How and Why Photobiomodulation with a Class IV Therapy Laser Can Help Manage Symptoms of Multiple Sclerosis
Multiple sclerosis (MS) is a chronic, immune-mediated disorder characterized by demyelination, neuroinflammation, mitochondrial dysfunction, and progressive neurodegeneration. While disease-modifying therapies target immune activity, many patients continue to experience debilitating symptoms such as fatigue, neuropathic pain, spasticity, gait instability, depression, and cognitive slowing. Photobiomodulation therapy (PBMT) delivered with a Class IV therapy laser offers a non-pharmacologic, mechanistically grounded approach to symptom management by influencing mitochondrial function, neuroinflammation, circulation, and neuromuscular performance.
At its core, PBMT enhances cellular respiration by stimulating cytochrome c oxidase (Complex IV) in the mitochondrial electron transport chain. Class IV lasers deliver therapeutic power densities that ensure adequate photon penetration through skin, fascia, and in some protocols, to deeper neural structures. By improving mitochondrial membrane potential, ATP generation, and redox balance, PBMT supports neurons and glial cells under oxidative and metabolic stress—two hallmarks of MS pathology. Increased ATP availability can improve axonal transport, support synaptic efficiency, and enhance the viability of demyelinated or partially demyelinated neurons.
Additionally, PBMT exerts potent anti-inflammatory effects. MS lesions are driven by microglial activation, pro-inflammatory cytokines (TNF-α, IL-1β, IL-6), and reactive oxygen species. Multiple studies show that PBMT down-regulates NF-κB signaling, reduces microglial reactivity, and increases antioxidant enzymes such as SOD and catalase. For MS patients, this may help reduce the frequency and intensity of inflammatory flares that exacerbate fatigue, neuropathic pain, and motor disturbances.
Circulatory effects also play a role. PBMT increases local nitric oxide bioavailability by releasing NO bound to Complex IV and by promoting endothelial nitric oxide synthase activity. Improved microcirculation and oxygen delivery can facilitate nutrient exchange and waste removal in areas affected by chronic inflammation. Many MS patients report enhanced extremity warmth, reduced limb heaviness, and improved exercise tolerance following PBMT.
Neuromuscular symptoms benefit as well. PBMT has been shown to reduce spasticity by modulating neuromuscular junction activity, improving muscle oxygenation, and decreasing localized muscle hyper-excitability. Class IV lasers, due to their higher power and deeper photon delivery, can effectively address large muscle groups involved in gait, posture, and core stabilization—critical functional domains for MS patients.
From a neuroprotective standpoint, PBMT promotes neurogenesis, synaptogenesis, and increased expression of brain-derived neurotrophic factor (BDNF). These effects may support long-term neural resilience and functional compensation, especially in progressive forms of MS where neurodegeneration is a dominant driver of disability.
Clinically, PBMT is well-tolerated and free of systemic side-effects, making it suitable as a complementary therapy alongside pharmaceuticals, physical therapy, and lifestyle interventions. Treatment areas typically include the cervical spine, thoracic spine, lumbar plexus, affected extremities, and in some cases cranial or transcranial protocols using appropriate parameters. Class IV devices are particularly effective for MS symptom management due to their ability to deliver adequate fluence to deeper tissues in a time-efficient manner, improving patient adherence and clinical workflow.
While PBMT is not a cure for MS, its multimodal effects—improved mitochondrial function, reduced neuroinflammation, enhanced circulation, neuromuscular optimization, and neuroprotection—make it a compelling adjunctive tool for reducing symptom burden and improving quality of life. Increasing clinical and mechanistic evidence supports its integration into comprehensive, patient-centered MS care.
