Shoulder / Rotator Cuff Tendonitis Treatment Using LLLT/PBMT

Low Level Laser Therapy (LLLT), also known as Photobiomodulation Therapy (PBMT), uses red and near-infrared light applied over targeted areas. In our clinic it is used as part of a GP-led treatment approach for selected musculoskeletal pain and injury presentations, including shoulder pain and rotator cuff-related pain.

PBMT/LLLT is non-invasive and generally well tolerated. Suitability and response vary, and treatment recommendations depend on the diagnosis, severity, duration of symptoms and individual clinical factors. PBMT/LLLT has been studied for a range of musculoskeletal pain and injury conditions. See our references page for supporting literature.

Shoulder soft tissue pain presentations can include:

  • Rotator cuff injury, tendonitis, tendinopathy, 
  • Supraspinatus, subscapularis etc tears
  • Impingement  
  • Overuse or repetitive strain injuries
  • Bursitis: shoulder, subacromial, subdeltoid
  • Frozen shoulder or adhesive capsulitis

Gentle. Drug-Free. Evidence-Informed

shoulder-pain

Key Points

  • The rotator cuff is a group of muscles and tendons that stabilise the shoulder joint and allow smooth arm movement. Injuries may involve inflammation, degeneration, or tears in one or more of these tendons.
  • Common conditions include tendonitis, tendinopathy, partial tears, bursitis, impingement, and frozen shoulder, often caused by overuse, repetitive strain, trauma, or age-related degeneration.
  • Typical symptoms include pain with overhead movement, night pain, weakness, restricted range of motion, tenderness over the deltoid region, and difficulty lifting or reaching.
  • Conditions such as impingement, supraspinatus tears, or bursitis often present similarly and may coexist, requiring careful clinical evaluation and sometimes imaging for accurate diagnosis.
  • Low Level Laser Therapy (LLLT), or Photobiomodulation Therapy (PBMT), is considered for selected shoulder and rotator cuff-related presentations where inflammation, soft tissue irritation or tendon-related pain is contributing to symptoms.
  • LLLT may be particularly relevant where pain limits rehabilitation or exercise, or where loading, stretching, injections or other interventions have provided only temporary or partial relief.
  • Some commonly used approaches, such as medication, injections, repeated loading, stretching or manual pressure, may not be suitable for every stage of recovery. We provide advice based on the diagnosis, symptom severity and clinical assessment.
  • Treatment is provided under medical supervision by Dr Shikha Parmar, a GP with expertise in musculoskeletal injury, through a structured six-week program tailored to shoulder conditions.
  • PBMT/LLLT has been studied in a range of musculoskeletal pain and injury conditions and is generally well tolerated. Individual responses vary, and outcomes depend on the condition being treated and the stage of recovery.
  • LLLT may be helpful to consider for people with persistent shoulder pain, rotator cuff injury or bursitis who have not improved with usual conservative care, after appropriate medical assessment.
Click here for FAQ/Costs

What is the Rotator Cuff and How Can it be Damaged?

The rotator cuff is a complex group of muscles, tendons and accompanying ligaments that stabilise the arm and shoulder and facilitate a wide range of movement. These muscles and tendons link the ball joint of the upper arm with the collarbone and the shoulder blade.

Injuries to the rotator cuff may involve one or more of its muscles or tendons.

Tears may be partial or full thickness. If the tendon is still attached to the bone, some presentations may be managed without surgery, depending on the clinical assessment, imaging findings and functional impact.

Tendon ruptures where the tendon detaches from the bone usually require surgical assessment and may require surgical intervention.

What Causes Rotator Cuff Tendonitis?

Tears fall into two categories. Traumatic tears may relate to falls, dislocation, strain, lifting and injuries sustained during strenuous labour. Gradual tears, on the other hand, may occur due to wear and tear or repetitive use. The supraspinatus tendon is often found to have small tears, which may sometimes be incidental findings in asymptomatic shoulders and can occur through wear and tear.

Tendonitis refers to microtrauma that occurs in the tendons, leading to an inflammatory or healing response by the body’s immune system in an attempt to repair it. In some persistent presentations, the inflammatory or repair process may not progress as expected.

