Photobiomodulation for fibromyalgia has been evaluated in multiple meta-analyses, systematic reviews, and randomized controlled trials across pain, physical function, fatigue, mood, and quality of life. A 2019 meta-analysis (Yeh et al.) of 9 RCTs with 325 patients found large, statistically significant effect sizes favoring photobiomodulation across all five symptom domains. A 2025 systematic review (Martín Pérez et al.) of 17 studies covering 857 participants found improvements across both localized and whole-body delivery methods. A 2025 umbrella review (Son et al.) synthesizing 204 RCTs across all health conditions rated the evidence for PBM's effect on fibromyalgia fatigue at moderate certainty — the highest tier achieved in the analysis — and found the largest effect size among musculoskeletal outcomes. And a 2026 systematic review (Ferreira et al.) of chronic pain RCTs found that PBM demonstrated significant pain reduction particularly in fibromyalgia and neuropathy.
This article is part of our complete guide to Red and Infrared Light Therapy for Fibromyalgia.
Key Takeaways
- Consistent positive direction across all reviews: Every meta-analysis and systematic review of PBM for fibromyalgia published to date has found a positive direction of effect. The 2019 Yeh meta-analysis found large effect sizes across five symptom domains. The 2025 Martín Pérez systematic review (17 studies, 857 participants) confirmed benefits. The 2025 Son umbrella review rated fibromyalgia fatigue evidence at moderate certainty — the highest tier in the analysis — with the largest effect size (eSMD 1.25) among musculoskeletal outcomes.
- Largest trial confirms multi-symptom benefit: The Silva et al. 2018 RCT (n=160), the largest photobiomodulation trial in fibromyalgia, found that both photobiomodulation alone and photobiomodulation combined with exercise produced significant improvements over placebo across pain, fibromyalgia impact, and quality of life, with the combined PBM + exercise group showing the strongest results across all outcomes.
What stands out about the fibromyalgia PBM evidence is the consistency. Every meta-analysis, every systematic review, every umbrella review points in the same direction. The effect sizes in the Yeh meta-analysis are large, not moderate, large, across pain, function, fatigue, depression, and anxiety. That breadth matters because fibromyalgia patients don't have one symptom. They have all of them at once. And the 2025 umbrella review describing fibromyalgia as among the conditions with the strongest evidentiary support across 204 RCTs, with the largest effect size for fatigue among musculoskeletal outcomes, that's not a marginal finding.— Dr. William Carter, MD
The 2019 Meta-Analysis
The Yeh et al. (2019) meta-analysis, published in Pain Physician, is the most comprehensive quantitative synthesis of fibromyalgia-specific photobiomodulation trials. Nine randomized controlled trials with 325 patients met the inclusion criteria.
The meta-analysis found large, statistically significant effect sizes favoring photobiomodulation over placebo: pain severity (SMD 1.18, 95% CI: 0.82–1.54), fibromyalgia impact as measured by FIQ (SMD 1.16, 95% CI: 0.64–1.69), tender point count (SMD 1.01, 95% CI: 0.49–1.52), fatigue, depression, and anxiety. All primary effect sizes exceeded the threshold for a large clinical effect by Cohen's convention (SMD > 0.8). The review concluded that photobiomodulation is an effective, safe, and well-tolerated treatment for fibromyalgia. (For the biological mechanisms behind these effects, see How Does Red Light Therapy Work.)
The 2025 Systematic Review
The Martín Pérez et al. (2025) systematic review, published in Applied Sciences, is the most recent fibromyalgia-specific review. Seventeen studies covering 857 participants were included. The review evaluated PBMT delivered via low-level laser, infrared, or LED-based devices, delivered either locally to tender points or to the whole body.
The review found improvements in pain, physical function, sleep quality, and overall well-being across both delivery methods. The authors concluded that PBMT has emerged as a promising non-pharmacological approach for fibromyalgia, while noting that variability in treatment parameters underscores the need for standardized protocols.
The 2025 Umbrella Review
The Son et al. (2025) umbrella review, published in Systematic Reviews, evaluated photobiomodulation across all health conditions using a modified GRADE framework. Fifteen meta-analyses encompassing 204 randomized controlled trials and over 9,000 participants were included, covering 35 health endpoints across 15 disease conditions.
No outcome across any condition reached high certainty. The evidence for PBM's effect on fibromyalgia fatigue was rated at moderate certainty — the highest tier achieved in the entire analysis — with an effect size of eSMD 1.25 (95% CI: 0.63–1.87), the largest among the musculoskeletal outcomes evaluated. Moderate certainty was also achieved for burning mouth syndrome pain, knee osteoarthritis disability, androgenetic alopecia, and cognitive function. Fibromyalgia was among the five conditions with the strongest evidentiary support.
The 2026 Chronic Pain Review
The Ferreira et al. (2026) systematic review, published in Frontiers in Integrative Neuroscience, evaluated PBM specifically for chronic pain conditions across 14 RCTs. The review found that most trials demonstrated significant pain reduction with PBM, particularly in fibromyalgia and neuropathy. The review noted a low incidence of adverse events, reinforcing the safety profile. The authors concluded that PBM has analgesic potential and a safe profile for managing chronic pain, especially in cases difficult to control with conventional therapies.
