Class IV Laser Therapy for Foot & Ankle Pain

What is Class IV Laser Therapy?

At The Podiatry Clinic, we use a medical Class IV diode laser using 810 nm and 980 nm wavelengths.

These wavelengths allow laser energy to be delivered into the tissues using carefully selected treatment settings.

Unlike surgical lasers that are designed to cut or remove tissue, the treatment technique used for musculoskeletal pain is non-invasive. The laser applicator is moved over or applied to the treatment area without making an incision.

Treatment parameters are selected according to the condition, tissue being treated and your individual treatment plan.

How does Class IV laser therapy work?

Laser therapy delivers light energy into the tissues where it interacts with cells and biological processes.

This process is often referred to as photobiomodulation.

The treatment is thought to influence several processes involved in pain and tissue recovery, including:

• cellular activity and energy metabolism
• local circulation
• biological processes involved in tissue repair
• modulation of inflammatory processes
• pain signalling; and
• tissue recovery and remodelling.

The aim is to help create an environment that supports pain reduction and recovery, particularly when laser therapy is combined with appropriate rehabilitation.

Why has Class IV laser therapy been recommended?

Laser therapy may be considered for a range of foot and ankle problems, including selected:

• tendon problems
• plantar heel pain / plantar fasciopathy
• muscle and soft-tissue injuries
• joint pain and osteoarthritis
• ligament and soft-tissue injuries
• areas of persistent pain or sensitivity; and
• other musculoskeletal conditions where your podiatrist considers laser therapy appropriate.

Your podiatrist will have considered your diagnosis, clinical findings, how long you have had the problem, previous treatment and individual circumstances before recommending laser therapy.

What happens during treatment?

Your podiatrist will identify the area requiring treatment.

Depending on your condition, this may be based on your clinical examination and, where appropriate, ultrasound findings.

You and the clinician will wear appropriate protective laser eyewear throughout treatment.

The laser applicator is then used over the treatment area.

Treatment parameters are selected according to:

• the condition being treated
• the size and location of the treatment area
• the depth of the affected tissue
• your symptoms
• your individual tolerance; and
• your response to treatment.

The applicator may be moved over a broader treatment area rather than treating only the exact point where you experience pain.

Treatment itself normally takes a relatively short period and does not require an injection or local anaesthetic.

What does laser therapy feel like?

Class IV laser therapy is generally comfortable.

Most patients experience a gentle or gradually increasing warmth in the treatment area.

Because Class IV laser can deliver significant energy into tissue, your podiatrist will continually move and monitor the applicator and adjust the treatment where required.

Please tell your podiatrist immediately if the area becomes excessively hot or uncomfortable.

Treatment should not normally be painful.

How many treatments will I need?

The number and frequency of treatments depend on your condition and individual response.

A course of approximately 6 treatments is commonly recommended.

Depending on the condition, treatments may initially be provided more frequently and then spaced further apart as symptoms improve.

Appointments may therefore be:

• twice weekly
• weekly; or
• approximately every two weeks,

depending on your diagnosis, stage of recovery and overall treatment plan.

Your podiatrist will recommend an appropriate schedule and review your response throughout the course.

What results can I expect?

Laser therapy has been studied across a range of musculoskeletal conditions, with clinical research demonstrating potential improvements in pain and function in appropriately selected patients.

The response varies according to the condition being treated, how long the problem has been present, the treatment parameters used and individual patient factors.

Some patients notice an improvement relatively early in their treatment course, while for others the response develops more gradually.

Laser therapy is not a guaranteed cure, but it can be a useful non-invasive treatment to help reduce symptoms and support rehabilitation in selected foot and ankle conditions.

Your podiatrist will explain what improvement is realistically expected for your particular condition.

Laser therapy works best as part of a treatment plan

For many musculoskeletal conditions, simply reducing pain does not address all of the factors contributing to the problem.

Your treatment plan may therefore also include:

• progressive strengthening and loading exercises
• mobility or flexibility work
• activity modification
• footwear advice
• taping or bracing
• orthotics where clinically appropriate
• gait or pressure analysis
• management of training or occupational load; and
• other treatments where appropriate.

Laser therapy is designed to support your recovery and rehabilitation, rather than replace these important components of treatment.

Following the rehabilitation programme recommended by your podiatrist remains an important part of achieving a good outcome.

What happens after treatment?

There is normally little or no downtime following Class IV laser therapy.

Most patients can walk normally and continue their usual everyday activities immediately after treatment.

