Influence of Photobiomodulation Therapy Combined with Pelvic Floor Exercises on Postpartum Coccydynia: A Randomized Controlled Trial

Shreen R Abdoelmagd; Ahmed Mahmoud Kadry; Walaa M Ragab; Dina M A Alhamaky; Yasser R Lasheen; Reem M Alwhaibi; Hoda M Zakaria; Afaf M Botla

doi:10.1089/photob.2024.0140

Therapeutics · Emerging Therapies

Influence of Photobiomodulation Therapy Combined with Pelvic Floor Exercises on Postpartum Coccydynia: A Randomized Controlled Trial

Abdoelmagd SR, Kadry AM, Ragab WM, Alhamaky DMA, Lasheen YR, Alwhaibi RM, Zakaria HM, Botla AM

Photobiomodulation, photomedicine, and laser surgery, 2025

DOI 10.1089/photob.2024.0140 PMID 39876713

Abstract

Objective

This study was conducted to investigate whether the addition of photobiomodulation therapy (PBMT) to pelvic floor exercises (PFEs) is more effective in treating postpartum coccydynia compared with either modality alone.

Background

Postpartum coccydynia is a widespread condition that significantly affects the quality of life. Inflammation as a response to childbirth trauma and weakening of the muscles and ligaments attached to the coccyx are presumed causes of postpartum coccydynia. Finding effective modalities to manage this condition will help the quality of life for most women.

Methods

Sixty women aged 25-35 years with postpartum coccydynia ≥6 weeks were randomly allocated to Group A (PBMT + hot pack + PFEs), Group B (PBMT + hot pack), and Group C (placebo PBMT + hot pack + PFEs). All groups received 12 sessions over 4 weeks of hot packs plus their allocated active treatment (PBMT and/or PFEs). Outcomes were pain intensity (visual analog scale), lumbar flexion range of motion (ROM) (modified Schober test), and self-reported disability (Oswestry Disability Index). The assessors were blinded to group allocation.

Results

All the measured outcomes showed significant differences (p < 0.001), with the superiority of Group A over the other groups (p < 0.001). Within groups, all groups showed statistically significant improvement from baseline across outcomes (p < 0.05).

Conclusions

Adding PBMT to PFEs is recommended in the management of postpartum coccydynia as this combination resulted in greater reductions in pain and disability, along with improved lumbar flexion ROM.

Topics

Related research

Emerging Therapies · Light Therapy

Effects of 660-nm Photobiomodulation Therapy on Pain and Healing of Nipple Trauma in Lactating Women: A Pilot Randomized Double-Blind Controlled Trial

Moraes BHM et al., 2026 Research Square (preprint)

Abstract To evaluate the effects of PBMT (λ = 660 nm) on pain, breastfeeding quality, and healing of nipple injuries. This randomized, double-blind, controlled pilot trial included 20 lactating postpartum women with nipple trauma. Participants were divided into PBMT (standard care + active PBMT) and Placebo (standard care + sham) groups. Interventions occurred up to seven sessions over 15 days. PBMT parameters: 660 nm, 40 mW, 10 J/cm², and 0.4 W/cm² for 10s per point (one central and four peripheral points). Assessments included the Visual Analogue Scale (VAS), LATCH Scale, Nipple Trauma Score (NTS), and photogrammetry. Most participants (90%) presented bilateral excoriations or fissures. The PBMT group showed significantly greater pain reduction from the third session onward (p < 0.05), achieving total analgesia by the seventh, whereas the Placebo group maintained higher VAS scores. Although both groups improved their breastfeeding technique, the PBMT group showed superior post-intervention LATCH scores. Furthermore, PBMT significantly accelerated tissue repair from the third session onward. The PBMT group reached complete lesion regression (NTS = 0), while the Placebo group maintained residual trauma (NTS = 1). PBMT combined with clinical management is effective for pain relief, tissue repair, and improving breastfeeding quality. It serves as a promising adjuvant resource to prevent complications and support the maintenance of exclusive breastfeeding.

