Laser Therapy for Osteoporosis – Helping Bones Back to a Regenerative State

Osteoporosis is a growing problem with the aging of the population. The CDC recently published data showing that in the 50 and older population 1 in 5 women have osteoporosis. By age 65 and older this has increased to 1 in 4 women. Osteopenia, which is the precursor to osteoporosis, occurs in 1 in 2 women 50 and older and in 1 in 4 men in that age range.

The complication of concern in those with osteoporosis is fracture. The two most common areas of concern are in the hip and in the spine as these fractures are associated with significant disability.

The standard recommended treatment for osteoporosis is the use of a class of drugs called bisphosphonates or a combination of drugs which target removing osteoclasts, the cells which remove bone, and anabolics which stimulate osteoblasts, the cells that build bone. The bisphosphonates have been associated with causing bones to be denser but more brittle which can cause atypical fractures. They also can cause erosion of the esophagus and stomach pain.

The second type of drugs used are monoclonal antibodies which target removing osteoclasts combined with an anabolic drug to stimulate bone building osteoblasts.  These drugs have been associated with suppression of the immune system and risk of infection.

Typically, the use of calcium and vitamin D is also recommended along with weight-bearing exercise. Many concerned about the adverse effects of the drug treatments will use these nutrients, but they are typically inadequate alone in preventing the progression of the disease. Getting results is dependent on balancing this dynamic between the bone building cells, osteoblasts, and the bone removing cells, osteoclasts.

It strikes some odd that we would have cells that breakdown bone, or osteoclasts. However, bone is constantly remodeling to strengthen in areas of higher stress. It does so by the combined action of osteoclasts removing bone where stress is minimal and osteoblasts building new bone where stress is higher.

Osteopenia and osteoporosis occur when the rates of osteoclastic (breakdown) activity exceeds that of osteoblastic (build back) activity in bone. During early growth, we typically have greater osteoblastic activity as we are building the bone structures. By midlife the activity of osteoblasts and osteoclast is even but beginning to shift towards more activity of osteoclasts and less activity of osteoblasts resulting in the beginning of bone mass decline. Lifestyle and general health have a significant impact on when and how aggressively this transition occurs. Even with good lifestyle some will transition to more bone loss than repair with aging and hormonal change that accompanies it.

Recent interest has shifted towards therapies that help to offset this common age related balance between bone building and eroding cells as a means to treat bone loss.  Some of this knowledge has spun off research which has investigated techniques to help with bone repair such as in non-healing fractures and surgical bone removal of tumors or dental procedures. 

In a study of surgically induced bone defects in lab animals the use of laser therapy or photobiomodulation increased new bone formation by 50% greater than simply letting the lesion try to heal on its own.(1) Seeing if that concept could apply to osteoporosis, researchers were able to show that the laser therapy stimulated osteoblast numbers putting the bone back into positive or “build-back” status both in an age related osteoporosis model and in animals where the bone loss was induced by removal of the ovaries.

In addition to directly lasering the osteopenic/osteoporotic bone area, an area of bone overlying dense bone marrow is also lasered. The purpose of that is to generate stem cell activity.  In any tissue that needs repair, that will be accomplished by migration of stem cells to that area from fat tissue and bone marrow. Once the stem cells home in on the “injured” tissue they transition into normal cells of that tissue; in this case osteoblasts. Laser has been shown to stimulate this stem cell migration.

As mentioned above simply taking supplements of calcium, Vit D, Vit K and the other bone raw materials rarely results in the improvement of osteoporosis. The problem is that the cells that will take those factors and make bone, osteoblasts in not present in high enough numbers. Laser can step in and resolve that problem.

  1. Freitas et al.  Evaluation of photobiomodulation therapy associated with guided bone regeneration in critical size defects. In vivo study.  J Appl Oral Sci, 2018;26:e20170244.
  2. Scudero et al.  Photobiomodulation therapy (PBMT) in bone repair: A systematic review.  Injury, 2019 Nov;50(11):1853-1867.
  3. Zhu et al.  Beneficial effects of low-level laser irradiation on senile osteoporosis in rats.  European Review for Medical and Pharmacological Sciences, 2017; 21: 5230-5238.
  4. Scalize et al.  Low‐level laser therapy enhances the number of osteocytes in calvaria bone defects of ovariectomized rats.  Animal Model Exp Med , 2019;2:51–57.
  5. Da Silva et al.  Photobiomodulation: An Effective Approach to Enhance Proliferation and Differentiation of Adipose-Derived Stem Cells into Osteoblasts.  Stem Cells International, 2021;8843179:13.