Red Light Therapy for Tendonitis: Elbow, Shoulder, Achilles and Wrist
Red light therapy for tendonitis has its clearest support when the light is added to a tendon exercise programme. In placebo-controlled trials on the elbow, shoulder and Achilles, red and near-infrared laser light lowered pain more than a sham device, and tennis elbow has the strongest support. Below: each tendon in turn, the doses the trials used, timing around exercise, when to see a doctor first, and how to match the studied doses on a home panel.
Key takeaways
- In a 2021 meta-analysis of 17 trials with 835 people, light plus exercise lowered tendon pain by 1.06 points on a 10-point scale more than sham light plus exercise. BMC Sports Sci Med Rehabil, 2021
- A 2022 clinical practice guideline on lateral elbow pain says clinicians "may use laser therapy for improvements in pain and grip strength". JOSPT guideline, 2022
- In a 2008 Achilles trial of 52 athletes doing eccentric exercises, pain during activity at 8 weeks was 37.3 mm with 820 nm laser against 62.8 mm with placebo, on a 100 mm scale. Am J Sports Med, 2008
- The tendon trials in the 2021 meta-analysis used small doses of 0.5 to 5 J/cm². BMC Sports Sci Med Rehabil, 2021
- The World Association for Photobiomodulation Therapy (WALT) suggests treating a tendon daily for 2 weeks or every other day for 3 to 4 weeks. WALT, 2010
Does red light therapy help tendonitis?
Research suggests it can help, mostly as an add-on to exercise. In a 2021 review of 17 trials, light plus exercise eased pain and improved function more than sham light plus the same exercise.
The review pooled 835 people: seven trials on the outer elbow, seven on the rotator cuff, and one each on the Achilles, the patellar tendon and the wrist. Every trial used near-infrared light, over a course of 2 to 4 weeks. Function on the DASH arm questionnaire was 5.65 points better with light. Five trials reported on side effects, and none occurred. BMC Sports Sci Med Rehabil, 2021 Our guide to red light therapy for pain and inflammation gives the pooled pain figures by body area; the sections below go tendon by tendon.
Does red light therapy work for tennis elbow?
Tennis elbow is the best-supported tendon for light. The positive trials aimed 904 nm infrared or 632 nm red laser light at the tendon where it attaches to the outer elbow bone.
A 2008 meta-analysis of 13 placebo-controlled trials with 730 patients is the main evidence on red light therapy for tennis elbow. BMC Musculoskelet Disord, 2008
- 904 nm on the tendon: pain 17.2 mm lower than placebo on a 100 mm scale, across 5 trials.
- 632 nm red: pain 14.0 mm lower, in one trial.
- Grip strength: still better at 3 months, in two trials.
- Placement: trials that lit acupuncture points instead of the tendon showed no clear benefit.
Doses ran from 0.5 to 7.2 J, with no side effects reported. The 2022 guideline gives laser a Grade C recommendation for pain and grip strength over follow-up from more than 4 weeks to 6 months, without setting a dose. JOSPT guideline, 2022
Does red light therapy help golfer's elbow?
It has been studied far less than tennis elbow. The one trial we found included 50 golfer's elbow cases inside a larger elbow study.
That double-blind, placebo-controlled trial enrolled 324 people, 274 with tennis elbow and 50 with golfer's elbow on the inner side. It used 830 nm laser on trigger points plus 632.8 nm and 904 nm light from a scanner. Across the whole trial, in the combination group, pain went completely, with better function, in 82% of recent cases and 66% of long-standing ones. J Clin Laser Med Surg, 1998
It is early evidence, scoring 4 out of 10 on the PEDro quality scale. The authors noted that too little or too much light can remove the benefit, a point covered in how much red light therapy is too much. The tennis elbow placement is a sensible starting point: light the tendon where it meets the bony point on the inner elbow.
Can red light therapy help rotator cuff tendinitis?
At adequate doses, the shoulder trials point that way. A 2015 meta-analysis of 17 shoulder trials found less pain with light than with placebo, both on its own and alongside exercise.
