Red and Infrared Light Therapy for Fibromyalgia: What the Research Shows

What Fibromyalgia Does to the Body

Fibromyalgia is a central nervous system disorder characterized by widespread musculoskeletal pain, profound fatigue, unrefreshing sleep, and cognitive dysfunction. The underlying biology involves multiple disrupted systems operating at once. Inflammation markers are significantly elevated in fibromyalgia patients (O'Mahony et al., 2021, in Rheumatology), a persistent inflammatory component that standard pain medications do not address. The body's built-in system for dampening pain signals is also compromised, with a meta-analysis in The Journal of Pain showing measurable impairment across fibromyalgia populations (O'Brien et al., 2018). And nearly half of patients show evidence of small fiber pathology: detectable structural or functional abnormalities in the smallest nerve fibers (Grayston et al., 2019, in Seminars in Arthritis and Rheumatism).

At the cellular level, fibromyalgia involves documented energy production problems. Cellular energy compound concentrations are significantly lower in fibromyalgia muscle tissue, accompanied by reduced blood flow (Gerdle et al., 2020). Skin biopsies tell a consistent story: oxidative stress, mitochondrial dysfunction, and inflammation confirmed in fibromyalgia patients (Sánchez-Domínguez et al., 2015). CoQ10 levels in blood cells run at roughly 40–50% of normal (Cordero et al., 2010), a deficiency severe enough to impair the basic energy cycle that every cell depends on.

The condition disproportionately affects women, though modern estimates place the ratio closer to 60:40 rather than the outdated 9:1 figure from older studies, with mean onset between 30 and 50 years. What makes current treatment inadequate is not that nothing helps at all, but that nothing helps enough. The EULAR guidelines (Macfarlane et al., 2016) issued only one "strong" recommendation across all interventions: exercise. Every pharmacological therapy received a weaker rating. Patients need options that address multiple symptom domains simultaneously, with a tolerability profile that allows sustained use.

The multi-system nature of fibromyalgia has practical implications for treatment selection.

How Red Light Therapy Works for Fibromyalgia

Red light therapy at wavelengths typically between 630 and 660nm works by stimulating energy production inside cells, triggering downstream effects: reduced inflammatory signaling, lower oxidative stress, and enhanced tissue repair. For fibromyalgia specifically, this addresses the mitochondrial dysfunction that multiple studies have directly measured in patients, including depleted cellular energy compounds and CoQ10 deficiency at 40–50% of normal levels. A 2025 review in Frontiers in Pain Research confirmed that oxidative stress and mitochondrial dysfunction are now recognized as key contributors to fibromyalgia's underlying biology. (For the complete evidence on red light mechanisms, see Red Light Benefits for Fibromyalgia.)

How Infrared Light Therapy Works for Fibromyalgia

Near-infrared light at wavelengths between 808 and 905nm penetrates deeper into tissue, reaching the muscles, joints, and nerve fibers where fibromyalgia pain originates. The largest fibromyalgia-specific RCT used a multi-wavelength device combining a 905nm super-pulsed laser with 640nm red LEDs and 875nm infrared LEDs, delivered to 11 tender point locations. Near-infrared wavelengths also modulate pain signaling at the peripheral nerve level. Separately, nearly half of fibromyalgia patients show evidence of small fiber pathology, though no study has yet tested photobiomodulation specifically on small fiber outcomes in this population. (For the complete evidence on infrared light mechanisms, see Infrared Light Benefits for Fibromyalgia.)

What the Clinical Evidence Shows

The clinical evidence for photobiomodulation in fibromyalgia spans multiple meta-analyses, systematic reviews, and individual randomized controlled trials.

Meta-Analytic Evidence

Large, statistically significant improvements across all five major fibromyalgia symptom domains. That is the headline finding from the most comprehensive quantitative synthesis of PBM trials for this condition. The 2019 meta-analysis by Yeh et al., published in Pain Physician, pooled 9 RCTs with 325 patients and found effect sizes of 1.18 for pain, 1.16 for physical function (FIQ scores), 1.40 for fatigue, 1.46 for depression, and 1.46 for anxiety. Every one of those exceeds the standard threshold for a large effect. Every result was statistically reliable. Calling this the "most comprehensive" synthesis might be generous for a meta-analysis of nine trials, but it remains the only quantitative pooling of fibromyalgia-specific PBM outcomes across all five symptom domains. The authors acknowledged low-to-middle methodological quality across included studies; the direction and magnitude of the pooled results held regardless.

The five-domain improvements from the Yeh meta-analysis gain additional weight from the broadest overview of photobiomodulation evidence published to date. The 2025 umbrella review by Son et al., published in Systematic Reviews, evaluated PBM across all health conditions and rated fibromyalgia fatigue reduction at moderate certainty, with the largest effect size (eSMD 1.25) among musculoskeletal outcomes. No outcome in the entire review reached high certainty. Moderate was the ceiling, and fibromyalgia fatigue shared it with only four other condition-outcome pairs. The review stated directly that PBM showed "the strongest support for fibromyalgia, osteoarthritis-related disability, and cognitive impairment."

