MLS Laser Therapy Is Transforming Pain Care

Abstract

Hello, I am Dr. Alex Jimenez. In this educational post, we will embark on a journey into the world of advanced healing, focusing on Multiwave Locked System (MLS) Laser Therapy. We will explore how this cutting-edge technology works at a cellular level to alleviate pain, reduce inflammation, and accelerate tissue repair. Drawing on the latest evidence-based research and clinical observations from leading experts, we will break down complex concepts such as photobiomodulation, energy density, and the mitochondrial cascade. You will learn how we apply these principles in a real-world clinical setting, particularly for conditions such as low back pain and joint stiffness, and in conjunction with orthobiologic treatments like Platelet-Rich Plasma (PRP). I will also explain our unique, multidisciplinary approach at Injury Medical Clinic PA, where I, as a Doctor of Chiropractic and Family Nurse Practitioner, collaborate with our esteemed Medical Director, Dr. Maria Guadalupe Cardenas, MD, to provide comprehensive, integrative care. This post will guide you through the science, application, and profound potential of MLS Laser Therapy as a cornerstone of modern, patient-centered healthcare.

Our Integrative Team: A Multidisciplinary Approach to Wellness

At Injury Medical Clinic PA, we pride ourselves on a truly integrative and collaborative model of care. Our strength lies in the synergy between different medical disciplines working together for the benefit of our patients.

I am Dr. Alex Jimenez, and my credentials reflect a deep commitment to a holistic view of health. With titles including Doctor of Chiropractic (DC), Advanced Practice Registered Nurse (APRN), and Board-Certified Family Nurse Practitioner (FNP-BC), along with advanced certifications in Functional Medicine (CFMP, IFMCP), I approach patient care from multiple angles. This allows me to combine the structural focus of chiropractic care with the broad diagnostic and treatment capabilities of a nurse practitioner and the root-cause analysis of functional medicine.

This comprehensive approach is further enhanced by our collaboration with Dr. Maria Guadalupe Cardenas, MD. Dr. Cardenas is a highly respected, board-certified Internist with over 40 years of invaluable experience. She serves as our Medical Director and Collaborative Physician, providing essential medical oversight and direction. This multidisciplinary structure is common in leading-edge integrative and injury care clinics. It ensures that our patients receive a well-rounded care plan that integrates:

• Chiropractic Adjustments: To address spinal alignment, nerve function, and biomechanics.
• Medical Oversight: For accurate diagnosis, management of underlying medical conditions, and ensuring the safety and efficacy of all treatments.
• Functional Medicine: To investigate and address the root causes of dysfunction, from metabolic imbalances to nutritional deficiencies.
• Advanced Rehabilitation: Including cutting-edge modalities like MLS Laser Therapy.
• Personal Injury Care: Specialized protocols for accident-related injuries.
• Nutritional and Lifestyle Counseling: To empower patients to take an active role in their healing.

By combining my expertise in musculoskeletal and functional health with Dr. Cardenas’s extensive experience in internal medicine, we create a powerful partnership that delivers superior patient outcomes.

Understanding MLS Laser Therapy: A Demonstration

Let’s dive into the practical application of MLS Laser Therapy. Today, we’re working with John, who has been experiencing low back pain and stiffness, particularly around the L4-L5 facet joints, with some referral of sensation down his right side.

Patient Setup and the Clinical Multimodal Approach

The first and most critical step is ensuring patient comfort. When using the robotic laser applicator, the patient must remain still, as the device is calibrated to target a precise area. For low back pain, a prone (face-down) position is ideal. We must also apply the laser directly to the skin for optimal energy delivery.

Once John is comfortable, I begin the setup process on the laser’s interface.

• Targeting the Epicenter: I start by zeroing out the X and Y axes of the robotic head. This allows me to position the laser’s aiming beam directly over the central point of his discomfort.
• Expanding the Treatment Field: After centering on the primary site of pathology, I expand the treatment area using the X and Y controls. This is a key part of our clinical multimodal approach. We don’t just treat the spot that hurts; we treat the entire functional unit. This includes the source of the pain, surrounding connective tissues, and related muscle groups. This global approach addresses the interconnectedness of the musculoskeletal system, which is crucial for lasting relief.