Light alone lowered pain by 20.41 mm on a 100 mm scale, and light with exercise by 16.00 mm. Trials below the recommended dose saw no effect. Physiother Res Int, 2015 In a 2011 double-blind trial of 80 people with rotator cuff or biceps tendinitis, pulsed infrared laser plus exercise improved pain and every range-of-motion measure more than placebo plus exercise, over 10 sessions in 2 weeks. Clin Rheumatol, 2011
The rotator cuff sits deeper than the elbow tendons, and WALT asks for twice the energy: 8 J in total, at least 4 J per point. For the shoulder, near-infrared is the band to lead with.
Does red light therapy help Achilles tendonitis?
Some Achilles trials found faster pain relief when light was added to exercise, and others found no added difference. Loading exercise is the foundation either way.
The best-known positive trial enrolled 52 recreational athletes with long-standing Achilles pain, all doing eccentric exercises. One group also had 820 nm laser on 6 points along the tendon, 5.4 J per session, for 12 sessions over 8 weeks. Am J Sports Med, 2008
| Time point | Pain during activity, laser | Pain during activity, placebo |
|---|---|---|
| 4 weeks | 53.6 mm | 71.5 mm |
| 8 weeks | 37.3 mm | 62.8 mm |
| 12 weeks | 33.0 mm | 53.0 mm |
The laser group at 4 weeks was about where the placebo group was at 12. In a smaller study, 904 nm light given after exercise had provoked the pain lowered PGE2, an inflammatory marker, beside the tendon 75 to 105 minutes later. Br J Sports Med, 2006 That shows a mechanism, not recovery.
A 2012 trial of 40 people using 3 J per point with eccentric exercise found no difference at 12 weeks. Arch Phys Med Rehabil, 2012 The 2024 guideline for midportion Achilles pain advises against low-level laser and rates loading exercise, "with loads as high as tolerated", as first-line. JOSPT guideline, 2024
Does red light therapy help wrist tendonitis such as de Quervain's?
One small trial suggests it may. In 30 wrists with de Quervain's, a painful tendon on the thumb side of the wrist, laser light improved grip and pinch strength while placebo did not.
The trial used 2 to 4 J/cm² over a 1 cm grid on the tendon, for up to 10 sessions. Grip (p < 0.001) and pinch strength (p = 0.024) improved, and on ultrasound the tendon sheaths measured thinner. Physiotherapy, 2002 It scored 3 out of 10 on PEDro, and the wavelength was not reported. Our article on red light therapy for hands and feet covers the wrist more widely.
What about jumper's knee and heel pain?
Heel pain makes up most of the lower-leg light trials, and one used visible red. Jumper's knee has very few, with only two in the largest review.
A 2022 meta-analysis of 18 trials and 784 people included 11 on plantar fasciitis, 5 on the Achilles and 2 on the patellar tendon. At recommended doses, pain fell by 14.98 mm more than placebo straight after treatment. BMJ Open, 2022 In a double-blind heel trial of 69 people, 635 nm red laser twice a week for 3 weeks lowered pain by 29.6 points on a 100-point scale at 8 weeks, against 5.4 with placebo. J Foot Ankle Surg, 2015 Our guide to red light therapy for knee pain covers the knee in detail.
Why does red light work best alongside loading exercise?
Because that is how most positive trials used it. Light added to exercise beat sham light added to the same exercise.
In the 2021 review, light on its own matched other treatments for pain but gave smaller gains in function. BMC Sports Sci Med Rehabil, 2021 As an add-on to exercise, stretching or insoles, light at recommended doses lowered lower-leg pain by 18.15 mm straight after treatment. At 9 weeks the gap was 19.67 mm. BMJ Open, 2022
Loading means progressive strengthening exercise for the tendon, usually set by a physiotherapist. The 2024 Achilles guideline gives it a Grade A rating, at least 3 times a week. So keep the exercise programme as the base and treat light as the extra.
Tendon trials do not settle whether light should come before or after exercise; the 2006 Achilles study lit tendons straight after a pain-provoking activity. As our article on light and muscle recovery notes, there is no settled answer, so a session on the same day as your rehab, on either side of it, fits the research.
What doses and schedules did the tendon trials use?