Symptoms 

  • Pain with overhead or reaching movements, especially during activities such as brushing hair, dressing, or lifting the arms. This is common in rotator cuff issues, impingement and bursitis.
  • Pain localised to the outer shoulder or upper arm, usually over the deltoid region, but not necessarily from the deltoid muscle itself. This may be seen in tendonitis, bursitis and repetitive strain injuries.
  • Night pain or difficulty sleeping on the affected side. This is common in rotator cuff tears, bursitis and tendinopathy.
  • Weakness or fatigue with shoulder use, particularly with lifting, pushing or reaching. This may reflect rotator cuff tear, tendinopathy or impingement.
  • Reduced range of motion due to pain or mechanical restriction. This may occur in impingement, tendinopathy, bursitis and more severe tears.
  • Pain with specific movements, such as abduction or external rotation. This may suggest supraspinatus or infraspinatus involvement or impingement.
  • Clicking, catching, or popping sensations, especially with rotation or raising the arm. This may occur with rotator cuff tears, bursitis or overuse injuries.
  • Gradual onset of pain. This is common in overuse, tendinopathy and bursitis, and can be mistaken for a muscle strain early on.
  • Tenderness on palpation over the rotator cuff tendons or subacromial space. This may be consistent with bursitis, tendonitis or tears.

These symptoms often coexist or mimic each other, which is why conditions such as rotator cuff injuries, impingement and bursitis can be difficult to distinguish without proper clinical testing and imaging if needed.

How is Shoulder Pain Diagnosed

Shoulder pain is diagnosed through a structured clinical process that begins with a thorough history. Dr Shikha Parmar, our GP, will ask about the onset, location, nature and triggers of the pain, as well as any history of injury, repetitive activity or referred pain from areas such as the neck or chest.

A detailed physical examination follows, focusing on the range of motion, muscle strength, and any tenderness, swelling or visible muscle wasting.

If further clarification is needed, imaging may be requested. X-rays are useful for assessing bone alignment, arthritis, or calcification. Ultrasound can visualise tendons and bursae in real time, helping identify tears or inflammation. MRI provides a more detailed view of soft tissue structures, making it especially helpful in diagnosing rotator cuff injuries or deeper inflammation.

Shoulder & Rotator Cuff Pain – Treatment Overview

Low Level Laser Therapy (LLLT), also known as Photobiomodulation Therapy (PBMT), is a non-invasive treatment approach used as part of a structured program for selected shoulder pain and rotator cuff-related presentations. It may help modulate inflammation, calm irritated soft tissues and support tendon and soft tissue recovery without adding mechanical stress to sensitive shoulder tissues.

Why Choose Low Level Laser Therapy (LLLT)?

Many patients present after limited relief from physiotherapy, massage, exercises, injections or anti-inflammatory medication. These approaches may reduce symptoms temporarily, but are not suitable for every stage of recovery, especially if loading, stretching or exercise aggravates sensitive shoulder tissues.

Why ice, anti-inflammatories, cortisone, and PRP may not support long-term recovery. Read more here.

How LLLT Supports Healing

LLLT uses red and near-infrared light and may support:

  • Help modulate inflammation and oxidative stress
  • Support local circulation and oxygenation
  • Support lymphatic drainage
  • Support cellular energy production (ATP)
  • Support tendon and soft tissue recovery processes where irritation is present
  • Assist pain reduction without mechanical loading or stressing the shoulder joint
Shoulder

Non-Invasive and Supported by Research

PBMT/LLLT is non-invasive and generally well tolerated. It has been studied in a range of musculoskeletal pain and injury conditions. Individual responses vary, and outcomes depend on the condition being treated and the stage of recovery. Read more here.

See how LLLT may support the cellular environment involved in tissue recovery here.

Our Treatment Program

All patients are assessed by Dr Shikha Parmar (GP). Treatment is delivered within a structured six-week program, including:

  • Up to 12 LLLT sessions
  • Early progress review after the first 6 treatments
  • Individualised advice and activity modification
  • Guided rehabilitation to support longer-term function

Progress is reviewed during the program. Many patients notice appreciable improvement after the first 6 treatments. If there has not been sufficient improvement by this review point, further treatment may not be recommended.