Calibrating the Dose: Energy Density vs. Total Joules

A common point of confusion in laser therapy is the concept of dosage. While many focus on the total energy delivered in joules, modern research, supported by organizations such as the World Association for Photobiomodulation Therapy (WALT), emphasizes the importance of energy density.

Energy density, measured in joules per centimeter squared (J/cm²), is the amount of energy delivered to a specific area of tissue. This is the critical factor in achieving a therapeutic biological response.

• The Therapeutic Window: The goal is to deliver an energy density within the therapeutic window, typically between 4 and 10 J/cm². Too little energy won’t produce an effect, while too much can lead to a bio-inhibitory effect, as described by the Arndt-Schultz Law.
• Automatic Calibration: For John’s condition, we’ve selected a target density of 6 J/cm². The M6 laser’s advanced software automatically calculates the required treatment time (in this case, eight minutes) to deliver this precise density over the defined area. If I were to change the size of the treatment area, the software would instantly recalibrate the time to maintain the target energy density—a significant technological advancement.

The Science Behind the Light: How the MLS Laser Works

As the robotic arm moves, it delivers synchronized pulses at two specific wavelengths: 808 and 905 nanometers. You can’t feel it, but a powerful biological process has been initiated. If you were to look at the treatment area through a phone camera, you would see a distinct triangle of light—this is the 808 nm wavelength at work. The 905 nm wavelength pulses too quickly for the camera to capture.

The Power of Pulsed Energy

The MLS system uses a high peak power of 50 watts, but it delivers this energy in extremely short pulses (nanoseconds). This “punch” of energy penetrates deep into the tissue without generating heat at the surface. Between these high-energy punches, there is a period of rest, allowing the tissue to absorb the photonic energy and initiate the healing cascade. This is why patients, like John, feel little to no sensation during treatment. If heat is generated at the skin’s surface, it often means the energy is not being effectively absorbed at the target depth. The constant tissue temperature during an MLS session indicates that the dosage, wavelength, and pacing are perfectly calibrated.

Dual-Wavelength Synergy and Concurrent Treatments

The MLS laser features both a robotic head (with three diodes) and a handheld applicator (with one diode). They operate on separate channels, allowing for simultaneous treatment.

While the robot addresses the broader lumbar region, I can use the handpiece to target specific, punctual points, such as trigger points. Trigger points are hyperirritable nodules within a taut band of skeletal muscle, which I often describe to patients using the analogy of “cooked meat” (the knot) versus “raw meat” (healthy, pliable muscle). Releasing these points is a key component of chiropractic and rehabilitative care. Using the handpiece allows for dynamic treatment; for instance, I could have the patient move while I treat the area to work on motor patterns and tissue release simultaneously.

Optimizing Healing: Combining MLS Laser with Orthobiologics

One of the most exciting frontiers in regenerative medicine is the combination of MLS Laser Therapy with orthobiologics, such as Platelet-Rich Plasma (PRP) injections. PRP therapy involves injecting a concentration of a patient’s own platelets to accelerate the healing of injured tendons, ligaments, muscles, and joints.

The Cascade of Healing: Acute vs. Chronic

To understand how laser therapy augments PRP, we need to understand the cascade of effects it produces.

1. Immediate Analgesic Effect: In the acute phase, laser energy can act on small, unmyelinated nerve fibers (C-fibers) that transmit pain signals. This, along with a gentle thermogenic effect, can provide rapid pain relief.
2. Anti-Inflammatory Modulation: The laser energy then initiates a powerful anti-inflammatory response. It modulates inflammatory mediators, reducing swelling and promoting a healthier cellular environment. This is not about suppressing the pro-inflammatory phase that is necessary for healing (as after a PRP injection) but rather about optimizing and guiding it to prevent it from becoming chronic and destructive. The laser therapy augments this crucial healing phase.
3. Mitochondrial Stimulation (Photobiomodulation): The deepest and most profound effect is on the mitochondria. These are the “powerhouses” of our cells. The photonic energy from the laser is absorbed by an enzyme within the mitochondria called cytochrome c oxidase. This absorption kicks the mitochondria into high gear, dramatically increasing the production of Adenosine Triphosphate (ATP), the cell’s primary energy currency.