Individual RCTs and Durability

The largest individual RCT enrolled 160 women with fibromyalgia and randomized them across four groups: photobiomodulation, exercise, combined therapy, and control (Silva et al., 2018). Over 10 weeks, both PBM and exercise improved pain thresholds across multiple tender points. The combined therapy group showed the most substantial effects, with improvements in VAS and FIQ pain scores alongside quality of life gains.

Most pain interventions show declining effect as time passes from the last treatment session. A triple-blinded RCT by Navarro-Ledesma et al. (2024), published in Frontiers in Neuroscience, challenged that expectation. Forty-two fibromyalgia patients received whole-body photobiomodulation and were followed for six months. Quality of life and self-efficacy improvements persisted at the six-month mark (both p < 0.001). Pain reached significance at six months (p = 0.001) but was not significant at three months, an uneven recovery pattern that suggests something more complex than simple symptom masking during active treatment.

Patient-Reported Outcomes

Beyond the quantitative data, the patient experience reinforces the clinical picture. A 2025 scoping review covering 702 participants found consistent reports of reduced pain, lower medication use, less stiffness and fatigue, and improved memory, alongside increased energy, motivation, and engagement in daily life. The accompanying qualitative study by Fitzmaurice et al. (2024) documented something the researchers termed "recomposition": fibromyalgia patients undergoing whole-body PBM described a positive spiral from dysfunction back toward identity recovery. They reported feeling like their "old self," a phrase that carries clinical weight when it comes from patients whose primary complaint is the loss of who they used to be.

(For the complete clinical evidence, see PBM for Fibromyalgia: Clinical Evidence.)

Is Light Therapy Safe for Fibromyalgia Patients?

Across the studies reviewed in the 2025 systematic review (Martín Pérez et al.), no serious adverse events were attributed to photobiomodulation therapy. The 2026 systematic review by Ferreira et al. found that 13 of 14 included chronic pain trials reported zero adverse events; the single exception described only low-grade transient effects (local warmth, mild discomfort) that resolved without intervention. Individual fibromyalgia RCTs, including the 160-patient Silva trial and the 90-patient triple-blinded Ribeiro trial, reported no treatment-related adverse events. (For the complete safety evidence, see Photobiomodulation Safety for Fibromyalgia.)

Can You Use an LED Device Instead of a Clinical Laser?

The largest fibromyalgia RCT (Silva et al., 2018) used a multi-wavelength cluster combining a super-pulsed laser with red and infrared LEDs, directly demonstrating that LED-inclusive devices produce significant clinical outcomes in this patient population. A network meta-analysis of 54 studies and 3,045 patients (Gikaro et al., 2023) found that laser therapy held the highest ranking for pain among electrophysical agents, though statistical significance was not reached for the between-group comparison. That distinction between ranking and confirmed superiority matters for interpreting the evidence.

The most comprehensive peer-reviewed analysis of the question comes from Heiskanen & Hamblin (2018), out of Massachusetts General Hospital and Harvard. Their conclusion: photobiomodulation does not appear to depend on lasers or coherence, and LED therapy appears similarly effective as laser therapy for superficial tissue applications at matched wavelength and dose. The biological mechanisms are wavelength-dependent; the cellular response depends on the wavelength and energy delivered to tissue, not the delivery device. For deeper tissue targets, laser devices may hold an advantage through focused beam delivery and higher energy concentration. For the superficial and moderate-depth applications typical of fibromyalgia tender point treatment, LED-based delivery is supported by the available evidence. (For the complete LED vs. laser evidence, see LED vs. Laser for Fibromyalgia.)

How Current Options Compare

Current frontline treatments for fibromyalgia have significant limitations. The three FDA-approved drug classes (pregabalin, duloxetine, and milnacipran) produce substantial pain relief (defined as at least 50% pain intensity reduction) in only approximately 1 in 10 patients, with side effects including sedation, weight gain, nausea, and dizziness. The EULAR guidelines issued a "strong" recommendation only for exercise, the sole intervention to reach that threshold. Within a JAMA Internal Medicine meta-analysis of 224 trials and 29,962 participants, exercise-based and multicomponent therapies showed the strongest associations with reduced pain and improved quality of life. Photobiomodulation's demonstrated ability to enhance exercise outcomes when used in combination, as shown in the Silva trial, positions it as a complementary tool within the multimodal approach that the evidence favors. A 2025 RCT by Kelini et al. reinforced this finding: high-intensity laser therapy combined with exercise produced significant improvements across all measured outcomes compared to exercise alone (all p < 0.001) in 52 women with fibromyalgia.

Conclusion

Red and infrared light therapy works at the cellular level to address multiple biological drivers of fibromyalgia simultaneously. It is not a cure. It does not replace medical management. But the research shows it is one of the most evidence-backed non-pharmacological options available, with a safety profile that allows sustained use and a multi-symptom benefit profile that the approved medications cannot match. For someone managing fibromyalgia who wants to know whether the science supports this therapy, it does.

For a deeper understanding of how red light therapy works for other pain conditions that commonly overlap with fibromyalgia, see our reviews of red light therapy for back pain and how red light therapy works.