Reading time: approx. 20 minutes | Article based on peer-reviewed scientific publications
Microcirculation — a network of capillaries, arterioles, and venules with a diameter under 100 micrometers — forms the foundation for the proper functioning of every tissue in the body. It is at this level that the exchange of oxygen, nutrients, and metabolites occurs between the blood and cells. Microcirculation disorders underpin many civilization diseases: diabetes, hypertension, cardiovascular diseases, as well as chronic inflammation and slow-healing wounds.
Photobiomodulation (PBM), also known as red and near-infrared light therapy (RLT/LLLT), is one of the few therapeutic methods that demonstrate a documented effect on microcirculation function at the cellular and vascular level.
1. What is microcirculation and why is it crucial?
The human circulatory system consists of two functionally distinct parts: macrocirculation (heart, aorta, large arteries and veins) and microcirculation. The latter includes vessels with a diameter of 5 to 100 μm and is responsible for the direct exchange of substances between blood and tissues.
- Distribution of oxygen and nutrients — capillaries deliver oxygen and glucose directly to cells
- Removal of metabolites — CO₂, lactic acid, and other metabolic products are drained by venules
- Temperature regulation — cutaneous microcirculation plays a key role in thermoregulation
- Immune response — leukocytes migrate through the capillary wall to sites of infection or injury
- Blood pressure regulation — peripheral vascular resistance is primarily determined by microcirculatory arterioles
The total length of capillaries in the human body is approximately 100,000 km — enough to circle the Earth two and a half times.
2. Microcirculation disorders — causes and health consequences
- Diabetes — hyperglycemia damages capillary endothelium, leading to diabetic retinopathy, nephropathy, and neuropathy
- Hypertension — chronic elevation of blood pressure causes vascular wall remodeling and reduction of their diameter
- Atherosclerosis — atherosclerotic changes in large vessels translate into reduced flow to microcirculation
- Chronic oxidative stress — excess free radicals damage endothelium and reduce nitric oxide bioavailability
- Inflammation — pro-inflammatory cytokines disrupt endothelial function and increase vascular permeability
- Mechanical injuries — contusions, sprains, and fractures cause local microcirculation disorders, slowing healing
3. What is photobiomodulation (PBM)?
Photobiomodulation is a non-thermal light therapy that uses light of specific wavelengths — mainly in the red (620–700 nm) and near-infrared (700–1100 nm) range — to induce biological therapeutic effects without tissue damage. The term was officially approved by the National Library of Medicine as a MeSH term in 2016.
You can read more about the scientific basis of the therapy on our page Our Science — Scientific Basis of Lumaflex Therapy and in the detailed description of the Mechanism of Light Therapy Action.
4. Molecular mechanisms of PBM’s effect on microcirculation
4.1 Stimulation of cytochrome c oxidase and ATP production
The main chromophore responsible for light absorption in PBM is cytochrome c oxidase (CCO, complex IV of the mitochondrial respiratory chain). Photon absorption by CCO leads to the dissociation of nitric oxide (NO) from the enzyme's active center, which restores full mitochondrial respiratory activity and increases ATP production.
4.2 Release of nitric oxide (NO) and vasodilation
Nitric oxide is one of the most important endogenous regulators of vascular tone. Red and NIR light releases NO from its stores in hemoglobin and myoglobin. The released NO leads to relaxation of the vessel wall — the result is vasodilation and improved blood flow in microcirculation.
4.3 Reduction of oxidative stress
The long-term effect of therapy is the activation of endogenous antioxidant systems (SOD, catalase, glutathione). Reduced oxidative stress protects vascular endothelium from damage.
4.4 Stimulation of angiogenesis by VEGF
PBM stimulates the expression of vascular endothelial growth factor (VEGF) — a key mediator of angiogenesis. This leads to the reconstruction of the capillary network in damaged areas, which directly improves their blood supply and oxygenation.
4.5 Modulation of inflammatory cytokines
PBM reduces the expression of pro-inflammatory cytokines (TNF-α, IL-1β, IL-6) and increases the level of anti-inflammatory cytokines (IL-10). Reduced inflammation in the vessel walls directly improves endothelial function.
