Treatment of Thoracic & Upper Back and Shoulder Pain 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 thoracic, upper back and shoulder 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.

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Key Points

  • Upper back and shoulder pain may result from trauma such as lifting or falls, or postural strain such as prolonged sitting and desk work.
  • Common causes include muscle or ligament strain, facet joint irritation, thoracic disc bulging and, in some cases, osteoporotic compression fractures.
  • Symptoms range from localised aching and muscle spasm to pain referred around the shoulder blades, chest or arms.
  • Low Level Laser Therapy (LLLT), or Photobiomodulation Therapy (PBMT), is considered for selected thoracic and upper back pain presentations where inflammation, soft tissue irritation or nerve sensitivity is contributing to symptoms.
  • LLLT may be particularly relevant where pressure, stretching, repeated movement or some other interventions aggravate sensitive thoracic or shoulder tissues.
  • Some commonly used approaches, such as medication, manipulation, repeated loading, stretching or manual pressure, are not suitable for every stage of recovery. We provide advice based on the diagnosis, symptom severity and clinical assessment.
  • Treatment is GP-led by Dr Shikha Parmar and delivered under medical supervision as part of a structured, six-week program tailored to individual needs.
  • 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 can be considered for people with persistent thoracic, upper back or shoulder pain who have not improved with usual conservative care, after appropriate medical assessment.
Click here for FAQ/Costs

Understanding Thoracic, Upper Back, and Shoulder Pain

Upper back (thoracic) and top-of-shoulder pain can significantly impact daily life. While many cases resolve within a couple of weeks with rest and home care, more severe injuries or persistent symptoms may become chronic and require further assessment.

Causes of Thoracic, Upper Back, and Shoulder Pain

Upper back pain can result from sudden trauma (e.g. falls, car accidents, or awkward lifting) or from sustained overuse or stress injuries, such as repetitive postural strain e.g., prolonged desk work, repetitive lifting or overhead activities, or poor sleeping postures can cause cumulative micro-trauma over time leading to persistent discomfort.

Upper back pain typically involves muscle strain, ligament sprain, or joint dysfunction. Weakened back and shoulder stabilisers often contribute. In some cases, especially with osteoporosis, thoracic vertebrae may develop compression fractures.

Muscle or Ligament Injury

Much of upper back pain is musculoskeletal in origin and referred to as non-specific thoracic pain. Typically, it involves:

  • Muscle strain of the large upper back muscles (trapezius, rhomboids, levator scapulae)
  • Ligament sprain (through over-stretching) around the facet joints of the thoracic spine
  • Joint dysfunction between the thoracic vertebrae and ribs

Common causes include heavy lifting, sports collisions, and motor vehicle accidents.

Bulging or Herniated Discs

Thoracic disc bulges or herniations, though less common than in the lower spine, can cause upper back pain and pain in the shoulder blades, stiffness, muscle spasm, or referred pain due to nerve irritation, into the chest or arms.

These issues may result from repetitive strain or sudden trauma such as a fall or heavy lift. Symptoms often worsen with sitting, slouching, coughing, or twisting. In more serious cases, nerve involvement may cause numbness, tingling, or weakness. Severe pain or symptoms such as shortness of breath require prompt medical attention.

Symptoms 

Pain can be felt at the top of the shoulder, about the scapulae (shoulder blades), through the thoracic spine and its supporting muscles and ligaments.

Discomfort is usually localised to the upper back without radiation into the arms. Patients often experience tenderness or spasms in the muscles at the top of the shoulder, around the spine or scapulae (shoulder blades) and through the thoracic spine.

Symptoms of upper back muscle pain can vary from a mild, nagging ache to sharp, stabbing pain, along with protective muscle tightness and stiffness.

Occasionally, the pain may be referred into the shoulders, the chest wall, or the arms.

How is Thoracic & Upper Back Pain Diagnosed?

