel pain. Achilles tendinopathy: Combined with the Alfredson eccentric protocol, MLS laser accelerates collagen remodeling and reduces neovascularization-mediated pain. Peripheral neuropathy: Multiple studies support MLS laser for diabetic peripheral neuropathy, with improvements in burning, tingling, and nerve conduction velocity. Morton’s neuroma, metatarsalgia, ankle sprains, post-surgical healing, and chronic wound management also respond well.
What to Expect During Treatment
Each MLS laser session takes 8–12 minutes. The robotic delivery system ensures precise, consistent dosing over the treatment area. Patients feel a gentle warmth — no pain, no vibration. There is no recovery time after each session. Most patients notice improvement beginning after sessions 3–4, with maximum benefit achieved after completing the full course of 6–10 sessions.
At Balance Foot & Ankle, we offer MLS laser in both our Howell and Bloomfield Hills locations. Treatment is available as a standalone therapy or as part of a comprehensive treatment protocol combining orthotics, physical therapy, and when appropriate, other in-office procedures. Many insurances cover MLS laser for neuropathy and chronic wound indications; self-pay pricing is available for other conditions.
Dr. Tom's Product Recommendations
PowerStep Pinnacle Insoles
⭐ Highly Rated | Foundation Wellness Partner | 30% Commission
MLS laser addresses tissue inflammation and stimulates healing — but biomechanical correction prevents the problem from returning. PowerStep Pinnacle insoles are prescribed alongside MLS therapy to ensure the structural causes of plantar fasciitis, Achilles tendinopathy, or metatarsalgia are simultaneously addressed.
Dr. Tom says: “I always combine MLS laser with orthotics. The laser heals the tissue; the insole prevents it from being re-injured. PowerStep Pinnacle is the OTC orthotic I prescribe most in this combination — it provides the arch support that prevents the repetitive microtrauma that started the condition.”
Post-MLS laser maintenance, PF and Achilles rehab, daily biomechanical support
Does not replace the therapeutic effect of MLS laser; not for acute injuries
Disclosure: We earn a commission at no extra cost to you.
Doctor Hoy’s Natural Pain Relief Gel
⭐ Highly Rated | Foundation Wellness Partner | 30% Commission
On days between MLS laser sessions, Doctor Hoy’s Natural Pain Relief Gel maintains topical anti-inflammatory activity. The arnica and camphor formula complements the laser’s tissue healing effects during the treatment course.
Dr. Tom says: “Between laser sessions, I recommend Doctor Hoy’s as a topical adjunct. Apply to the treatment area morning and evening. The arnica maintains anti-inflammatory activity between the laser sessions, and patients consistently report better day-to-day comfort during their treatment course.”
Between-session pain management, adjunct to MLS therapy, daily use
Not a substitute for MLS laser treatment; consult before combining with other topicals
Disclosure: We earn a commission at no extra cost to you.
✅ Pros / Benefits
- FDA-cleared, non-invasive, no downtime
- Highly effective for PF, Achilles, neuropathy (70–85% pain reduction)
- No injections or medications required
- Accelerates healing of chronic conditions that failed other conservative care
❌ Cons / Risks
- Requires 6–10 sessions (time and cost commitment)
- Not covered by all insurance for all indications
- Effects take 3–4 sessions before noticeable improvement
- Not effective for osseous (bone) pathology — targets soft tissue only
Dr. Tom Biernacki’s Recommendation
MLS laser has genuinely changed how I treat chronic plantar fasciitis and Achilles tendinopathy in my practice. For patients who’ve been suffering for 6+ months and failed stretching, orthotics, and injections, MLS laser provides a real path to healing. I typically see 70–80% meaningful improvement after a full course. I combine it with PowerStep insoles and the stretching protocol — treat the tissue AND fix the biomechanics. That combination is as close to a cure as conservative care gets.
