Medically reviewed by Dr. Tom Biernacki, DPM, FACFAS
Board-Certified Podiatric Foot & Ankle Surgeon
Quick Answer: Laser therapy is an in-office treatment that uses focused light to calm inflammation and ease chronic foot and ankle pain, with no surgery, no injection and no downtime. At Balance Foot & Ankle we use laser therapy alongside the rest of your treatment plan for neuropathy, plantar fasciitis, Achilles tendinopathy and arthritis, rather than as a treatment on its own. How much it helps varies from patient to patient, and we will tell you what to expect before you start. A full protocol is 6–8 treatments over 3–4 weeks. Available at both Howell and Bloomfield Township, MI.
Ready to be seen? Book a real appointment time online, 24/7 — Howell or Bloomfield Township. Takes about a minute, 24/7.
Laser nail-fungus and pain therapy is also available at our Bloomfield Township clinic serving Oakland County.
After years of chronic foot pain, patients often arrive at Balance Foot & Ankle having tried everything: orthotics, injections, physical therapy, rest. Laser therapy is one of the options we may add at that point. It is also called photobiomodulation, and the research on it is mixed: some trials show short-term pain relief, especially as part of a rehab program, and others show no benefit over a sham treatment. We use a therapeutic laser in both offices, and we will tell you plainly whether the evidence supports it for your problem.
What Is Laser Therapy?
Laser therapy, also called photobiomodulation, uses light at specific wavelengths to change the biochemical environment of injured tissue rather than to cut or burn it.
The laser energy penetrates 3–5 cm into tissue — deep enough to reach tendons, fasciae, joint capsules, and peripheral nerves — without discomfort. Most patients describe the sensation as a gentle warmth. There is no downtime; patients leave the clinic and return to normal activity immediately.
How Laser Works: The Science
Laser is thought to work through three biological mechanisms, studied mostly in the laboratory rather than in patients:
- Photobiomodulation of Mitochondria: Laser photons are absorbed by cytochrome c oxidase in mitochondria, upregulating ATP production. In theory, this gives injured cells more energy for repair.
- Anti-inflammatory Cascade Modulation: The 810 nm wavelength may reduce COX-2 enzyme activity (the same target as ibuprofen) and with it local inflammation.
- Nerve Fiber Modulation: The 980 nm wavelength is thought to alter C-fiber and A-delta pain signal transmission. That is the rationale for trying it in nerve pain, though the evidence is limited.
Key takeaway: a therapy laser does not cut or burn tissue. It is meant to change the biochemical environment of injured tissue. It is one part of a treatment plan, not a cure on its own.
Conditions We Treat With Laser at Balance Foot & Ankle
The evidence for laser differs from one condition to the next, so we judge it condition by condition. The conditions we use it for most often:
Peripheral Neuropathy
Peripheral neuropathy — especially diabetic neuropathy — produces burning, tingling, and numbness that is notoriously resistant to treatment. Small trials of laser in diabetic peripheral neuropathy have reported improvements in pain scores, while other studies have found no benefit over sham treatment: in a double-blind trial, 90 days of home infrared light treatment worked no better than a sham device, and a review of the trials found no lasting gain in foot sensation. Medicare has not covered infrared or near-infrared light for neuropathy since 2006. Laser does not restore lost feeling or reverse nerve damage, so it never replaces finding the cause of the neuropathy, daily foot checks and protective shoes. Some patients notice less burning and better sleep over a course of sessions, and some notice no change.
Plantar Fasciitis (Chronic / Refractory)
For plantar fasciitis that has failed stretching, orthotics, and cortisone injections, laser is our first-line advanced intervention before considering shockwave therapy or surgery. The laser penetrates directly to the calcaneal insertion of the plantar fascia, reducing the chronic inflammatory cycle and promoting fascial remodeling. A 6-session protocol helps some patients with long-standing heel pain and not others.
Achilles Tendinopathy
Laser is sometimes added for Achilles tendinopathy, but the evidence is weak: the 2024 physical therapy guideline for Achilles pain advises against low-level laser for pain in the middle of the tendon, above the heel. The proven treatment is a progressive loading (strengthening) program, so if we use laser at all, it is alongside that program, never in place of it.
Arthritis (Hallux Rigidus, Ankle Arthritis)
Hallux rigidus and osteoarthritis of the ankle produce pain, swelling, and stiffness that limit every step. Laser is used to try to calm joint inflammation and pain. It does not reverse structural joint changes, and good evidence that it improves pain or function in foot and ankle arthritis is lacking, so we offer it only alongside shoe changes, activity changes and other proven treatments.
Other Conditions Treated
- Heel bursitis and Haglund’s deformity
- Peroneal and posterior tibial tendonitis
- Post-surgical pain and swelling reduction
- Morton’s neuroma (early stage)
- Tarsal tunnel syndrome
- Wound healing acceleration (diabetic foot)
What to Expect at Your Laser Session
- Duration: 8–15 minutes per area treated. The laser is applied over the treatment area for the length of the session.
- Sensation: Gentle warmth. Some patients describe mild tingling during treatment. There is no pain.
- Frequency: Typically 2–3 sessions per week, for 3–4 weeks (6–8 total sessions for a full protocol).
- After the session: No restrictions. Resume normal activity immediately. Some patients notice a mild flare of symptoms for 24–48 hours after early sessions; tell us if it lasts longer or is worse than that.
- Cost and Insurance: laser is currently classified as elective/experimental by most insurance carriers in Michigan and is not covered. The cost per session at Balance Foot & Ankle is competitive with other advanced regenerative therapies. Many patients choose to use HSA or FSA funds. Book online or call (810) 206-1402 for current pricing.
Laser Results: What Clinical Evidence Shows
Laser therapy has been studied in heel pain, tendon pain and neuropathy with mixed results: some randomised trials report short-term pain improvement and others find no benefit over sham treatment. There is no good evidence that it cures these conditions, which is why we use it as one part of a plan and not as the plan.
What we tell patients: response varies, we reassess after the third session, and if nothing has changed by the fourth we stop and talk about other options.
⚠️ Laser is NOT appropriate for: Active cancer (near treatment site), pregnancy, pacemakers, active skin infections over the treatment area, or patients taking photosensitizing medications. Dr. Tom will review your complete medical history before recommending laser.
Frequently Asked Questions — Laser Therapy Michigan
How many laser sessions do I need?
Most conditions require 6–8 sessions for a full protocol. Some patients with mild acute conditions respond in 3–4 sessions. For neuropathy, where the evidence is weakest, we do not recommend open-ended maintenance sessions. Response is assessed after session 3 — if no improvement is seen by session 4, we discuss alternative approaches.
Does laser hurt?
No. The most common sensation patients describe is a gentle warmth, similar to a warm towel. Some feel mild tingling in the treated area. There is no discomfort during or after treatment. The session is pain-free.
How is laser different from cold laser or LLLT?
Low-level (cold) laser uses lower power and longer sessions. Higher-power devices deliver more energy in less time; whether that changes the outcome for foot and ankle pain is not settled.
The Bottom Line: laser therapy is one of the non-invasive options for chronic foot and ankle pain. Its best support is for short-term relief of heel pain as part of a rehab program; for Achilles pain and for neuropathy the evidence is weak, and it does not restore lost feeling. It takes 3–4 weeks of commitment, some patients get meaningful relief and some do not, and we will tell you plainly whether it is worth trying for your problem.
Is Laser Right for Your Condition?
Schedule a consultation — Dr. Tom will assess your case and tell you directly whether laser is likely to help.
Howell & Bloomfield Township, Michigan
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Related
Combined laser and shockwave protocols: