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

Background: Pain management in cancer patients represents a major clinical challenge due to its multimorphic nature. 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 option to attenuate these symptoms and reduce reliance on systemic analgesics.1-6 Objective: This narrative review aims to critically evaluate the clinical efficacy of photobiomodulation in managing pain related to anticancer treatments, while providing clear guidance regarding dosimetric parameters, oncological safety, and current limitations in the literature. Method: A narrative review of the literature was conducted. The sources consulted primarily included the PubMed and PubMed Central databases for publications extending up to 2026. The selection criteria focused on randomized controlled trials, systematic reviews, meta-analyses, and international consensus guidelines addressing painful complications in oncology. Results: The strongest evidence supports the preventive efficacy of photobiomodulation for oral mucositis induced by radiotherapy or chimiotherapy, as well as for acute radiodermatitis.7-15 Results appear promising but remain insufficient for pain related to lymphedema and for chemotherapy-induced peripheral neuropathy.16-24 Pronounced protocol heterogeneity (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 studies, small sample sizes for secondary indications, a high risk of blinding bias, and a lack of rigorous standardization of parameters across equipment manufacturers.16-18 Conclusion: Photobiomodulation constitutes a useful tool in the multimodal analgesic strategy in oncology, provided it is delivered within validated therapeutic windows. The clinical message calls for caution: efficacy must not be overstated for curative indications or chronic sequelae, and direct irradiation of active, non-resected tumor sites must be strictly proscribed.