Effects of photobiomodulation on multiple health outcomes: an umbrella review of randomized clinical trials

doi:10.1186/s13643-025-02902-3

. 2025 Aug 6;14(1):160.

doi: 10.1186/s13643-025-02902-3.

Effects of photobiomodulation on multiple health outcomes: an umbrella review of randomized clinical trials

Yejun Son^#^{1

2}, Hyeri Lee^#^{1

3}, Seungyeong Yu^#⁴, Hyeon Jin Kim^{1

2}, Jaeyu Park^{1

2}, Selin Woo¹, Hayeon Lee^{1

5}, Guillaume Fond⁶, Laurent Boyer⁶, Masoud Rahmati^{6

7

8}, Lee Smith^{9

10}, Guillermo F López Sánchez¹¹, Elena Dragioti¹², Jiseung Kang^#^{13

14

15}, Tae Kim^#¹⁶, Dong Keon Yon^#^{17

18

19

20}

Affiliations

¹ Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea.
² Department of Precision Medicine, Kyung Hee University College of Medicine, Seoul, South Korea.
³ Department of Regulatory Science, Kyung Hee University, Seoul, South Korea.
⁴ Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, 123, Cheomdangwagi-Ro, Buk-Gu, Gwangju, Gwangju, 61005, South Korea.
⁵ Department of Electronics and Information Convergence Engineering, Kyung Hee University, Yongin, South Korea.
⁶ Research Centre On Health Services and Quality of Life, Assistance Publique-Hopitaux de Marseille, Aix Marseille University, Marseille, France.
⁷ Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran.
⁸ Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-E-Asr University of Rafsanjan, Rafsanjan, Iran.
⁹ Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK.
¹⁰ Department of Public Health, Faculty of Medicine, Biruni University, Istanbul, Turkey.
¹¹ Department of Public Health Sciences, Division of Preventive Medicine and Public Health, School of Medicine, University of Murcia, Murcia, Spain.
¹² Research Laboratory Psychology of Patients, Families, and Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina, Greece.
¹³ Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA.
¹⁴ Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.
¹⁵ School of Health and Environmental Science, College of Health Science, Korea University, Seoul, South Korea.
¹⁶ Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, 123, Cheomdangwagi-Ro, Buk-Gu, Gwangju, Gwangju, 61005, South Korea. tae-kim@gist.ac.kr.
¹⁷ Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea. yonkkang@gmail.com.
¹⁸ Department of Precision Medicine, Kyung Hee University College of Medicine, Seoul, South Korea. yonkkang@gmail.com.
¹⁹ Department of Regulatory Science, Kyung Hee University, Seoul, South Korea. yonkkang@gmail.com.
²⁰ Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, 23 Kyungheedae-Ro, Dongdaemun-Gu, Seoul, 02447, South Korea. yonkkang@gmail.com.

^# Contributed equally.

PMID: 40770824
PMCID: PMC12326686
DOI: 10.1186/s13643-025-02902-3

Effects of photobiomodulation on multiple health outcomes: an umbrella review of randomized clinical trials

Yejun Son et al. Syst Rev. 2025.

. 2025 Aug 6;14(1):160.

doi: 10.1186/s13643-025-02902-3.

Authors

Affiliations

¹ Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea.
² Department of Precision Medicine, Kyung Hee University College of Medicine, Seoul, South Korea.
³ Department of Regulatory Science, Kyung Hee University, Seoul, South Korea.
⁴ Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, 123, Cheomdangwagi-Ro, Buk-Gu, Gwangju, Gwangju, 61005, South Korea.
⁵ Department of Electronics and Information Convergence Engineering, Kyung Hee University, Yongin, South Korea.
⁶ Research Centre On Health Services and Quality of Life, Assistance Publique-Hopitaux de Marseille, Aix Marseille University, Marseille, France.
⁷ Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran.
⁸ Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-E-Asr University of Rafsanjan, Rafsanjan, Iran.
⁹ Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK.
¹⁰ Department of Public Health, Faculty of Medicine, Biruni University, Istanbul, Turkey.
¹¹ Department of Public Health Sciences, Division of Preventive Medicine and Public Health, School of Medicine, University of Murcia, Murcia, Spain.
¹² Research Laboratory Psychology of Patients, Families, and Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina, Greece.
¹³ Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA.
¹⁴ Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.
¹⁵ School of Health and Environmental Science, College of Health Science, Korea University, Seoul, South Korea.
¹⁶ Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, 123, Cheomdangwagi-Ro, Buk-Gu, Gwangju, Gwangju, 61005, South Korea. tae-kim@gist.ac.kr.
¹⁷ Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea. yonkkang@gmail.com.
¹⁸ Department of Precision Medicine, Kyung Hee University College of Medicine, Seoul, South Korea. yonkkang@gmail.com.
¹⁹ Department of Regulatory Science, Kyung Hee University, Seoul, South Korea. yonkkang@gmail.com.
²⁰ Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, 23 Kyungheedae-Ro, Dongdaemun-Gu, Seoul, 02447, South Korea. yonkkang@gmail.com.

