MLS Laser Therapy in Columbus, Ohio: What Class IV Laser Actually Does for Back and Joint Pain

By Nikhil Verma, MD, fellowship-trained interventional spine and sports medicine physician, Essential Sports and Spine Solutions, Columbus, OH

A patient asked me last month, standing next to the laser unit in my treatment room, whether it was real or whether it was a gimmick. He’d seen a groupon for laser therapy at a chiropractic office. He’d also seen a handheld device on Amazon for eighty dollars. He genuinely could not tell whether the thing in my office belonged in the same category as either of those.

That’s a completely fair question, and almost nobody answers it straight.

So here is the straight answer. MLS laser therapy is a Class IV medical laser that delivers light at specific wavelengths into tissue, and the evidence supports it as a reasonable adjunct for reducing musculoskeletal pain and improving function in conditions like chronic low back pain and knee osteoarthritis. It is not a cure for anything. It does not regrow cartilage or repair a disc. And the evidence base is genuinely mixed in a way I’m going to walk you through honestly, because the reason it’s mixed turns out to be the most useful thing in this entire article.

I’m an interventional spine and sports medicine physician in Columbus, Ohio, and I use MLS laser as part of a regenerative medicine practice, not as a standalone service line. Here’s what I actually know about it.

What is MLS laser therapy?

MLS stands for Multiwave Locked System. It’s a Class IV laser technology that emits two wavelengths at once and synchronizes them: a continuous 808 nanometer beam and a pulsed 905 nanometer beam, locked together in a single pulse.

The reason that matters is that the two wavelengths are thought to do different jobs. The continuous 808 nanometer emission is associated with anti-inflammatory and anti-edema effects. The pulsed 905 nanometer emission is associated with analgesia. The premise of the technology is that synchronizing them produces a more consistent therapeutic effect than delivering either alone, and that the higher power of a Class IV system allows meaningful energy to actually reach deeper tissue rather than dissipating at the skin.

Class IV is the important word. Laser therapy devices are classified by power output. Class I, II, and III devices, which is what most people mean when they say “cold laser” or “low-level laser therapy,” operate at a fraction of the power. A Class IV system delivers substantially more energy per session. Whether that difference translates to a difference in outcomes is exactly the question the research is still working out, and I’ll get to that.

The treatment itself is non-invasive. There’s no needle, no incision, and no anesthesia. A handpiece is moved over the treatment area. Most patients feel a mild warmth and nothing else. Sessions typically run somewhere in the range of five to fifteen minutes depending on the area being treated, and a course of care is usually a series of sessions rather than a single visit.

Does laser therapy work for back pain?

This is where I have to be careful, because the honest answer requires holding two findings that appear to contradict each other.

The negative signal. A 2020 systematic review published in the Journal of Physiotherapy pooled twelve randomized controlled trials with roughly 1,046 patients, most of them at low risk of bias, and concluded that photobiomodulation produced clinically unimportant effects on pain and disability in non-specific low back pain. That’s a serious result from a rigorous review, and I’m not going to pretend it doesn’t exist. Any physician who tells you laser therapy is definitively proven for back pain is either unfamiliar with that paper or choosing not to mention it.

The positive signal. A 2023 systematic review with meta-analysis in Lasers in Medical Science looked specifically at high-intensity laser therapy for low back pain and found it favorable over control for pain intensity, for Oswestry Disability Index scores, and for Roland disability scores. Separate randomized trials have compared high-intensity laser directly against low-level laser in chronic non-specific low back pain and found differences between them.

So which is it?

Here’s the distinction that resolves most of the apparent contradiction, and it’s the single most important thing on this page. The 2020 review that found no clinically important benefit specified its included interventions as laser classes I, II, and III plus light-emitting diodes. It did not include Class IV devices. It was, in effect, a rigorous evaluation of low-power light therapy, and it found low-power light therapy underwhelming for back pain.

That is not the same question as whether a Class IV system delivering an order of magnitude more energy does something.

I want to be precise about what I’m claiming here. I am not saying the negative review is wrong. I’m saying it answered a narrower question than the headline suggests, and that people on both sides of this debate quote it as though it settled something it didn’t.

The dose problem, which is the same problem PRP has

If you’ve read anything else I’ve written, this pattern will look familiar.

