• Chien-Hung Lin, Szu-Ying Wu, Wen-Long Hu, Chia-Hung Hung, Yu-Chiang Hung, and Aurea KuoChun-EnCEDepartment of Traditional Medicine, Kaohsiung Chang Gung Memorial Hospital.Department of Nursing, Meiho University, Pingtung, Taiwan..
• Department of Traditional Medicine, Kaohsiung Chang Gung Memorial Hospital.
• Medicine (Baltimore). 2020 Feb 1; 99 (6): e18860.

RationaleCoccyx fracture is an injury usually caused by trauma. In most cases, the fractures recover after conservative therapy. For refractory cases that exhibit coccydynia after more than 2 months of conservative treatment, coccygectomy is indicated. However, limited information about the efficacy of this procedure is available, and it is known to have a high complication rate. As such, other therapeutic approaches are needed. Here, we report our experience using another conservative treatment option, low-level laser therapy, to successfully reduce refractory coccydynia in a patient with coccyx fracture.Patient ConcernsA 23-year-old woman had refractory coccydynia and increased pain after a traffic accident-induced coccyx fracture.DiagnosesInitially, the patient reported transient improvement after conservative treatment with non-steroidal anti-inflammatory drugs. However, the pain increased in severity (numerical rating scale score of 8) soon after she resumed work in her office, and progressed in the following 2 months. Surgical intervention was suggested owing to the prolonged coccydynia following the failure of conservative treatment and difficulties in performing daily life activities. However, she sought other conservative therapy options, because she was concerned about the risks associated with the coccygectomy surgery.InterventionsThe patient received low-level laser therapy once a week, for 24 weeks.OutcomesAfter 11 weeks of treatment, the patient reported significant improvements in her symptoms; her pain was reduced to a numerical rating scale score of 2 and bone healing was noted on radiographs. The patient could eventually perform her daily activities satisfactorily, without coccydynia, after 24 weeks of treatment.LessonsLaser acupuncture produced analgesic effects in this patient with refractory coccydynia after traumatic coccyx fracture. This is the first case report to apply laser acupuncture for refractory coccydynia after traumatic coccyx fracture. Our findings imply that laser acupuncture may be a good conservative therapy option for coccyx fracture.

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