Class IV Targeted Laser Therapy

What Is It?

Healing Light, Delivered Deep

Class IV Targeted Laser Therapy — also called photobiomodulation (PBM) — uses concentrated wavelengths of near-infrared and red light to penetrate tissue and stimulate your body's own healing processes. Unlike older cold lasers (Class III), a Class IV device delivers significantly more power, reaching tendons, joints, and nerve trunks at depths of 3–10 cm where hand and upper extremity injuries actually live.

Our practice uses the EVO Metal Class IV therapy laser — a multi-wavelength system delivering up to 30 watts across four therapeutic wavelengths. It is FDA-cleared, non-invasive, and requires no needles, no incisions, and no recovery time.

EVO Metal Class IV therapy laser device used at Reach Beyond Therapy in Redondo Beach

Who It Helps

Conditions We Target

Drug-free support for the hand and upper extremity conditions we treat every day. Laser therapy is most often added to an existing plan of care — not used alone.

Hand & Fingers

Trigger finger & trigger thumb
Hand arthritis & thumb basal joint
Dupuytren's contracture
Finger stiffness & scar tissue

Wrist

Carpal tunnel syndrome
TFCC tears & wrist sprains
De Quervain's tenosynovitis
Wrist & hand fractures

Elbow & Upper Arm

Tennis elbow & golfer's elbow
Cubital tunnel syndrome
Tendon injuries & tendinitis
Nerve injuries & radial nerve palsy

Post-Surgical

Post-op swelling & edema
Scar tissue mobilization
Tendon repair recovery
Nerve repair & regeneration

Patients also seek laser therapy for pain relief, reduced inflammation, faster recovery, improved circulation, and tissue and nerve repair — as a drug-free alternative or complement to other care.

Your Visit

What to Expect

1

Quick Sessions

Most treatments take only a few minutes per area. You stay fully clothed and simply relax — no preparation needed.

2

No Downtime

Return to your normal activities right away. No needles, no incisions, no recovery period of any kind.

3

Comfortable

You may feel a gentle, soothing warmth over the treated area. Nothing more. Protective eyewear is provided.

4

A Course of Care

Most conditions respond best over a series of 6–12 sessions. Your therapist will build a schedule around your goals and how quickly you respond.

Please Tell Us If You:

Are pregnant
Have a pacemaker or implanted device
Have cancer or an active infection
Have tattoos over the treatment area

Why Class IV?

Not All Laser Therapy Is the Same

You may have heard of "cold laser therapy" (Class III LLLT). Class IV is different in a meaningful way for hand and upper extremity conditions.

Class III devices output 25–500 milliwatts and penetrate roughly 0.5–2 cm — effective for surface-level tissue but limited when the target is a deep tendon, joint, or nerve trunk. Sessions often run 20–40 minutes per site.

The EVO Metal operates at up to 30 watts and reaches 3–10 cm into tissue — deep enough to target the structures that matter most in hand therapy: carpal tunnel space, flexor tendons, the ulnar nerve at the elbow, and more. Sessions are efficient, typically 5–10 minutes per area.

Both use photobiomodulation. Class IV simply delivers the light energy where it needs to go — deeper, faster, and with body-site-specific protocols built in.

	Class III (cold laser)	Class IV (EVO Metal)
Power output	25–500 mW	Up to 30,000 mW
Tissue depth	0.5–2 cm	3–10 cm
Session time	20–40 min	5–10 min
Wavelengths	1	4
Best for	Superficial, chronic	Deep tissue, acute & chronic

The Science

How It Works

The light energy from the laser is absorbed by an enzyme inside your mitochondria called cytochrome c oxidase. This triggers a cascade of cellular responses:

Energy

ATP Production Increases

Cells have more energy available to carry out tissue repair, collagen synthesis, and regeneration.

Circulation

Blood Flow Improves

Nitric oxide is released, dilating blood vessels and delivering more oxygen to injured tissue.

Inflammation

Swelling Decreases

Pro-inflammatory cytokines are downregulated, reducing swelling and post-surgical edema faster.

Pain

Pain Signals Calm

Laser light modulates nerve conduction velocity, reducing the intensity of pain signals reaching the brain.

Four Wavelengths, One Treatment

The EVO Metal uses four simultaneous wavelengths, each targeting a different tissue depth and mechanism:

637 nm — Visible Red

Superficial penetration. Best for surface-level wound healing, scar tissue remodeling, and skin-level inflammation.

810 nm — Near-Infrared

The gold standard PBM wavelength. Highest affinity for cytochrome c oxidase. Primary driver of deep cellular repair and ATP production.

915 nm — Near-Infrared

Preferentially absorbed by hemoglobin. Promotes local blood flow and oxygen delivery to hypoxic or ischemic tissue.

980 nm — Near-Infrared

Absorbed by water molecules. Supports lymphatic drainage and delivers an immediate analgesic effect by modulating nerve conduction velocity.

Common Questions

Laser Therapy FAQs

Does laser therapy hurt?

No. Most patients feel only a mild, pleasant warmth at the treatment site. There is no pain, no needles, and no incisions. Protective eyewear is worn during treatment as a standard safety precaution.

Is Class IV laser therapy safe?

Yes. The EVO Metal is an FDA-cleared Class IV medical device used in clinics, hospitals, and therapy practices. At Reach Beyond Therapy, laser treatment is always administered by a Certified Hand Therapist using body-site-specific protocols. We will screen you for contraindications before starting.

How will I know it is working?

Many patients notice reduced pain and swelling within 24–48 hours of their first treatment. Others experience cumulative improvement over a series of sessions. Results vary by condition, chronicity, and how laser therapy is combined with your other therapies. Your Certified Hand Therapist will track your progress and adjust accordingly.

How many sessions will I need?

It varies by condition and severity. Acute conditions often respond in 4–6 sessions. Chronic or post-surgical conditions may need 8–12 sessions or more. Your therapist will recommend a schedule built around your goals and progress.

Will laser therapy replace my other treatments?

No — and it works best when it does not. Class IV laser is a complement to hands-on therapy, therapeutic exercise, and custom splinting, not a substitute. At Reach Beyond Therapy, we use it as one tool within a personalized, one-on-one plan of care.

Is laser therapy covered by insurance?

Coverage for photobiomodulation varies by payer. We are currently in-network with Medicare Part B. For patients with other insurance, we can help you understand your out-of-network benefits. Contact us to discuss your specific situation before your first visit.

Who is not a candidate for laser therapy?

We perform a screening before starting laser therapy. Contraindications include pregnancy, active cancer over the treatment area, implanted pacemakers or certain electrical devices, active infection, and tattoos directly over the treatment site. Please share your full medical history with your therapist.