Photobiomodulation for Non-Cancer Pain Management: Mechanisms, Clinical Evidence, Treatment Parameters, and Practical Considerations for Clinicians - A Narrative Review

Background: Pain management in non-cancer pathologies represents a major public health challenge due to its chronic nature, functional impact, and the limitations or side effects of long-term systemic therapies. As a direct sequel and clinical complement to our companion review focusing on oncology supportive care, photobiomodulation-defined as the therapeutic use of non-ionizing and athermal light radiation within the red and near-infrared spectrum-emerges as a promising non-pharmacological modality to attenuate musculoskeletal, neuropathic, and orofacial symptoms outside the cancer field.1?6131 Objective: This narrative review aims to critically evaluate the clinical efficacy of photobiomodulation in managing non-cancer pain, completing our global evaluation of light-based analgesia by providing clear guidance regarding dosimetric parameters, clinical consensus frameworks updated to 2026, and current methodological limitations in the literature. Method: A narrative review of the literature was conducted. The sources consulted primarily included the PubMed, PubMed Central, and Cochrane databases for clinical publications extending up to September 2026. The selection criteria focused on randomized controlled trials, systematic reviews, meta-analyses, and international consensus guidelines (such as the World Association for lIght Therapy) addressing non-oncological painful conditions. Results: The strongest evidence supports the clinical efficacy of photobiomodulation for knee osteoarthritis, acute and chronic neck pain, temporomandibular disorders, and acute post-operative complications (pain, edema, trismus) following third-molar extraction.25?2838?4055?58 Recent data from late 2025 and 2026 confirm that results appear promising but remain preliminary or highly variable for fibromyalgia, burning mouth syndrome, carpal tunnel syndrome, pelvic pain, and painful diabetic neuropathy.33?3744?4748?54143 Pronounced protocol heterogeneity across studies (variations in wavelengths, power, irradiance, and treatment frequencies) accounts for the divergence of certain clinical outcomes. Limitations: The main weaknesses of the current literature reside in the variable methodological quality of trials, small sample sizes for emerging indications, a high risk of blinding bias in chronic syndromes, incomplete reporting of physical parameters, and a lack of rigorous standardization across equipment manufacturers.29?313637143 Conclusion: Expanding upon our previous oncological findings, photobiomodulation constitutes a useful tool in the multimodal analgesic strategy for non-cancer pain, provided it is delivered within validated therapeutic windows and ideally combined with active physical rehabilitation. The clinical message calls for caution: efficacy must not be overstated for complex systemic syndromes, and parameters must be strictly tailored to anatomical depth barriers.