^# Contributed equally.

PMID: 40770824
PMCID: PMC12326686
DOI: 10.1186/s13643-025-02902-3

Abstract

Background: Photobiomodulation (PBM) is a non-invasive therapy increasingly used for pain, inflammation, and tissue repair, yet a comprehensive synthesis of its effectiveness across multiple health outcomes remains lacking. Herein, we aimed to systematically assess the clinical effects and strength of evidence for PBM across a wide range of health outcomes using data from existing meta-analyses of randomized controlled trials (RCTs).

Methods: We conducted an umbrella review of meta-analyses of RCTs, searching five databases up to December 8, 2023. Two reviewers independently assessed methodological quality using AMSTAR 2 and evaluated certainty of evidence using a modified GRADE framework. Pooled effect sizes were recalculated as equivalent standardized mean differences (eSMD) with 95% confidence intervals (CI). The study was registered with PROSPERO (CRD42023495502).

Results: A total of 15 meta-analyses encompassing 204 RCTs and over 9000 participants were included, covering 35 health endpoints across 15 disease conditions. PBM showed significant effects for 12 outcomes, with moderate certainty of evidence supporting improvements in burning mouth syndrome (pain reduction, eSMD - 0.92 [95% CI - 1.38 to - 0.46]), knee osteoarthritis (disability, 0.65 [0.14 to 1.15]), fibromyalgia (fatigue, 1.25 [0.63 to 1.87]), androgenetic alopecia (hair density, 1.32 [1.00 to 1.63]), and cognitive function (0.49 [0.14 to 0.84]). Most other outcomes exhibited low or very low certainty due to heterogeneity or small-study effects. P-curve and funnel plot analyses indicated evidential value for several outcomes, though potential publication bias was identified in some.

Conclusions: PBM appeared beneficial for some health conditions, such as the strongest support for fibromyalgia, osteoarthritis-related disability, and cognitive impairment. However, given the overall low-to-moderate certainty of evidence for most endpoints, further high-quality trials and standardization of PBM protocols are warranted before widespread clinical adoption.

Keywords: Health outcomes; Low-level light therapy; Photobiomodulation; Randomized controlled trials; Umbrella review.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: An ethics statement is not applicable because this study is based exclusively on published literature. In its reporting, this manuscript follows PRISMA 2020 Guideline. Consent for publication: This article does not contain any studies with human participants or animals performed by any of the authors. This paper is a systematic review of published literature, so ethical approval and consent were not required. Competing interests: The authors declare no competing interests.

Figures

**Fig. 1**
PRISMA 2020 flow diagram. Abbreviations: RCT, randomized controlled trials

**Fig. 2**
Point estimates of health outcomes following PBM intervention. Abbreviations: CI, confidence interval; eSMD, equivalent standard mean difference; FIQ, fibromyalgia impact questionnaire; PBM, photobiomodulation; THI, Tinnitus Handicap Inventory; VAS, visual analogue scale

