Advanced & regenerative therapies
Class IV laser therapy
High-intensity laser light for heel and tendon pain: needle-free, in the office, as part of a plan.
Medically reviewed by Efe Ozturk, DPM · Last reviewed
How it works
Laser therapy (also called photobiomodulation) delivers light energy into tissue, where it is thought to influence cellular metabolism, circulation and pain signaling. Class IV refers to higher-powered devices that can reach deeper tissue in a shorter treatment time than older, low-level lasers. A session usually takes several minutes per area and is repeated over a series of visits.
What the evidence shows
- Plantar fasciitis. A meta-analysis of low-level laser trials found that it reduced heel pain, with the effect lasting up to three months after treatment.[3] A randomized trial comparing high-intensity and low-level laser found similar improvement with both, though patients rated the high-intensity treatment more favorably.[4]
- Compared with shockwave, a 2026 meta-analysis found no significant difference in pain between high-intensity laser and shockwave, with foot function favoring shockwave in some analyses.[1]
- Compared with exercise alone, a 2026 randomized trial found that adding high-intensity laser or radial shockwave to a structured home exercise program did not add benefit at 12 weeks, supporting exercise as the first-line treatment.[2]
In short: laser therapy is a reasonable option for some people, particularly those who want an in-office, needle-free treatment alongside their exercises, but it isn’t a substitute for the basics.[5]
What it’s used for at the practice
- Plantar fasciitis and heel pain. See heel pain.
- Tendon pain, such as Achilles and peroneal tendinopathy. See Achilles tendon.
- Soft-tissue pain after sprains and overuse injuries, as part of rehabilitation.
Safety
Laser therapy is generally well tolerated. Protective eyewear is worn during treatment. It is not used over the eyes, over a pregnancy, over cancerous tissue, or over areas treated with light-sensitizing medication, and we check your health history first.
What to expect
Most people feel a pleasant warmth. There is no downtime. Treatments are typically given over a series of visits, and any improvement tends to build over several weeks. Our article on Class IV laser therapy covers what a session is like.
Who it suits
Laser therapy tends to suit people with a soft-tissue problem that is already being treated properly (stretching, strengthening, the right shoes or inserts) but is slow to settle, and who want a needle-free option in the office. It is less useful when the cause is structural, such as a stress fracture or a torn tendon, which needs a different plan, and when nerve symptoms (burning, numbness, tingling) are the main complaint, which calls for a nerve evaluation first. See nerve pain in the feet.
Common questions
How many sessions will I need?
It depends on the problem and how long you have had it. Laser is given as a course of short sessions over several weeks rather than a single treatment, and we reassess as we go. If there is no meaningful change after a reasonable course, we stop and change the plan rather than continue.
Should I choose laser or shockwave?
For plantar fasciitis, a 2026 meta-analysis found the two similar for pain, with foot function favoring shockwave in some analyses.[1] We decide together, based on your condition, how long you have had it and your preferences. See shockwave therapy.
Can I skip the exercises if I’m having laser?
No. In a 2026 trial, adding laser to a structured home exercise program didn’t improve results at 12 weeks, which is a good reminder that the exercises do most of the work.[2] Laser is an addition to them, not a replacement.
Is this the same laser used for toenail fungus?
No. Lasers marketed for fungal nails are a different use of laser light with a different goal. This page is about laser therapy for pain in soft tissues such as the plantar fascia and tendons.
Insurance
Coverage for laser therapy varies from plan to plan. We’ll confirm your cost with you before you start.
When to seek care
References
- 1.Wu PC, Liu DH, Cheng YS, Lin CS, Yang FA. High-Intensity Laser Therapy Versus Extracorporeal Shockwave Therapy for Plantar Fasciitis: A Systematic Review and Meta-Analysis. Bioengineering (Basel). 2026;13(1). PubMed 41596021 (external site)
- 2.Kosehasanogullari M, Büyükvural Şen S, Okur Yılmaz N, Aygün Bilecik N, Koçyiğit BF. Home Exercise With or Without High-Intensity Laser or Radial Shockwave Therapy for Plantar Fasciitis: A Randomized Controlled Trial. Foot Ankle Int. 2026;47(3):386-397. PubMed 41664959 (external site)
- 3.Wang W, Jiang W, Tang C, Zhang X, Xiang J. Clinical efficacy of low-level laser therapy in plantar fasciitis: A systematic review and meta-analysis. Medicine (Baltimore). 2019;98(3):e14088. PubMed 30653125 (external site)
- 4.Naruseviciute D, Kubilius R. The effect of high-intensity versus low-level laser therapy in the management of plantar fasciitis: randomized participant blind controlled trial. Clin Rehabil. 2020;34(8):1072-1082. PubMed 32513018 (external site)
- 5.Morrissey D, Cotchett M, Said J'Bari A, Prior T, Griffiths IB, Rathleff MS, et al. Management of plantar heel pain: a best practice guide informed by a systematic review, expert clinical reasoning and patient values. Br J Sports Med. 2021;55(19):1106-1118. PubMed 33785535 (external site)
This is general health information and isn’t a substitute for advice from a clinician who knows your history. Read our medical disclaimer and how we write and review content.
Keep reading
Service
Shockwave therapy (ESWT)
Acoustic pulses that help stubborn heel and tendon pain heal, in the office, with no needles or downtime.
Service
Heel pain & plantar fasciitis
The most common cause of pain under the heel, and the stepped treatment that helps most people without surgery.
Blog · Treatments
Class IV laser therapy for foot pain: what a session is like and what the research says
What a Class IV laser session is like, and an honest look at what the research shows.