Laser treatment for knee and joint pain: light instead of needles

MLS laser treatment is a noninvasive light therapy for the pain, stiffness and swelling of an arthritic or irritated joint. You sit or lie comfortably while the device is positioned over the knee, hip or sore soft tissue; a session takes 5–10 minutes and there is nothing to recover from. It is offered as a low-risk add-on to proven care — never as a cure. Laser sessions are given by clinic staff at the Pacific Bone & Joint clinic at Ala Moana in Honolulu. Self-pay patients can book a series directly; if you'd rather start with a diagnosis, Dr. Paul Morton, a fellowship-trained hip and knee surgeon, decides with you whether it belongs in your plan after an exam and X-rays.

MLS (Multiwave Locked System) laser therapy is a form of photobiomodulation — treating tissue with specific wavelengths of light to influence how cells behave. The system delivers two synchronized near-infrared wavelengths at once: a continuous emission aimed at inflammation and swelling, and a pulsed emission aimed at pain. That synchronization is what sets it apart from older single-wavelength "cold lasers," and the higher-powered class of device allows deeper tissue penetration with shorter treatment times. Laser therapy of this kind is now a familiar fixture in orthopedic, sports medicine and rehabilitation settings.

It is not a surgical laser. Nothing is cut or burned: MLS is a low-level treatment that influences how cells behave rather than destroying tissue, which is why most patients feel nothing during a session, or at most mild warmth. For the longer, evidence-focused discussion, read Dr. Morton's article on MLS laser therapy for arthritis.

The mechanism is real biology, not mystique. Near-infrared light penetrates the skin and is absorbed by structures within cells — most notably the mitochondria, the cell's energy producers. That absorption appears to nudge cells toward higher energy output and better function. In inflamed tissue, the observed downstream effects include improved local circulation, reduced fluid accumulation and a dampening of inflammatory signaling.

The pulsed wavelength adds a second effect: modulation of pain signaling in the treated tissue, which is why many patients notice the joint simply feels quieter after a series of sessions. For an arthritic knee or hip, the practical translation is less swelling, less stiffness and less day-to-day ache — the same targets we chase with ice, anti-inflammatories and injections, approached through a different mechanism. For the bigger picture on what is happening inside the joint, start with our overview of hip and knee arthritis.

Where laser therapy earns its place: arthritis pain and stiffness flares, irritated tendons and soft tissue around a joint, and swelling — including as an adjunct during recovery after surgery or injury, where calmer, less swollen tissue tends to move and heal more comfortably. Around the hip and knee, that includes the soft-tissue irritations that can slow a recovery — pes anserine bursitis on the inner knee, iliotibial band irritation, iliopsoas tendinitis and trochanteric bursitis at the hip — where laser is used alongside stretching, strengthening, topical anti-inflammatories and, when needed, an injection. Studies of photobiomodulation for knee arthritis report short-term improvements in pain and function when used alongside standard care, and interest in the technology is growing.

Now the honest part. Laser therapy does not regrow cartilage, reverse arthritis or straighten a worn-out joint. The evidence base is still developing — results vary between studies, and between patients — so it should be understood as an adjunct: a low-risk tool layered onto proven treatment, not a replacement for it. For a bone-on-bone joint, laser may take the edge off symptoms, but it will not change the underlying mechanics, and no responsible surgeon should tell you otherwise. Laser supports the healing environment; it does not do the healing.

From the patient's side, it is about as undramatic as treatment gets. Sessions are given by clinic staff at the Honolulu clinic at Ala Moana. You sit or lie comfortably while the device is positioned over the joint. There are no needles, no incisions and no medication. Most people feel nothing, or mild warmth. A session takes 5–10 minutes, there is no recovery period, and you drive yourself home. Treatment is typically 2–3 sessions a week, for a course of 6–12 sessions, then reassessed based on how you respond: if your pain and swelling improve meaningfully, the series can be repeated or maintained; if not, we move to other tools rather than repeating what isn't working.

As with any light-based treatment, there are situations where it is not used — over active cancers, for example — which is part of the screening before a series begins.

Arthritis care works as a ladder, and laser therapy sits on the nonoperative rungs. The foundation is activity modification, targeted strengthening and weight optimization. Above that come medications and injections, and for the right patients, biologic options such as PRP. Laser therapy can be layered alongside any of these — its appeal is that it adds no drug interactions, no needles and essentially no recovery burden, which matters for patients whose medication lists or medical conditions already limit the usual anti-inflammatory options.

What it should never do is delay an honest conversation. If your arthritis has progressed to the point where nonoperative tools only rent you short stretches of relief, treating the underlying joint becomes the better investment — and the full range of options, from laser to joint replacement, is laid out in our guide to alternatives to knee replacement surgery. Good arthritis care means using every rung of the ladder for what it does best, and being straightforward about when it is time for the next one.

The best candidates are patients with mild to moderate arthritis who want more relief without more medication, patients working through a flare, and patients recovering from injury or surgery who want an extra tool against swelling and soreness. It is noninvasive and generally well tolerated, which makes the risk side of the ledger unusually short. Patients with advanced, bone-on-bone arthritis should set expectations accordingly: some symptom relief is possible, but structural problems ultimately need structural answers.

There are two ways to start. If you already know you want to try laser, self-pay patients can book a series directly — call (808) 439-6201; no consultation is needed first. If you'd rather know exactly what is causing the pain, start with an orthopedic consultation: an exam and X-rays establish exactly where your arthritis stands, and from there Dr. Morton decides with you whether laser therapy, injections, orthobiologics or something more definitive gives you the most relief for the effort. Call or book online to get that conversation started.

Workers' compensation covers MLS laser therapy; if your problem is work-related, ask the office how coverage applies and how to start. Regular health insurance generally does not cover it, so otherwise it is self-pay — and the office explains the cost before you commit to a series.