View the full treatment protocol and expected outcomes here.

Ready to Discuss Your Shoulder or Rotator Cuff Pain Treatment Options?

If you are struggling with shoulder pain, rotator cuff-related pain or bursitis, we invite you to contact our team at Laser Pain Therapy to discuss the suitability of LLLT for your presentation. Treatment suitability and outcomes vary, and assessment is required before recommendations can be made.

Contact us to arrange your consultation.
📍 Located in Melbourne
📞 (03) 8529 2225 Contact Us

View treatment cost here

Cost / FAQ

At Laser Pain Therapy, we use the terms Low-Level Laser Therapy (LLLT) and Photobiomodulation Therapy (PBMT) interchangeably, as they both refer to the same therapeutic approach. “LLLT” specifically focuses on the use of laser light, while “PBMT” is the broader scientific term describing how light interacts with cells and tissues to influence biological processes involved in tissue recovery.

Both terms refer to light-based therapy that acts on cellular processes involved in local inflammatory modulation, tissue recovery, and healing.

The initial consultation with Dr Shikha Parmar requires up to 60 minutes where your condition is fully assessed along with your medical history. Dr Parmar will take a thorough history of your problem from its onset, through its progression to now. She will review any imaging reports pertaining to your problem, and may recommend further investigations. Dr Parmar will give you a detailed explanation of your problem, and will discuss our holistic approach and management plan including the utilisation of Low Level Laser Therapy (LLLT). If your condition is amenable to LLLT the treatment is commenced at the initial consultation. A medical consultation with Dr Shikha Parmar, GP, is billed and is rebatable through Medicare for patients who hold a Medicare card.


The fee for an initial consultation including Low Level Laser Therapy treatment is $265.00. This includes a Medicare rebate for the GP consultation of $87.10, the out of pocket cost being $177.90.


Pension and Health Care Card holders receive a further reduced fee for the initial consultation of $215.00 only with the out of pocket fee (gap fee) being $127.90.

For each subsequent follow-up consultation involving review of progress, tailored advice and management, and Low Level Laser Therapy treatment, a fee of $135.00 applies. This includes a Medicare rebate for the GP consultation of $45.05, the out of pocket cost (gap fee) being $89.95.

Longer review visits are charged at $215.00 which includes a Medicare rebate $87.10, the out-of-pocket cost being $127.90.

A $15.00 surcharge applies to appointments after 6pm.

Fees may be subject to change and will be confirmed with you at the time of booking. We utilise specialised equipment from Europe and the USA, operated with the assistance of highly trained clinic assistants. No further rebate can be claimed from private health insurance. We are unable to offer bulk billing.

Yes. LLLT/PBMT has been used clinically in Europe for nearly 30 years and has been the subject of substantial published research. The literature includes double-blind studies, laboratory studies, randomised controlled trials, clinical studies and systematic reviews. The strength of evidence varies according to the condition being treated, treatment parameters and clinical context.

Published literature includes papers in journals such as:

  • Nature, Pain, PNS, Blood, BMJ, Spine, Muscle and Nerve, The Lancet, Circulation and BJSM
  • Around 30 LLLT papers published per month
  • Over 4000 laboratory studies and over 400 randomised controlled trials

Over 2,500 clinical studies and published research reports have investigated the use of LLLT/PBMT across a variety of health issues. In the LLLT dental literature alone, involving 370 studies, more than 90% of these studies have reported clinical value for laser therapy.

LLLT has been used in veterinary practices for decades. In recent years, professional sports teams have also begun utilising LLLT/PBMT.