Small doses on points, over 2 to 8 weeks. The 2021 review's trials used 0.5 to 5 J/cm², and the WALT tables give a few joules per tendon.
| Tendon | Light | Dose | Sessions | Result vs placebo |
|---|---|---|---|---|
| Tennis elbow, 2008 | 904 nm or 632 nm | 0.5 to 7.2 J | Varied | 17.2 and 14.0 mm less pain |
| Shoulder, 2011 | Pulsed infrared, with exercise | Not stated in abstract | 10 in 2 weeks | More gain in pain and movement |
| Achilles, 2008 | 820 nm, with exercise | 5.4 J per session | 12 over 8 weeks | 37.3 vs 62.8 mm at 8 weeks |
| Wrist, 2002 | Not reported | 2 to 4 J/cm² | Up to 10 | Better grip and pinch |
| Heel, 2015 | 635 nm | Not stated here | 6 in 3 weeks | 29.6 vs 5.4 points less pain |
The WALT table for 780 to 860 nm gives these totals: WALT, 2010
- Outer elbow: 1 to 2 points, 4 J in total.
- Rotator cuff: 2 to 3 points, 8 J in total, at least 4 J per point.
- Achilles and patellar tendon: 2 to 3 points, 8 J in total.
- Schedule: daily for 2 weeks or every other day for 3 to 4 weeks, with the dose cut by 30% once inflammation is controlled.
These trials used clinic lasers held over points along the tendon, and laser joules per point do not convert directly into the joules per square centimetre a broad panel delivers. Both bands have positive results: red at 632 and 635 nm on the elbow and heel, and near-infrared at 820 and 904 nm on the Achilles and elbow.
When should you not use red light on a tendon?
Not on a suspected rupture, and not as the first step for a hot, swollen or newly injured tendon. Sudden pain with a "popping or snapping" feeling needs urgent advice, through NHS 111 in the UK.
The NHS says a mild tendon injury should improve in about 2 to 3 weeks. For the first 2 to 3 days it advises rest, ice wrapped in a cloth for up to 20 minutes every 2 to 3 hours, and a snug support, then gentle movement. See a GP if it is no better within a few weeks. NHS Most light trials studied long-standing tendon pain, which is where light fits: alongside a rehab plan, once the problem is diagnosed.
How do you use a Kivorla panel on a sore tendon?
Point the panel at the tendon on bare skin, wear the goggles, and use the controls to set a dose close to the trial range. Fit the sessions around your exercise programme.
The 9-Spectrum Red Light Therapy Panel carries 480, 590, 630, 660, 670, 810, 830, 850 and 1060 nm, each dimmable from 1 to 100%. Its 630 nm channel sits next to the 632 and 635 nm red of the elbow and heel trials, and its 810 and 830 nm channels sit in the WALT 780 to 860 nm band, either side of the 820 nm Achilles trial. At 6 inches it puts out at least 1,567 W/m², with near-infrared at least 1,200 W/m². At 640 x 230 mm, hung on a door or wall or standing, it reaches the elbow, shoulder, wrist, knee, Achilles and heel.
- Elbow: face the outer or inner elbow to the panel, aiming where the tendon meets the bone, with the 630 nm channel on.
- Shoulder: face the front and side of the shoulder, with near-infrared leading.
- Achilles: sit or lie so the whole tendon, heel to calf, faces the panel.
- Eyes and comfort: wear the goggles; warm is fine, hot is not.
Our general guide for joints is 10 to 15 minutes at 6 inches, three to five times a week, judged at three to four weeks. To follow the tendon trials more closely, bring the dose down. On paper, at 6 inches with every channel at 100%, the near-infrared channels deliver at least about 7 J/cm² a minute. Three controls bring a session towards the trial range:
- Shorter timer: it starts at 1 minute, and the panel stops at 5 minutes if no time is set.
- Dimmer channels: turn near-infrared and red down from 100%.
- More distance: step back to 12 inches, our suggested distance for broad areas.
For the elbow, wrist or Achilles, start with a short timer, dimmed channels and the 12-inch distance, and keep the same settings for 3 to 4 weeks so you can judge the change. Leave at least 6 hours between 30-minute sessions. Goggles, a controller, a pulley and a door hook are included. The 4-Wavelength Red Light Therapy Mask covers the face only and is not designed for tendons.
Standard shipping to the US, UK and Germany is free. Read the precautions before ordering. Under our return and refund policy, returns are accepted within 30 days: an unopened device with its seals intact is refunded less a 10% restocking fee, and an opened device that is undamaged and complete is refunded less 20%.
Kivorla devices are general wellness devices, not medical devices, and are not intended to treat tendonitis. See a doctor or physiotherapist for a new, hot or swollen tendon, and get urgent help for a suspected rupture.