5. Review of scientific studies
5.1 Microcirculation in diabetes and wound healing
A study published in Photomedicine and Laser Surgery (Kajagar et al., 2012) involved 68 patients with diabetic wounds. The group treated with PBM (660 nm, 15 sessions) showed a reduction in wound area by 45.5% vs 27.4% in the control group. Histological examinations confirmed increased capillary density in the irradiated areas.
5.2 Sports recovery
A meta-analysis by Leal Junior et al. (2015) included 13 randomized controlled trials. PBM applied before physical exertion significantly reduced muscle damage (CK and LDH) and accelerated recovery by improving muscle microcirculation.
5.3 Hypertension and endothelial function
A study by Barolet et al. (2016) — 30 patients with hypertension, 8 weeks of therapy. Result: FMD improvement by 2.1 percentage points and reduction in systolic blood pressure by an average of 8 mmHg.
5.4 Cerebral microcirculation
A study by Naeser et al. (2014): transcranial photobiomodulation (810 nm) improved cognitive functions and increased cerebral blood flow measured by fMRI in patients after brain injuries.
5.5 Veterinary medicine
A study by Oliveira et al. (2019): PBM in horses with tendon injuries accelerated healing by 35% compared to the control group, which correlated with increased capillary density.
6. PEMF vs photobiomodulation — which method works on microcirculation?
Two technologies are increasingly appearing on the wellness device market: PEMF (Pulsed Electromagnetic Field) and photobiomodulation (PBM). Both are promoted as methods to improve health and regeneration, but their mechanisms of action are fundamentally different — especially in the context of microcirculation.
How does PEMF work?
PEMF uses pulsed electromagnetic fields to stimulate tissues. Documented effects include: bone regeneration (FDA approved), pain and inflammation reduction through ion channel modulation, and improved bone mineral density.
What PEMF does not do — in light of research
Despite numerous marketing claims, current scientific literature does not confirm a direct effect of PEMF on microcirculation comparable to photobiomodulation. PEMF does not have a mechanism for releasing nitric oxide from hemoglobin, does not stimulate cytochrome c oxidase, and does not activate VEGF in a manner documented in vascular studies. A systematic review by Funk et al. (2018) published in Bioelectromagnetics indicated that evidence for PEMF's effect on microcirculation is inconsistent and requires further research.
Comparison of mechanisms
| Mechanism | PEMF | Photobiomodulation |
|---|---|---|
| Nitric oxide (NO) release | No evidence | Documented |
| Vascular vasodilation | Indirectly | Directly |
| Angiogenesis stimulation (VEGF) | No evidence | Documented |
| Mitochondrial stimulation (CCO) | No evidence | Documented |
| Bone regeneration | Documented (FDA) | Documented |
| Wound and ulcer healing | Limited evidence | Strong evidence |
7. Synergy of PEMF and photobiomodulation — combining methods
Although PEMF and photobiomodulation work through different mechanisms, this very difference makes them an excellent complement. More and more rehabilitation centers, sports clinics, and wellness centers combine both technologies as part of comprehensive therapeutic protocols.
Why does synergy work? PEMF primarily acts at the cellular membrane and bone tissue level — it modulates the electrical potential of cells, reduces pain, and accelerates bone regeneration. Photobiomodulation, on the other hand, acts on mitochondria and vascular endothelium — it improves microcirculation, stimulates angiogenesis, and reduces inflammation at the tissue level. Together, they cover the full spectrum of regeneration.
Application in clinics:
- Rehabilitation after fractures — PEMF accelerates bone union, PBM improves soft tissue blood supply around the injury
- Treatment of chronic joint inflammation — PEMF reduces neuropathic pain, PBM reduces synovial membrane inflammation
- High-level sports regeneration — PEMF protocol before session + PBM after training maximizes regenerative effects
- Veterinary medicine — sports horses — combining both methods shortens recovery time after tendon and ligament injuries
- Anti-aging medicine — the synergy of both technologies supports cellular regeneration and improves tissue quality
Lumaflex devices, thanks to their portability and professional parameters, are an ideal complement to stationary PEMF devices in the clinic — patients can continue photobiomodulation therapy at home between visits.