— Dr. Tom Biernacki, DPM | Board-Certified Podiatric Surgeon | Balance Foot & Ankle
Frequently Asked Questions
Is MLS laser therapy painful?
No. MLS laser is completely painless. Patients feel a gentle warmth over the treatment area. There is no downtime, no needles, and no side effects.
How many MLS laser sessions do I need?
Most foot conditions require 6–10 sessions, typically 2–3 times per week. Plantar fasciitis and neuropathy generally need the full 10-session course for maximum benefit.
Is MLS laser covered by insurance?
Diabetic peripheral neuropathy and some wound care indications may be covered. Most musculoskeletal indications (plantar fasciitis, Achilles) are currently self-pay. Our office can verify your specific coverage.
How soon will I feel results from MLS laser?
Most patients notice improvement beginning around sessions 3–4. Full benefit is achieved after completing the course, with continued improvement for 4–8 weeks following the final session.
Is MLS laser the same as cold laser (LLLT)?
No. MLS laser is a Class IV therapeutic laser (higher power) with synchronized dual wavelengths. LLLT (cold laser/Class III) operates at much lower power levels with different penetration depth and clinical evidence.
Michigan Foot Pain? See Dr. Biernacki In Person
4.9★ rated | 1,123 Reviews | 3,000+ Surgeries
Same-week appointments · Howell & Bloomfield Hills
📞 (810) 206-1402 Book Online →When Shoes Aren’t Enough — Dr. Tom’s Top 9 Orthotics
About 30% of patients I see for foot pain need MORE than a great shoe — they need a structured insole. Below: my complete 2026 orthotic ranking with pros, cons, and the specific patient I’d give each one to.
★ DR. TOM’S COMPLETE 2026 ORTHOTIC RANKING
9 Best Prefab Orthotics by Use Case
PowerStep, Currex, Spenco, Vionic, and PowerStep Pinnacle — every orthotic I’ve fitted to thousands of patients across both Michigan offices. Each card includes pros, cons, and the specific patient I’d give it to. Real Amazon ratings, review counts, and prices below.
Best All-Purpose Orthotic for Most Patients
Semi-rigid arch shell + dual-layer cushion + deep heel cup. The orthotic I’ve fitted to more patients than any other for 15 years. APMA-accepted. Trim-to-fit design works in athletic shoes, casual shoes, and most work boots.
✓ Pros
- Semi-rigid arch shell provides true biomechanical correction
- Deep heel cup centers the heel and reduces lateral instability
- Dual-layer cushion (top + bottom) lasts 9-12 months daily wear
- Available in 8 sizes for precise fit
- APMA-accepted and clinically validated
- Lower price than PowerStep Pinnacle for equivalent function
✗ Cons
- Too thick for most dress shoes (use ProTech Slim instead)
- Some break-in period required (3-7 days for arch tolerance)
- Not enough correction for severe pes planus or rigid pes cavus
Dr. Tom’s Recommendation: If a patient has run-of-the-mill plantar fasciitis, mild flat feet, or arch fatigue, this is the first orthotic I try. Better value than PowerStep Pinnacle for 90% of patients, which is why I swapped it into our clinic kits three years ago. Sub-$50 typically.
Maximum Motion Control · Flat Feet & Severe Over-Pronation
PowerStep’s most aggressive stability orthotic. Adds a 2°-7° medial heel post on top of the standard PowerStep platform — designed specifically for flat-footed patients and severe pronators who need real corrective force.
✓ Pros
- 2°-7° medial heel post adds aggressive pronation control
- Same trusted PowerStep arch shell, more correction
- Built specifically for flat-foot biomechanics
- Excellent for posterior tibial tendon dysfunction (PTTD)
- Removable top cover for cleaning
✗ Cons
- Too aggressive for neutral-arch patients
- Needs longer break-in (10-14 days) due to stronger correction
- Adds 2-3 mm of stack height — won’t fit slim dress shoes
Dr. Tom’s Recommendation: When a patient comes in with significant flat feet AND symptoms (heel pain, arch pain, knee pain), the Original PowerStep isn’t aggressive enough. The Maxx is what gets prescribed. About 25% of my flat-footed patients end up here.
