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Class IV Laser for Pelvic Pain



Photobiomodulaton therapy or class IV laser has been shown to treat muscle spasm & pain and nerve pain. Hundreds of published studies have documented the benefits of laser on sprains and strains, post-surgical pain, whiplash, muscular back pain, radiculopathy, tendinitis, osteoarthritis and neck and back pain, plantar fasciitis, chronic regional pain syndrome and neuropathic pains like diabetic neuropathy and trigeminal neuralgia. But what about “pain down there?”


Chronic pelvic pain is defined by pain below your belly button and between your hips that lasts 6 months or longer. One subset of pelvic pain is pain in the vestibule. The vestibule is located at the entry of the vagina. Vestibulodynia can be pain all the time called unprovoked vestibulodynia. It can also be just with touch (tight pants, underwear, sex, sitting) called provoked vestibulodynia. Vestibulodynia can be caused by hormonal issues, issues with the muscles and joints of the pelvis (that is what pelvic floor physical therapy specializes in) or nerve overgrowth called neuroproliferation.


Class IV laser has been shown to help muscle spasm and pain and pain arising from nerves elsewhere in the body. A study of low-level laser therapy for provoked vestibulodynia found 78% of patients receiving laser reported improvement compared to 44% of controls. There were no side-effects in the laser group.


At RVA Holistic PT, if you have “pain down there” or painful sex, we offer an integrated approach including helping your spine and pelvis orthopedically, alignment, breathing, mindfulness and pelvic floor muscle relaxation. If “pain down there” is caused by muscle spasm/ pain or neuroproliferation, laser is a wonderful “extra” boost. Many of our patients have had excellent success with laser treatment (integrated with all the other wonderful things we do).


One thing is for certain, there needs to be much more research in the field of pelvic pain. All-in-all 14% of women are estimated to have chronic pelvic pain. Of those, 60-85% of women with CPP have pain in their pelvic floor muscles, which is why physical therapy is advocated as a first-line treatment for provoked vestibulodynia (Morin). If you are in the Richmond, Virginia area and are interested in an integrative approach to pelvic pain-- including class IV laser -- you can book with us for a clinic visit.







Lev-Sagie, Ahinoam, Asia Kopitman, and Amnon Brzezinski. “Low-Level Laser Therapy for the Treatment of Provoked Vestibulodynia—A Randomized, Placebo-Controlled Pilot Trial.” Journal of sexual medicine 14.11 (2017): 1403–1411. Web.


Morin, Mélanie et al. “Multimodal Physical Therapy Versus Topical Lidocaine for Provoked Vestibulodynia: a Multicenter, Randomized Trial.” American journal of obstetrics and gynecology 224.2 (2021): 189.e1–189.e12. Web.


Zipper, Ralph, and Brian Pryor. “Evaluation of a Novel Deep Tissue Transvaginal Near-Infrared Laser and Applicator in an Ovine Model.” Lasers in medical science (2021): n. pag. Web.


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