You may occasionally notice:

• temporary warmth
• mild redness
• temporary sensitivity; or
• a short-lived change in your symptoms.

Your podiatrist may recommend temporary modification of strenuous activity depending on the condition being treated, but this is usually because of the underlying injury rather than the laser treatment itself.

When should I expect improvement?

Response varies between patients.

Some people notice improvement during the early stages of their treatment course. For others, changes become more noticeable after several treatments or as rehabilitation progresses.

For longstanding tendon, joint and soft-tissue problems, recovery can take time.

Even if pain improves relatively quickly, it is important to continue your rehabilitation programme because reduced pain does not necessarily mean that the underlying tissue has completed its recovery.

Your podiatrist will monitor both your symptoms and function during treatment.

What are the potential benefits?

Potential benefits of Class IV laser therapy include:

• non-invasive treatment
• no injection or surgical incision
• generally comfortable treatment
• short treatment sessions
• little or no downtime
• ability to treat a range of musculoskeletal tissues
• potential reduction in pain
• potential improvement in function
• ability to combine treatment with rehabilitation; and
• an additional treatment option for persistent conditions that have not responded sufficiently to initial management.

What are the possible side effects and risks?

Class IV laser therapy is generally well tolerated when appropriately performed.

Most patients experience no significant side effects.

Temporary effects may include:

• warmth in the treatment area
• mild redness
• temporary sensitivity; or
• a temporary change or increase in symptoms.

Because Class IV laser therapy delivers relatively high levels of energy, there is a potential risk of excessive heating, blistering or superficial thermal injury/burn if tissue becomes overheated.

Your podiatrist uses controlled treatment settings and monitors the treatment area to minimise this risk.

Class IV laser can cause serious eye injury if appropriate safety precautions are not followed. Protective eyewear must therefore be worn by everyone in the treatment area while the laser is operating.

Is Class IV laser therapy suitable for everyone?

Laser therapy is not appropriate for every patient or every treatment area.

Your podiatrist will consider your medical history, medications and the area being treated before recommending treatment.

Particular consideration may be required where there is:

• pregnancy
• known or suspected malignancy within the treatment area
• active bleeding
• significant loss of sensation
• significant circulation problems
• active infection or certain skin conditions
• photosensitivity
• medication that may increase sensitivity to light
• recent surgery or another procedure; or
• another medical condition that may affect treatment.

The laser is also not applied directly over the eyes or other areas where treatment would be inappropriate.

Please tell your podiatrist about any significant change in your health or medication during your treatment course.

What are the alternatives?

Your alternatives depend on the condition being treated.

These may include:

• rehabilitation and progressive loading
• activity modification
• footwear changes
• taping or bracing
• orthotics where appropriate
• focused shockwave therapy
• radial shockwave therapy
• injection therapy where clinically appropriate
• medication
• further imaging or specialist assessment; or
• continuing with conservative management without laser therapy.

Your podiatrist can explain which alternatives are relevant to your particular condition.

How much does Class IV Laser Therapy cost?

Single treatment: £85

Course of 6 treatments: £450

Your podiatrist will recommend the most appropriate treatment frequency and course according to your condition and response.

When should I contact the clinic?

Significant reactions following laser therapy are uncommon.

Please contact us if you experience:

• unexpected or significant pain
• persistent redness
• blistering or a suspected burn
• significant swelling
• unexpected changes to the skin
• symptoms substantially different from your usual condition; or
• anything else that concerns you following treatment.

Your next step

If you have already booked your treatment

Please attend your appointment as arranged.

Continue any exercises, loading programme or other treatment recommended by your podiatrist unless you have been advised otherwise.

If there has been a significant change in your health, medication or symptoms, please tell your podiatrist before treatment.

If Class IV laser therapy has been recommended but you have not yet booked

You can book your Laser Therapy – Foot & Ankle Pain – Follow-Up appointment when you are ready to proceed.

£85 per treatment | Course of 6 treatments £450

Important information

This information sheet supports the discussion you have had with your podiatrist and is intended to help you make an informed decision about treatment. It does not replace individual clinical advice.

Class IV laser is a non-invasive treatment that may help reduce pain and support recovery in selected musculoskeletal conditions. It is normally used as part of a structured treatment and rehabilitation programme.

Individual responses vary and improvement cannot be guaranteed.

Before each treatment, your podiatrist will confirm that laser therapy remains appropriate and you will have an opportunity to discuss any questions or concerns.

The Podiatry Clinic