In platelet-rich plasma, the trials that show benefit and the trials that show nothing are often testing preparations that differ by a factor of five or ten in delivered platelet dose. The intervention is called the same thing in both papers. It is not the same intervention. When you separate the studies by dose, a signal starts to appear that was invisible when everything was pooled together.

Laser therapy has an identical problem, and arguably a worse one. Across the published literature, trials vary in wavelength, in power output, in energy density, in whether the delivery is continuous or pulsed, in total joules per session, in number of sessions, and in whether the beam is applied in contact with the skin or scanned above it. A trial using a 785 nanometer device at 8 joules per square centimeter and a trial using a 1064 nanometer Nd:YAG at 60 joules per square centimeter are both filed under “laser therapy for back pain.” They are not testing the same thing.

Pool them and you get exactly what you’d expect: a small average effect with enormous heterogeneity. That’s not evidence that laser doesn’t work. It’s evidence that “laser” is a category, not a treatment.

I’d also add the honest caveat on the positive side. In the high-intensity laser meta-analysis, the pooled reduction in pain intensity sits close to the threshold most researchers consider the minimum clinically important difference for low back pain. It’s a real effect. It is not a dramatic one. Anyone showing you a laser brochure with a testimonial about someone throwing away their cane is showing you an outlier, not an expectation.

What MLS laser therapy does not do

I’d rather set expectations correctly than have you feel misled later.

It does not regrow cartilage. It does not repair a herniated disc or reverse degenerative disc disease. It does not fix spinal stenosis. It does not replace physical therapy, load management, or the strength work that actually changes how your spine tolerates life.

It also does not work on everyone. Some patients feel a meaningful change after two or three sessions. Some feel very little after a full course. I don’t know how to reliably predict which is which ahead of time, and I’ll tell you that before we start rather than after.

The mechanism people cite, that light in the red and near-infrared range is absorbed by cellular structures and influences energy production and the local inflammatory environment, is a working model with real laboratory support behind it. It is not established clinical fact in the way that “cortisone suppresses inflammation” is established clinical fact.

A physician asked me recently, plainly, how I like it and whether I think it works. Here’s the same answer I gave him. I’m optimistic on it. I see it work. And “I see it work” is not the same sentence as “the literature proves it works,” which is exactly the distinction most clinics offering this won’t draw for you. Optimistically cautious is the honest summary of where I am, and if that changes I’ll say so.

One more thing on mechanism, because you may hear a version of it elsewhere that goes further than I’m willing to go. There is a real body of laboratory research on light at these wavelengths influencing the behavior of the body’s own repair cells, and a professional society position paper reviewed it in 2025. That work is genuine. It is also almost entirely from cell culture and animal models, and the same position paper was direct about the shortage of clinical studies. If a clinic tells you their laser activates your stem cells, they are stating as fact something that has been shown in a dish. I’m not going to tell you that, because I can’t.

Where laser fits in a regenerative medicine protocol

This is the part I care about most, and it’s the reason I have a Class IV laser at all.

I don’t run a laser clinic. I run an interventional and regenerative medicine practice. Most of the patients who get laser at Essential Sports and Spine Solutions are getting it around something else: a platelet-rich plasma procedure, a bone marrow concentrate procedure, a micronized adipose procedure, or a structured rehabilitation plan.

Here’s the logic. When we place a biologic into a joint or a tendon, the result depends heavily on the environment that biologic lands in. An inflamed, poorly perfused, sleep-deprived, deconditioned system is a hard place for anything to work. A great deal of what determines outcome happens outside the syringe: sleep, nutrition, blood sugar, how you load the tissue in the weeks afterward, and how much pain you’re in during the window when you’re supposed to be moving.

Laser is one of the tools I use to influence that window. If a patient is more comfortable in weeks two through six after a procedure, they move better, they rehab better, and they load the tissue the way it needs to be loaded. That’s not a claim that photons regenerate anything. It’s a claim that comfort during rehab is not a soft outcome, it’s a mechanism.

The injection is one piece. The protocol is the point. Laser is one component of the protocol, sequenced deliberately, not offered as an upsell at checkout.

There are also patients I treat with laser and nothing else, usually people who aren’t candidates for an injection yet, people who want to try a conservative option first, or people managing a flare who need something that isn’t another round of anti-inflammatories.

Why I speak on this nationally

I present on photobiomodulation to other physicians, which shapes how I think about it and how I use it.