In the last 20 years, 8 systematic reviews have reported findings in favour of LLLT/PBMT in selected clinical contexts, including:

  • American College of Physicians Guidelines include a “strong recommendation” for Low-Level Laser Therapy as a non-invasive treatment for acute, subacute & chronic low back pain. (2017) Click here
  • BMJ LLLT for chronic non-specific low back pain: a systematic review and meta-analysis of randomised controlled trials found “moderate quality of evidence” and “clinically important benefits” in the short term. (2016) Click here
  • BMJ sports medicine journal, systematic review of surgical and conservative interventions for frozen shoulder found “strong evidence” for LLLT. (2010) Click here
  • The BMJ clinical evidence recommendations for tennis elbow 2011 now include LLLT Click here
  • American Physical Therapy Association guidelines recommend LLLT for Achilles tendonitis. (2010) Click here
  • Lancet systematic review: “LLLT reduces pain immediately after treatment in acute neck pain and up to 22 weeks after completion of treatment in patients with chronic neck pain”. (2009) Click here
  • World Health Organisation Bone and Joint Task Force for neck pain reported Low Level Laser Therapy as “more effective than no treatment, sham, or alternative interventions”. (2008) Click here

Laser Therapy does not heat or cut tissue, unlike high intensity lasers. The question is often asked: “If it’s a laser, aren’t lasers used in surgical operations to cauterise tissue?” The answer is yes. High intensity surgical lasers can cauterise or cut tissue. The lasers used at Laser Pain Therapy are Class 3B low level lasers, a well-researched class in LLLT, designed for low-intensity therapeutic application. Our lasers use light energy to influence cellular processes rather than heat or cut tissue.

Regulatory bodies assess LLLT/PBMT devices according to intended use and device class. Device selection, dosing and clinical supervision are important for appropriate application.

For the past 30 years, Low Level Laser Therapy (LLLT) technology has been formally accepted in many parts of the world such as Canada, USA, Brazil, Europe, Scandinavia, Russia and Japan. Published research and clinical experience over this period support a favourable tolerability profile. LLLT/PBMT is non-invasive and generally well tolerated.

Industry has been using laser diodes for years in applications such as bar code readers, CD players, DVD players, laser printers and pointers. Some bio-stimulation laser devices have been listed as non-significant risk (NSR) devices in specific regulatory contexts.

Hundreds of research studies have investigated Laser Therapy in pain and tissue recovery settings. Laser Therapy is non-invasive and non-thermal. Over 400 LLLT clinical trials (RCTs) and over 2500 laboratory studies have been published. Comparisons with pharmaceutical anti-inflammatory medication depend on the condition being treated, study design and treatment parameters.

LLLT has also been investigated for tissue recovery processes, muscle fatigue, muscle damage and delayed onset muscle soreness, or DOMS.

Most patients tolerate LLLT/PBMT well. Patients may occasionally experience mild discomfort or aching after treatment. This is usually temporary and should settle within 24 to 48 hours.

LLLT/PBMT uses red and near-infrared light and does not use ionising radiation. No mutational effects have been observed from light with wavelengths in the red or infrared range and doses used within LLLT/PBMT in published studies.

Where a patient has known or suspected cancer, this requires medical assessment and appropriate management. LLLT/PBMT at Laser Pain Therapy is not used as a treatment for cancer.

The effects of LLLT/PBMT on cancer cells have been studied in vitro and in animal models, but these findings should not be translated into broad clinical claims about treating cancer or tumour behaviour in people. Treatment decisions are made according to the patient’s clinical context and medical history.

Similarly, laboratory findings involving bacteria or viruses can differ from clinical infection management. This section should not be read as a claim that LLLT/PBMT treats bacterial or viral infection. If infection is suspected, appropriate medical assessment and treatment are required.

Laser Therapy should be avoided in the following instances:

  • Over the womb for women in pregnancy
  • Over cancerous tumour, primary or secondary (LLLT is not a treatment for these conditions)
  • Direct irradiation of the eyes

At Laser Pain Therapy, we use state-of-the-art, TGA-approved laser devices, applied by highly trained assistants. Our laser devices deliver the appropriate red and infrared laser energy to trigger the desired tissue response. With the application of up to 37 diodes (laser lights) across multiple devices, we ensure time-efficient treatment without compromising dosage or energy delivery. Unlike LED devices, our laser technology provides deeper penetration and more effective tissue healing.