Diagnosing thoracic and upper back pain requires a comprehensive clinical evaluation to identify the source of discomfort and guide treatment. Dr Shikha Parmar will begin by taking a detailed history, including your activities, posture, and any previous injuries. The following diagnostic methods are commonly used to confirm the cause of pain:

Key Diagnostic Steps:

  • Medical History: Dr Parmar will ask about the onset of pain, any recent trauma or strain, and factors such as prolonged sitting, desk work, or lifting habits.
  • Physical Examination: A physical examination will assess areas of tenderness, muscle tightness, and mobility restrictions. Specific tests may be performed to evaluate the range of motion in the thoracic spine and shoulders.
  • Imaging: In some cases, X-rays or MRI scans may be used to assess structural issues, such as disc bulges, facet joint problems, or compression fractures. MRI may also help rule out serious underlying conditions.
  • Palpation and Special Tests: Tenderness over specific areas, such as the vertebrae or shoulder blades, may help identify muscle, ligament, or joint dysfunction. Tests to assess nerve involvement may also be performed if radicular symptoms (e.g., pain radiating to the arm) are present.

The combination of physical exams and diagnostic imaging helps determine the precise cause of your thoracic and upper back pain, enabling Dr Parmar to develop an appropriate treatment plan tailored to your needs.

Thoracic, Upper Back and Shoulder 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 thoracic, upper back and shoulder pain presentations. It may help modulate pain and local inflammatory processes and support soft tissue and nerve recovery without adding mechanical stress to sensitive spinal and shoulder structures.

Why Consider Low Level Laser Therapy (LLLT)?

Many patients present after limited relief from medications, massage, manipulation, stretching or exercise programs. These approaches may temporarily ease symptoms, but are not suitable for every stage of recovery, especially if pressure, loading or stretching aggravates sensitive 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:

  • Helping modulate inflammation and oxidative stress
  • Local circulation and oxygenation
  • Lymphatic drainage
  • Cellular energy production (ATP)
  • Soft tissue and nerve recovery processes where irritation is present
  • Assisting pain reduction without loading or stressing the thoracic spine or shoulder
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Cervical

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 Thoracic or Upper Back Pain Treatment Options?

If you are struggling with persistent thoracic, upper back or shoulder pain, 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 today to arrange your consultation and take the first step towards recovery.
📍 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 a 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 red and infrared laser energy at selected treatment parameters to support the intended tissue response. With the application of up to 37 diodes (laser lights) across multiple devices, we support time-efficient treatment without compromising dosage or energy delivery. Unlike LED devices, our laser technology provides deeper penetration and more targeted tissue application.

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, supporting each patient to stay on track with their recovery plan and treatment goals.

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 suitable for targeted musculoskeletal treatment.

Our state-of-the-art equipment features 37 laser diodes, allowing us to efficiently cover a larger surface area. This optimises treatment time and supports targeted energy delivery. Unlike devices that use just 2-4 diodes, our technology allows more time-efficient treatment delivery while maintaining the intended dose and treatment parameters.

The effects of LLLT are accumulative. For many patients undergoing a treatment program, improvements can be sustained when the condition is suitable and the recommended activity advice and rehabilitation plan are followed. Some patients notice early improvement, while others may not notice improvement until after 3 to 5 treatments. Most patients usually require 10-12 treatments.

More severe conditions will usually require more treatments than less severe injuries. Since each person’s condition varies in severity, Dr Parmar 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 has not been sufficient improvement after 6 to 8 treatments, LLLT will not be continued and alternatives will be considered 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 may help support tissue recovery processes, but activity modification and rehabilitation remain important for longer-term recovery.

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

Low level lasers do not generate perceivable heat. Therefore, when the laser contacts the skin, the patient should not experience 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 broader coverage and targeted application for musculoskeletal conditions. Our treatment protocols are tailored to each patient’s unique needs, using the latest technology and treatment parameters with the aim of optimising treatment response.

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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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