Besides increasing blood perfusion and collagen proliferation along with peripheral nerve stimulation, laser therapy has direct analgesic and anti-inflammatory effects [9-10]. This is because our 905 nm high-power laser reduces the level of PGE2, which in turn decreases the release of the substance P, a neuropeptide playing a significant role in inflammation and pain. 

In the case of a high-level nerve sensitization, the pain level could already be too high for the patient to accept a dose-efficient shockwave treatment. Pre-use of the laser can enable the subsequent use of this therapeutic modality as the reduced sensation of pain allows for using more energy in the shockwave therapy, thus making it more effective.