Low-Profile · Fits Dress Shoes & Narrow Casuals
3 mm slim profile with podiatrist-designed tri-planar arch technology. Engineered specifically to fit inside dress shoes, oxfords, loafers, and women’s flats without crowding the toe box. Vionic was founded by an Australian podiatrist.
✓ Pros
- 3 mm slim profile (vs 7-10 mm for standard orthotics)
- Tri-planar arch technology adds support without bulk
- Built-in deep heel cup despite slim design
- Fits dress shoes WITHOUT having to remove the factory insole
- Trim-to-fit · APMA-accepted
✗ Cons
- Less arch support than full-volume orthotics
- Top cover wears faster than thicker alternatives
- Not enough correction for severe foot deformities
Dr. Tom’s Recommendation: My default when a patient says ‘I need orthotics but I have to wear dress shoes for work.’ Slim enough to fit in oxfords and pumps without the heel sliding out. The single highest-impact change you can make for office workers with foot pain.
Built-In Metatarsal Pad · Morton’s Neuroma · Ball-of-Foot Pain
Standard Pinnacle orthotic with a built-in metatarsal pad positioned proximal to the metatarsal heads — the exact location that offloads neuromas and metatarsalgia. No need for separate met pads or pad placement guesswork.
✓ Pros
- Built-in met pad eliminates DIY pad placement errors
- Specifically designed for Morton’s neuroma + metatarsalgia
- Same trusted PowerStep arch + heel cup platform
- Top cover protects sensitive forefoot skin
- Faster relief than orthotics + add-on met pads
✗ Cons
- Met pad position is fixed (can’t fine-tune individual placement)
- Some patients with very small or very large feet need custom
- Slightly thicker than the standard Pinnacle
Dr. Tom’s Recommendation: If a patient has Morton’s neuroma, sesamoiditis, or generalized ball-of-foot pain (metatarsalgia), this saves a clinic visit and a prescription. The built-in pad placement is anatomically correct for 80% of feet. Way better than DIY met pads.
Adaptive Dynamic Arch · Athletic & Daily Wear
Currex’s flagship adaptive arch technology — the orthotic flexes with your gait instead of fighting it. Different stiffness zones along the length give you targeted support at the heel, midfoot, and forefoot. Available in three arch heights (low/medium/high).
✓ Pros
- Dynamic flex zones adapt to natural gait cycle
- Three arch heights ensure precise fit
- Lighter than rigid orthotics (no ‘heavy foot’ feel)
- Excellent for runners and athletic walkers
- European podiatric design (German engineering)
✗ Cons
- More expensive than PowerStep Original ($55-65 typically)
- Less aggressive correction than Pinnacle Maxx for severe cases
- Three arch heights means you must self-select correctly
Dr. Tom’s Recommendation: I started recommending Currex three years ago for runners who said PowerStep felt ‘too rigid.’ The dynamic flex zones respect natural gait. Best for active patients who walk 8K+ steps daily and don’t need maximum motion control.
Running-Specific · Heel Strike + Forefoot Strike Compatible
Currex’s purpose-built running orthotic. The midfoot flex zone is positioned for runner’s gait mechanics, with a flared heel cushion for heel strikers and a forefoot rocker for midfoot/forefoot strikers. Tested on 1000+ runners during product development.
✓ Pros
- Designed by German biomechanics lab specifically for runners
- Dynamic arch flexes with running gait (not static like PowerStep)
- Three arch heights (low/medium/high)
- Reduces overuse injury risk in mid-distance runners
- Lightweight (no impact on cadence)
✗ Cons
- Premium price ($60-75)
- Not aggressive enough for severe over-pronators (use Pinnacle Maxx)
- Runner-specific design = less ideal for daily walking shoes
Dr. Tom’s Recommendation: If a patient runs 20+ miles per week and has plantar fasciitis or shin splints, this is the orthotic I prescribe. The dynamic flex zones respect running biomechanics in a way that no rigid PowerStep can match. Pricier but worth it for serious runners.