Dr Shikha Parmar, an experienced GP with over 30 years in General Practice and 14 years of expertise in photobiomodulation therapy, leads our clinic, making her one of the most experienced doctors in this field. Treatment at Laser Pain Therapy is medically supervised, ensuring each patient receives a thorough assessment that takes into account not only their presenting condition but also relevant health factors, such as co-morbidities, medications, lifestyle, work, personal activity demands, and nutritional deficiencies. This holistic approach allows us to tailor care with LLLT at the core, supported by personalised advice.

Additionally, our treatment plans are finite, with clear goal-setting and regular progress reviews, ensuring that each patient is on track towards long-term recovery and optimal outcomes.

At Laser Pain Therapy, we use advanced equipment with laser diodes, not LED lights. Unlike LEDs, laser diodes provide more focused light with deeper penetration, making them significantly more effective for treating musculoskeletal conditions.

Our state-of-the-art equipment features 37 laser diodes, allowing us to efficiently cover a larger surface area. This optimises treatment time, ensuring deeper penetration for superior results. Unlike devices that use just 2-4 diodes, our technology delivers more effective treatment in less time, promoting faster healing, reduced inflammation, and long-lasting pain relief.

The effects of LLLT are accumulative. The good news is that for most patients undergoing a treatment program, the results from the treatments are sustained. While some patients get immediate results, improvements are often not noticed until after 3 to 5 treatments. Most patients usually require 6-12 treatments to achieve resolution of the problem or a lasting effect.

More severe conditions will require more treatments than less severe injuries. Since each person’s condition varies in severity the doctor will determine after reviewing your condition how laser treatments may benefit you and how many you might require

Your situation will be assessed after 6 treatments and if there is no improvement after 6 to 8 treatments (very uncommon), LLLT will not be continued and alternatives will be looked at for your future management.

You will need to follow precautions in order to avoid re-injury or the pain may return. Low Level Laser Therapy not only helps injured tissues heal faster, it also makes them stronger and less vulnerable to re-injury.

Contact us to book a consultation at our clinic or to learn more about how this form of therapy could help you.

No. Low level lasers do not generate perceivable heat. Therefore, when the laser contacts the skin the patient experiences no burning as a result of the laser. Most people feel nothing at all while a few may feel a slight tingling or warmth during the treatment.

No. As Dr Shikha Parmar is a General Practitioner a doctor’s referral is not required.

With our dedicated clinic in Melbourne, contact us at Laser Pain Therapy to discuss how we can assist you

Images and Illustrations Disclaimer
Please note that the images, diagrams, and illustrations used on this website are for demonstration and illustrative purposes only. They are intended to provide a general overview of Photobiomodulation Therapy (PBMT) and Low-Level Laser Therapy (LLLT). The specific methods and equipment we use at Laser Pain Therapy may differ from those depicted. For instance, while some images may show a small laser being applied to the skin, we utilise advanced cluster lasers equipped with multiple diodes, offering superior coverage and effectiveness for treating musculoskeletal conditions. Our treatment protocols are tailored to each patient’s unique needs, using the latest technology for optimal results.

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Laser Pain Therapy

South Yarra, Victoria
Suite 8, 200 Toorak Road
(Ground floor from William St)
South Yarra, Vic 3141
Ph: 03 8529 2225
Email us:
info@laserpaintherapy.com.au

 

Location

TRANSPORT ACCESS:
Train: South Yarra Station, 100m, 1 minute walk
Tram: Route 58, stop no. 127

Easy free street parking:
If driving you will find many free 1P and 2P spots on and around Toorak Rd and William St near the clinic.

 
Call now: 03 8529 2225
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Our Mission

We are dedicated to providing advanced, evidence-informed and affordable medical care for selected musculoskeletal pain and injury presentations. Our approach combines GP-led assessment, individual treatment planning, non-invasive PBMT/LLLT, and practical guidance to support pain relief, recovery, function, and quality of life.

Disclaimer

The contents of this website have not been evaluated by the Australian Government Department of Health. The information of this site is not intended to diagnose, treat, cure or prevent any disease. Individual articles are based upon the opinions of the author, who retains copyright as listed…..Continue Reading

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