Knee osteoarthritis (OA) is one of the most common musculoskeletal conditions encountered by physical therapists, often presenting as chronic knee pain, a progressive disorder that limits mobility and function. Traditional rehabilitation approaches—manual therapy, exercise, and electrotherapy—offer varying degrees of relief, but many patients still experience persistent pain and disability.
Emerging research on high-intensity laser therapy (HILT) using the 1064 nm YAG laser suggests it may be a valuable adjunct to physical therapy interventions, offering deep tissue penetration, inflammation modulation, and pain relief without the side effects associated with medications or invasive procedures.

In this blog post, we explore the clinical evidence supporting the use of 1064 nm YAG laser therapy for knee OA and how it can be a game-changer for those suffering from this degenerative joint condition.
Why 1064 nm YAG Laser for Knee Osteoarthritis?
Unlike low-level laser therapy (LLLT), which provides superficial effects, 1064 nm YAG laser therapy delivers high-intensity energy capable of penetrating deep into the joint structures. This wavelength is particularly suited for treating knee OA due to:
- Deep Tissue Reach: The 1064 nm wavelength allows for greater penetration than shorter wavelengths (e.g., 810 nm, 980 nm), reaching synovial tissue, cartilage, and subchondral bone.
- Photobiomodulation Effects: Cellular response to laser therapy includes reduced inflammation, improved mitochondrial function, and enhanced tissue repair.
- Non-Invasive Pain Modulation: The analgesic effects of laser therapy are mediated through altered nociceptive signaling, endorphin release, and improved microcirculation, making it a valuable tool alongside manual therapy and exercise.
Clinical Evidence: How Effective Is 1064 nm YAG Laser for Knee Osteoarthritis?
Multiple randomized controlled trials (RCTs) and systematic reviews have demonstrated that 1064 nm YAG laser therapy provides significant improvements in pain relief, function, and inflammatory response in patients with knee OA.
1. Pain Reduction and Functional Gains
A randomized controlled trial published in Lasers in Medical Science investigated the effects of 1064 nm YAG laser therapy on knee OA patients undergoing physical therapy. The study compared laser therapy + exercise vs. exercise alone over a four-week period.
- Results: Patients receiving laser therapy + exercise demonstrated greater reductions in pain intensity (VAS scores) and improved functional scores (WOMAC index, timed-up-and-go test) compared to the exercise-only group.
- Long-Term Benefits: The pain-relieving effects were sustained for up to 12 weeks post-treatment, indicating a prolonged therapeutic effect beyond immediate symptom relief.
2. Anti-Inflammatory and Cartilage-Protective Effects
A 2023 clinical study evaluated the effect of 1064 nm YAG laser on inflammatory biomarkers (C-reactive protein [CRP] and interleukin-6 [IL-6]) in knee OA patients.
- Patients undergoing laser therapy demonstrated a significant reduction in CRP and IL-6 levels, supporting the hypothesis that laser therapy has an anti-inflammatory effect at the joint level.
- MRI imaging showed reduced synovial effusion and improved joint space preservation, suggesting that laser therapy may have disease-modifying potential rather than just symptomatic relief.
3. Comparing Laser for Knee Osteoarthritis with Traditional Physical Therapy Modalities
Another RCT compared 1064 nm YAG laser therapy with standard physical therapy interventions such as ultrasound, TENS, and manual therapy.
- While all treatment groups showed pain reduction and functional improvement, the laser therapy group had superior pain relief and faster functional recovery.
- Unlike TENS or ultrasound, which primarily provide symptomatic relief, 1064 nm laser therapy appears to influence deeper physiological processes, potentially altering disease progression.
Mechanisms of Action: How Does 1064 nm YAG Laser Therapy Work?
The benefits of 1064 nm YAG laser therapy in knee OA stem from multiple biophysical and neurophysiological effects, making it an effective adjunct for physical therapists.
✅ Deep Tissue Penetration
- The higher wavelength allows energy to reach deeper structures, including joint cartilage, menisci, and synovium, making it more effective for chronic OA compared to lower-wavelength lasers.
✅ Anti-Inflammatory Modulation
- Laser therapy downregulates pro-inflammatory cytokines (IL-1β, IL-6, TNF-α) while upregulating anti-inflammatory mediators (IL-10, TGF-β), leading to reduced joint inflammation and effusion.
- Decreased oxidative stress at the cellular level contributes to a reduction in cartilage degradation.
✅ Pain Modulation and Neural Effects
- Laser energy inhibits pain transmission by altering nociceptor function, leading to a reduced perception of pain.
- Increases in beta-endorphin release and enhanced peripheral nerve regeneration provide a neuroprotective effect beneficial in chronic OA cases.
✅ Cartilage Protection and Cellular Repair
- Some studies suggest that laser therapy stimulates chondrocytes, leading to increased production of collagen and extracellular matrix proteins, which may slow disease progression.
- The combination of cartilage preservation, pain relief, and improved biomechanics makes it a compelling intervention for physical therapists treating OA patients.
Clinical Application: How Can Physical Therapists Integrate 1064 nm YAG Laser Therapy?
For physical therapists considering adding laser therapy to their clinical practice, 1064 nm YAG laser therapy can be effectively combined with:
1. Exercise Therapy
- Laser therapy before exercise can reduce pain and improve range of motion, enhancing patient compliance and tolerance to rehabilitation exercises.
- Post-exercise laser therapy may assist in reducing post-activity inflammation and muscle soreness.
2. Manual Therapy & Myofascial Release
- Combining laser therapy with joint mobilization or soft tissue techniques may improve joint mechanics and pain modulation.
3. Non-Responders to Standard Treatment
- Patients with persistent pain despite traditional rehabilitation may benefit from laser therapy as an adjunct to conventional therapy.
4. Pre/Post-Surgical Rehabilitation
- Pre-operative laser therapy can reduce inflammation before knee replacement surgery, improving post-operative recovery.
- Post-surgical application can aid in reducing swelling, pain, and enhancing tissue healing.
Final Thoughts: A Powerful Adjunct for Physical Therapists
The 1064 nm YAG laser is an emerging evidence-based intervention that can significantly enhance physical therapy outcomes for knee OA patients.
✔️ Deep penetration reaches joint structures beyond the capabilities of LLLT or ultrasound
✔️ Clinically proven to reduce pain, inflammation, and improve function
✔️ Non-invasive, well-tolerated, and drug-free treatment modality
✔️ Can be seamlessly integrated into existing physical therapy protocols
For physical therapists seeking innovative, evidence-backed strategies to enhance knee OA rehabilitation, 1064 nm YAG laser therapy presents an exciting, clinically validated option.py could be the answer.
Want to Learn More?
At MED7, we specialise in advanced laser therapy for pain management. Get in touch today to see how 1064 nm YAG laser treatment can help your patients break the pain cycle. Or you can also learn more about the disease here