The Largest Fibromyalgia RCT: Silva et al. (2018)
The Silva et al. (2018) trial, published in Lasers in Medical Science, is the largest photobiomodulation RCT in fibromyalgia. One hundred and sixty women with fibromyalgia were randomized across four groups: placebo, photobiomodulation alone, exercise alone, and combined photobiomodulation plus exercise.
Photobiomodulation was delivered at 11 tender point locations using a cluster device with nine diodes (one super-pulsed infrared laser at 905nm, four red LEDs at 640nm, and four infrared LEDs at 875nm), delivering 39.3 J per site. The protocol ran twice weekly for 10 weeks.
Both photobiomodulation alone and exercise alone improved pain thresholds at multiple tender point sites. The combined therapy group showed the strongest results across all outcomes: pain (VAS), number of tender points, fatigue, fibromyalgia impact (FIQ), and quality of life (SF-36). The authors noted that a more substantial effect was observed for the combined therapy, in which pain relief was accomplished by improving VAS and FIQ scores as well as quality of life. The combined group significantly reduced the overall number of tender points beyond what either intervention alone achieved. (For how the different wavelengths in this device work together, see Infrared Light Benefits for Fibromyalgia. For a comparison of LED and laser delivery methods, see LED vs Laser Therapy for Fibromyalgia.)
The Ribeiro Trial (2023)
The Ribeiro et al. (2023) trial, published in the European Journal of Physical and Rehabilitation Medicine, randomized 90 fibromyalgia patients to photobiomodulation combined with static magnetic field (PBMT-sMF) or placebo, with blinding of patients, therapists, and assessors. PBMT-sMF was superior to placebo for tender point count (p<0.0001) and pain intensity (p<0.0001). The fibromyalgia impact questionnaire also showed significant improvement, with p<0.001 at end of treatment and p<0.01 at follow-up. The trial concluded that PBMT-sMF supports its use in fibromyalgia patients and may be considered an important adjuvant to existing treatment regimens.
The Whole-Body PBM Trials
The University of Granada conducted a series of studies investigating whole-body photobiomodulation for fibromyalgia. The 2022 short-term trial (Navarro-Ledesma et al.), a triple-blinded RCT with 42 fibromyalgia patients, found significant improvements in pain (p≤0.001) and quality of life (p≤0.001) compared to placebo. The 2024 follow-up (Navarro-Ledesma et al.) tracked the same patient cohort for six months and found that quality of life remained significantly improved at every assessment point from mid-treatment through six months post-treatment — the most consistently sustained outcome in the trial. Self-efficacy and kinesiophobia showed significant improvements from two weeks post-treatment onward, maintained at six months. Pain was significantly reduced at treatment completion and at the six-month follow-up. That durable benefit across multiple symptom dimensions is clinically meaningful: symptom recurrence after treatment cessation is one of the most persistent challenges of fibromyalgia management, and a therapy that produces improvements lasting months beyond the treatment period addresses a real limitation of existing approaches.
The Fitzmaurice et al. (2023) feasibility trial at the University of Birmingham independently confirmed positive changes across all symptom domains with whole-body PBM, sustained at 24 weeks. A 2024 qualitative analysis (Fitzmaurice et al.) of the same patients identified a process the authors termed "recomposition" — characterized by increased motivation, improved confidence, and feeling like their former selves — language reflecting genuine re-engagement with daily life after prolonged symptom burden. (For the safety profile of whole-body PBM, see Photobiomodulation Safety for Fibromyalgia.)
The Network Meta-Analysis
The Gikaro et al. (2023) network meta-analysis, published in Clinical Rehabilitation, evaluated 54 studies and 3,045 participants across electrophysical agents for fibromyalgia. The review found low to moderate quality evidence that laser therapy ranked among the most effective electrophysical agents for fibromyalgia. This study provides important comparative context: across a broad landscape of physical modalities, PBM consistently ranks at or near the top.
How PBM Compares to Pharmacological Treatment
The comparison is informative. A 2024 overview of Cochrane Reviews (Moore et al.) of pharmacological therapies for fibromyalgia found that only approximately 1 in 10 patients achieves substantial pain relief from the three approved drug classes (pregabalin, duloxetine, milnacipran), with no evidence of efficacy beyond six months. The side effect profiles of these medications, including weight gain, sedation, dizziness, nausea, and cognitive dulling, cause substantial discontinuation rates.
In the PBM trial literature, no serious adverse events have been reported across the 17 studies in the most recent systematic review. The effect sizes in the Yeh meta-analysis are large across five symptom domains. Quality of life improvements persisted at every assessment through six months post-treatment in the whole-body delivery trial. And the therapy can be combined with exercise — the only intervention with a "strong" recommendation from the EULAR guidelines (Macfarlane et al., 2017) — with additive benefits demonstrated in the largest trial.
A JAMA Internal Medicine meta-analysis of 224 trials and 29,962 participants (Mascarenhas et al., 2021) found that exercise and multicomponent therapies showed the strongest associations with pain reduction and quality of life improvement in fibromyalgia. PBM's demonstrated synergy with exercise in the Silva trial places it squarely within the evidence-favored multimodal approach. (For the biological mechanisms, see Red Light Benefits for Fibromyalgia and Infrared Light Benefits for Fibromyalgia. For safety data, see Photobiomodulation Safety for Fibromyalgia.)