8. Therapeutic parameters — what matters?
- Wavelength: 630–670 nm (red) for superficial tissues; 810–850 nm (NIR) for deeper structures
- Power density: 10–100 mW/cm²
- Energy dose: 1–10 J/cm² for vascular indications
- Exposure time: 60–300 seconds per application point
- Session frequency: 3–5 times a week for a minimum of 4 weeks
Compare Lumaflex models on the page Compare Lumaflex products.
9. Practical clinical applications
Orthopedic rehabilitation
PBM accelerates capillary network reconstruction, improves tissue oxygenation, and shortens recovery time by 30–50% compared to standard treatment.
Dermatology and wound healing
PBM stimulates angiogenesis, improves tissue perfusion, and accelerates fibroblast proliferation responsible for collagen synthesis.
Sports medicine and regeneration
Athletes use PBM before training (muscle microcirculation priming) and after training (metabolite removal). Lumaflex devices are valued for their portability and ability to be used in the field.
Neurology and cognitive functions
Improved cerebral microcirculation through tPBM shows promising results in the treatment of neurodegenerative disorders and brain injuries.
Veterinary medicine — horses and dogs
Photobiomodulation accelerates the healing of tendon and ligament injuries in sports horses. Lumaflex offers dedicated sets — Lumaflex Essential + Horse.
10. Therapeutic protocols
Sports recovery
- Session time: 10–20 minutes per muscle group
- Frequency: before and/or after training, 5x/week
- Wavelength: 660 nm + 850 nm
Wound healing and injuries
- Session time: 5–15 minutes per injury area
- Frequency: daily for the first 2 weeks, then 3x/week
- Treatment duration: minimum 4–8 weeks
General microcirculation improvement
- Session time: 15–30 minutes
- Frequency: 3–5x/week
- Duration: minimum 8–12 weeks
11. Safety and contraindications
Photobiomodulation is considered a safe method. A review covering over 4000 clinical studies (Hamblin, 2018) showed no serious adverse effects.
Absolute contraindications: active cancers in the irradiation area, direct eye irradiation without protection, thyroid irradiation.
Relative contraindications: pregnancy (abdominal and pelvic area), photosensitizing drugs, photosensitive epilepsy, blood clotting disorders.
12. Summary and clinical conclusions
Photobiomodulation is a scientifically documented method for improving microcirculation function. The release of nitric oxide, mitochondrial stimulation, reduction of oxidative stress, activation of angiogenesis, and modulation of inflammatory cytokines create a synergistic therapeutic effect confirmed in numerous clinical studies. The combination of PBM with PEMF opens new therapeutic possibilities — especially in rehabilitation centers and sports clinics.
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FAQ — Frequently Asked Questions
Does photobiomodulation really improve microcirculation? +
Yes — the mechanism is well-documented. Red and NIR light releases nitric oxide from hemoglobin and myoglobin, leading to vasodilation of blood vessels and improved blood flow. Additionally, PBM stimulates angiogenesis via VEGF, which leads to the rebuilding of the capillary network. Effects confirmed in numerous randomized clinical trials.
Can PEMF and photobiomodulation be used simultaneously? +
Yes, both methods can be combined — they work through different mechanisms and complement each other. The recommended protocol is PEMF before a PBM session or in separate sessions. There are no known negative interactions between these methods.
How long does it take for photobiomodulation to improve microcirculation? +
The first effects (vasodilation, improved flow) occur after a single session and last for several hours. Long-term effects (angiogenesis, improved endothelial function) require regular use for at least 4–8 weeks, 3–5 sessions per week.
Is photobiomodulation suitable for a rehabilitation clinic? +
Yes — Lumaflex devices are used by physiotherapists as well as sports doctors. The portability of the devices allows for use in the clinic and advising the patient to continue therapy at home, which increases treatment effectiveness.
What wavelength is best for microcirculation? +
For superficial microcirculation (skin, subcutaneous tissues), 660 nm is optimal. For deeper vascular structures, muscles, and joints — 850 nm (NIR). Lumaflex devices emit both wavelengths simultaneously, providing comprehensive action at various tissue depths.
Is photobiomodulation safe for vascular diseases? +