See this image and copyright information in PMC

References

1. Herkes G, McGee C, Liebert A, Bicknell B, Isaac V, Kiat H, McLachlan CS. A novel transcranial photobiomodulation device to address motor signs of Parkinson’s disease: a parallel randomised feasibility study. EClinicalMedicine. 2023;66:102338. - PMC - PubMed
1. Figueiro Longo MG, Tan CO, Chan ST, Welt J, Avesta A, Ratai E, Mercaldo ND, Yendiki A, Namati J, Chico-Calero I, et al. Effect of transcranial low-level light therapy vs sham therapy among patients with moderate traumatic brain injury: a randomized clinical trial. JAMA Netw Open. 2020;3(9):e2017337. - PMC - PubMed
1. Behroozian T, Goldshtein D, Ryan Wolf J, van den Hurk C, Finkelstein S, Lam H, Patel P, Kanee L, Lee SF, Chan AW, et al. MASCC clinical practice guidelines for the prevention and management of acute radiation dermatitis: part 1) systematic review. EClinicalMedicine. 2023;58:101886. - PMC - PubMed
1. Pigatto GR, Silva CS, Parizotto NA. Photobiomodulation therapy reduces acute pain and inflammation in mice. J Photochem Photobiol B. 2019;196:111513. - PubMed
1. Murphy MP, Bayir H, Belousov V, Chang CJ, Davies KJA, Davies MJ, Dick TP, Finkel T, Forman HJ, Janssen-Heininger Y, et al. Guidelines for measuring reactive oxygen species and oxidative damage in cells and in vivo. Nat Metab. 2022;4(6):651–62. - PMC - PubMed

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[1] Herkes G, McGee C, Liebert A, Bicknell B, Isaac V, Kiat H, McLachlan CS. A novel transcranial photobiomodulation device to address motor signs of Parkinson’s disease: a parallel randomised feasibility study. EClinicalMedicine. 2023;66:102338. - PMC - PubMed

[2] Herkes G, McGee C, Liebert A, Bicknell B, Isaac V, Kiat H, McLachlan CS. A novel transcranial photobiomodulation device to address motor signs of Parkinson’s disease: a parallel randomised feasibility study. EClinicalMedicine. 2023;66:102338. - PMC - PubMed

[3] Figueiro Longo MG, Tan CO, Chan ST, Welt J, Avesta A, Ratai E, Mercaldo ND, Yendiki A, Namati J, Chico-Calero I, et al. Effect of transcranial low-level light therapy vs sham therapy among patients with moderate traumatic brain injury: a randomized clinical trial. JAMA Netw Open. 2020;3(9):e2017337. - PMC - PubMed

[4] Figueiro Longo MG, Tan CO, Chan ST, Welt J, Avesta A, Ratai E, Mercaldo ND, Yendiki A, Namati J, Chico-Calero I, et al. Effect of transcranial low-level light therapy vs sham therapy among patients with moderate traumatic brain injury: a randomized clinical trial. JAMA Netw Open. 2020;3(9):e2017337. - PMC - PubMed

[5] Behroozian T, Goldshtein D, Ryan Wolf J, van den Hurk C, Finkelstein S, Lam H, Patel P, Kanee L, Lee SF, Chan AW, et al. MASCC clinical practice guidelines for the prevention and management of acute radiation dermatitis: part 1) systematic review. EClinicalMedicine. 2023;58:101886. - PMC - PubMed

[6] Behroozian T, Goldshtein D, Ryan Wolf J, van den Hurk C, Finkelstein S, Lam H, Patel P, Kanee L, Lee SF, Chan AW, et al. MASCC clinical practice guidelines for the prevention and management of acute radiation dermatitis: part 1) systematic review. EClinicalMedicine. 2023;58:101886. - PMC - PubMed

[7] Pigatto GR, Silva CS, Parizotto NA. Photobiomodulation therapy reduces acute pain and inflammation in mice. J Photochem Photobiol B. 2019;196:111513. - PubMed

[8] Pigatto GR, Silva CS, Parizotto NA. Photobiomodulation therapy reduces acute pain and inflammation in mice. J Photochem Photobiol B. 2019;196:111513. - PubMed

[9] Murphy MP, Bayir H, Belousov V, Chang CJ, Davies KJA, Davies MJ, Dick TP, Finkel T, Forman HJ, Janssen-Heininger Y, et al. Guidelines for measuring reactive oxygen species and oxidative damage in cells and in vivo. Nat Metab. 2022;4(6):651–62. - PMC - PubMed

[10] Murphy MP, Bayir H, Belousov V, Chang CJ, Davies KJA, Davies MJ, Dick TP, Finkel T, Forman HJ, Janssen-Heininger Y, et al. Guidelines for measuring reactive oxygen species and oxidative damage in cells and in vivo. Nat Metab. 2022;4(6):651–62. - PMC - PubMed

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Effects of photobiomodulation on multiple health outcomes: an umbrella review of randomized clinical trials

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Effects of photobiomodulation on multiple health outcomes: an umbrella review of randomized clinical trials

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