Cavus Foot & High-Arch Patients
Polyurethane base with a deeper heel cup and higher arch profile than PowerStep — built for cavus (high-arched) feet that need maximum cushion and support. The 5-zone cushioning system addresses the unique pressure points of high-arch feet.
✓ Pros
- Deeper heel cup centers the heel for cavus foot stability
- Higher arch profile fills the void under high arches
- 5-zone cushioning addresses cavus foot pressure points
- Polyurethane base lasts 12+ months
- Available in Wide width
✗ Cons
- Too tall/aggressive for normal or low arches
- Won’t fit slim dress shoes
- Pricier than PowerStep Original
- Some patients find the arch height uncomfortable initially
Dr. Tom’s Recommendation: Cavus foot patients are often misdiagnosed and given low-arch orthotics — that makes everything worse. Spenco’s Total Support has the arch profile that high-arch feet actually need. About 15% of my patients have cavus feet; this is what they wear.
Cushion Layer · Standing All Day · Gel Pressure Relief
NOT a true biomechanical orthotic — this is a cushion insole. But for patients who want gel pressure relief instead of arch correction (or to add ON TOP of factory insoles in work boots), this is the best gel option on Amazon.
✓ Pros
- Genuine gel cushioning (not foam pretending to be gel)
- Targeted gel waves under heel and ball of foot
- Trim-to-fit · works in most shoe types
- Sub-$15 price (most affordable option in this list)
- Massaging texture is genuinely soothing
✗ Cons
- ZERO arch support — this is cushion only
- Won’t fix plantar fasciitis or flat-foot issues
- Compresses faster than PowerStep (4-6 months)
- Top cover wears through in high-mileage applications
Dr. Tom’s Recommendation: I recommend these to patients who tell me ‘I just want my feet to stop hurting at the end of my shift’ and who don’t have a biomechanical issue. Construction workers, factory workers, retail. Pure cushion does the job for them.
Tight-Fitting Shoes · Cycling Shoes · Hockey Skates
PowerStep Pinnacle’s slim version of their famous Green insole. The trademark stabilizer cap is preserved but the overall thickness is reduced — works in cycling shoes, hockey skates, ski boots, and other tight-fitting footwear that the standard PowerStep Pinnacle can’t fit into.
✓ Pros
- Stabilizer cap centers the heel (PowerStep Pinnacle’s signature feature)
- Slim profile fits tight athletic footwear
- Lasts 12+ months daily wear
- Excellent for cycling shoes specifically
- Built-in odor-control treatment
✗ Cons
- Premium price ($45-55)
- Less cushion than PowerStep equivalents
- Not as aggressive correction as Pinnacle Maxx for flat feet
- The signature ‘heel cup feel’ takes 1-2 weeks to adapt to
Dr. Tom’s Recommendation: If you’re a cyclist with foot numbness, hot spots, or knee pain — this is the orthotic. The stabilizer cap solves cycling-specific biomechanical issues that no other orthotic addresses. Worth the premium for athletes.
None of these solving your foot pain?
Some patients (about 30%) need custom-molded prescription orthotics. We make 3D-scanned custom orthotics in our Howell and Bloomfield Hills offices — specifically built for your foot mechanics.
Schedule a Custom Orthotic Fitting →FSA/HSA eligible · Most insurance accepted · (810) 206-1402
Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.
- Plantar Fasciitis: Diagnosis and Conservative Management (PubMed)
- Plantar Fasciitis (APMA)
- Diagnosis and Treatment of Plantar Fasciitis (PubMed / AAFP)
- Heel Pain (APMA)