Functional Neurology and Photobiomodulation as Alternative Non-pharmacologic Treatment Modalities for Chronic Pain: A Narrative Review.

Chronic pain affects many adults worldwide. Its prevalence increases with age, making it an important and growing public health concern. At the neurophysiological level, pain transmission follows a complex neuronal pathway. With repeated activation, this system can become sensitized, contributing to the persistence of chronic pain through central augmentation. Given its complexity, chronic pain has been approached through multiple medical paradigms, including allopathic/pharmaceutical, osteopathic, chiropractic, and psychological therapies. More recently, functional neurology has emerged as a noninvasive therapeutic approach. This field operates on the principle that stimulation of intact neural circuits can influence and rehabilitate neighboring dysfunctional neurons, thereby improving overall neural function. Another treatment modality for chronic pain is photobiomodulation, also known as low-level laser therapy (LLLT). This technique has gained attention for its application across a myriad of conditions and shows promise in the treatment of chronic pain. Because human tissues absorb specific wavelengths of light differently, targeted application can optimize therapeutic effects. Using these principles, LLLT has been successfully applied in the management of several chronic pain conditions, including carpal tunnel syndrome, lateral epicondylitis, nonspecific low back pain, and fibromyalgia. Our review found that LLLT intervention led to statistically significant improvement in chronic pain patients affected by osteoarthritis, carpal tunnel syndrome, epicondylitis, low back pain, and fibromyalgia. This review aims to highlight the potential of functional neurology as an innovation to the approach to chronic pain management, with particular emphasis on the emerging role of photobiomodulation. It seeks to encourage further research into these modalities as potentially transformative options for patient care.