More ATP means cells have more energy to perform their functions—repairing damage, synthesizing new proteins, and replicating. This is the cornerstone of accelerated healing.

A Progressive Protocol for PRP and Laser Therapy

Based on emerging research and clinical protocols, we recommend a specific regimen to maximize the synergistic effects of laser and PRP:

• Priming the Soil (Pre-Injection): We advise two to three laser sessions before the PRP injection. This “prepares the soil” by reducing baseline inflammation, increasing local blood circulation, and initiating mitochondrial stimulation. This creates an optimal healing environment for incoming platelets to thrive.
• Day of Injection: A laser session is performed on the same day as the PRP injection to further enhance cellular activity and support the initial healing response.
• Supporting the Growth (Post-Injection): We recommend six additional laser sessions post-injection. This provides the healing tissues and activated platelets with a continuous supply of cellular energy (ATP) to support the demanding process of regeneration.

Studies and our clinical observations at Chiropractic-Scientist.com, along with my professional network, suggest that combining MLS with PRP can improve efficacy by 15-20% compared to PRP alone.

Broader Applications and Optimizing Outcomes

The principles of photobiomodulation extend to many other conditions. For instance, in a patient with knee osteoarthritis, we would use the laser to target the joint space from multiple angles (e.g., medial and posterior), often with the knee flexed to open the joint and allow deeper penetration, bypassing the reflective surface of the patella.

Addressing Mitochondrial Health Holistically

The conversation about mitochondrial health also brings up a critical point in functional medicine. Many common medications, such as statins and metformin, can negatively impact mitochondrial function. As clinicians, we must consider the patient’s entire metabolic picture. To optimize outcomes from laser therapy, we can:

• Review Medications: Discuss with the patient and their primary physician if any medications might be hindering mitochondrial biogenesis.
• Nutritional Support: Recommend supplements that support mitochondrial function, such as Coenzyme Q10 (CoQ10), NAD+, and creatine.
• Lifestyle Changes: Encourage exercise, which is a powerful natural stimulator of mitochondrial production.

By taking this comprehensive, functional approach, we can move beyond simply treating a symptom and work to optimize the body’s innate healing potential on every level. Laser therapy is not just a modality; it is a catalyst within a larger, patient-centered strategy for health and recovery.

Treatment Frequency and Patient Commitment

The effects of MLS Laser Therapy are cumulative. For an acute condition, a series of six treatments is typically recommended. For chronic issues, 12 treatments are often necessary. Ideally, sessions are performed two to three times per week (e.g., Monday, Wednesday, Friday) to build momentum. It’s crucial that patients complete the entire recommended course. They will often start feeling significantly better after three or four sessions, and we must educate them to continue the full protocol to achieve lasting structural and functional changes, rather than just temporary symptomatic relief.

Tonight, about four to six hours after his first treatment, John will likely begin to notice a decrease in his pain and stiffness. While a single session can provide relief, it is the full course of therapy that will bring about the significant cellular changes necessary for long-term healing.

References

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

Pires de Sousa, M. V., Ferraresi, C., & Hamblin, M. R. (2021). Photobiomodulation for the management of knee osteoarthritis: a review of the literature. Lasers in Medical Science, 36(6), 1167–1178. https://doi.org/10.1007/s10103-020-03204-5

World Association for photobiomoduLation Therapy. (n.d.). Dose & Dose Rate Effects in Photobiomodulation. WALT. Retrieved May 3, 2026, from https://waltpbm.org/