I presented on photobiomodulation at the Ohio Society of Interventional Pain Physicians annual meeting, and I was the guest speaker for a live session with TOBI, The Orthobiologic Institute, on Class IV MLS laser therapy for spine and joint recovery, hosted alongside Cutting Edge Laser Technologies. The audience for those talks is other interventional physicians who are skeptical by training and who ask hard questions about parameters, patient selection, and whether the technology earns its place in a busy practice.

I mention this for one reason. When you’re evaluating any clinic offering laser therapy, it’s reasonable to ask whether the physician can explain the mechanism, cite the evidence including the negative evidence, and tell you what the technology doesn’t do. If they can’t do those three things, the laser in the room is a revenue line rather than a clinical tool.

Laser therapy for back pain in Columbus and Central Ohio

If you’re in Columbus, Dublin, Westerville, Upper Arlington, or Gahanna and you’ve been handed the same script everyone gets, anti-inflammatories, then physical therapy, then a cortisone injection, then a surgical consult, you’re not imagining that something is missing from that sequence.

Here’s what an evaluation with me actually looks like. I review your imaging myself rather than reading someone else’s report. We talk through what’s actually generating your pain, which is often not what the MRI headline says. Then we build a plan, and laser may or may not be part of it. If you’re not a good candidate for what I do, I’ll tell you that directly, and I’d rather tell you in the first visit than after you’ve spent money.

We’re a cash-pay practice. Laser therapy is generally not covered by insurance, which I’ll be transparent about up front along with what a course of care actually costs.

If you want to go deeper on this, the specific protocols I use, how I think about system selection, and what I tell every patient after an injection, I cover all of that in my paid newsletter, Essentials of Healing. You can find it at nikhilvermamd.substack.com.

Frequently asked questions about MLS laser therapy

What is MLS laser therapy? MLS stands for Multiwave Locked System. It’s a Class IV laser that emits two synchronized wavelengths, a continuous 808 nanometer beam and a pulsed 905 nanometer beam. It’s used to reduce pain and inflammation in musculoskeletal conditions. Treatment is non-invasive, takes roughly five to fifteen minutes per session, and most patients feel only mild warmth.

Does laser therapy actually work for back pain? The evidence is mixed and depends heavily on what kind of laser you’re talking about. Reviews of low-level laser and LED devices have found clinically unimportant effects for non-specific low back pain. Reviews focused on high-intensity laser therapy have found reductions in pain and disability, though the studies vary widely in their parameters. My honest read is that it’s a reasonable adjunct with a real but modest effect, not a primary treatment.

Is MLS laser therapy the same as cold laser? No. “Cold laser” usually refers to Class III low-level laser therapy, which operates at much lower power. MLS is a Class IV system. The distinction matters because much of the negative research on laser therapy was conducted on low-power devices, and that research is often cited as though it applies to all laser therapy.

Does laser therapy hurt? No. Most patients feel a gentle warmth over the treatment area and nothing more. There’s no needle, no incision, and no recovery time. You can drive yourself home and go back to work.

How many laser sessions will I need? It’s typically a series rather than a single visit, and the number depends on the condition, how chronic it is, and how you respond. I’d rather evaluate you and build a real plan than quote you a package before I’ve looked at your imaging.

Is MLS laser therapy covered by insurance in Ohio? Generally no. Laser therapy is usually cash-pay. We’re transparent about cost before you commit to anything.

Can laser therapy replace surgery? No, and I won’t tell you it can. For some patients it’s part of a plan that helps them delay or avoid a procedure they weren’t ready for. For others, surgery is genuinely the right answer and I’ll say so. Laser is a tool, not an alternative to appropriate surgical care.

Can I get laser therapy with PRP or a bone marrow concentrate procedure? Yes, and that’s how I use it most often. Laser is sequenced around orthobiologic procedures as part of the recovery protocol rather than offered as a standalone add-on.

Where can I get MLS laser therapy near Columbus, Ohio? We offer Class IV MLS laser therapy at Essential Sports and Spine Solutions, serving Columbus, Dublin, Westerville, Upper Arlington, and Gahanna. You can request an appointment at essentialsportsspine.com.

If you’re in Central Ohio and you want to talk through whether laser therapy or orthobiologics fit your situation, you can request an appointment at https://www.essentialsportsspine.com/request-appointment/.

This is for educational purposes only and does not constitute medical advice. I may be a doctor, but I am not your doctor.