Emerging Therapies · Light Therapy

Transvaginal Photobiomodulation Improves Pain in Women with Pelvic Muscle Tenderness and Interstitial Cystitis/Bladder Pain Syndrome: A Preliminary Observational Study

Butrick CW et al., 2022 Urology

Interstitial Cystitis/ Bladder Pain Syndrome (IC/BPS) is characterized by pelvic/bladder pain, associated with pelvic muscle tenderness, urgency, frequency, and dysuria. Prior studies show that transvaginal photobiomodulation (TV-PBM) reduces pain in women with chronic pelvic pain (CPP). Our objective was to obtain preliminary data on treatment effect and adherence, in women with IC/BPS who selected TV-PBM therapy for management of pelvic pain. Before-and-after observational cohort study of women with IC/BPS who received TV-PBM in 17 US practices. Pain was measured using a 0-10 numeric rating scale (NRS). The primary outcome was a minimal clinical important difference (MCID); reduction of overall pelvic pain severity by ≥2 NRS points from baseline compared to after 8 treatments. Cohen d coefficient measured effect size (low effect size d<0.2, medium 0.20.8). Of 140 patients with IC/BPS who self-selected to start TV-PBM therapy, 89.3% (n=125) completed 4 treatments and 59.3% (n=83) completed 8. Improvement ≥1 NRS point was reported by 73.5% (n=61) and meaningful improvement (≥2 points) was reported by 63.9% (n=53) after 8 treatments. In this group, patients with severe / moderate pain decreased from 83.1% (n=44) to 38.5% (n=20); p<0.001. Pain levels decreased as follows: overall pelvic pain MCID=-2.7, d=1.07, pain with urination MCID=-2.6, d=1.0; pain with exercise MCID=-2.6, d=0.91, pain with intercourse MCID=-2.5, d=0.82. In real-world clinical settings, 2/3 women with IC/BPS who opted to undergo TV-PBM therapy reported significant decrease in pelvic pain and dysuria. These findings are promising; however, controlled studies are needed.

Emerging Therapies · Light Therapy

Low-level laser therapy improves pain in postcesarean section: a randomized clinical trial

de Holanda Araujo AMP et al., 2020 Lasers in medical science

This study aimed to evaluate the effect of low-level laser therapy (LLLT) on immediate postpartum pain relief during cesarean section. A randomized, parallel controlled trial was carried out. In total, 88 women with immediate postpartum were divided into 4 groups: control group (n = 22), placebo group (n = 22), experimental group I (n = 22, dose of 4 J/cm2), and experimental group II (n = 22, dose of 2 J/cm2). The pain measured by Numeric Rating Scale (NRS), algometry, and Global Change Perception Scale (GCPS) was assessed at 12, 20-24, and 44-48 h postpartum. Two LLLT sessions were performed at 12 and 24 h postpartum. A significant interaction was observed between time versus group for NRS F (2.40) = 36.80, p < 0.001 and algometry F (1.70) = 27.18, p < 0.001. GCPS revealed a significant difference between the groups during second (p = 0.04) and third evaluation (p = 0.04). The NRS and algometry presented a large effect size for the experimental groups. LLLT is an efficient method to reduce pain and enhance the GCP in postcesarean section. No significant clinical differences were found between the laser doses.

Emerging Therapies · Light Therapy

The Effect of Photobiomodulation on Analgesia During Childbirth: A Controlled and Randomized Clinical Trial

Traverzim MA et al., 2021 Photobiomodulation, photomedicine, and laser surgery

Pain during labor can be a barrier when choosing vaginal delivery. In an attempt to relief pain during labor, several pharmacological and nonpharmacological methods are proposed. To assess the effect of light-emitting diode (LED) photobiomodulation on analgesia during labor. A clinical trial was conducted with 29 women who were divided into two groups: G1 (experimental group-LED) and G2 (control group-hot shower). In the experimental group, an LED plate with red and infrared merged [red 660 ± 20 nm, 5 mW/cm2, 3 J per LED (108 J) and infrared 850 ± 20 nm, 5 mW/cm2, 3 J per LED (108 J), total energy = 216 J] was placed on the subjects' dorsal region, at the level of T10 to S4, for 10 min, with the plate automatically turning off. Hot shower at controlled temperature was offered for 30 min. To verify the effect of LED on analgesia during labor, the following variables were assessed: (1) perception of pain, (2) fetal well-being assessed by cardiotocography or intermittent auscultation of fetal heart rate, (3) Apgar score at minutes 1 and 5 after birth, and (4) labor duration. There was a statistically significant difference (p < 0.05) in pain reduction evidenced by a millimetric visual scale, before and after application on G1-LED (7.92 ± 1.78). Regarding the other variables, there was no statistical difference between the groups when comparing fetal well-being, Apgar score and labor duration. It is concluded that LED can be considered an alternative, since it caused pain reduction without changing other parameters during labor, compared with hot shower, a method included in hospital protocols, proving to be safe. Clinical NCT03496857.

Therapeutics › Emerging Therapies › Light Therapy · General Gynecology › Pelvic Pain › Chronic Pelvic Pain · Postpartum › Recovery › Physical Recovery

Shreen R Abdoelmagd, Ahmed Mahmoud Kadry, Walaa M Ragab, Dina M A Alhamaky, Yasser R Lasheen, Reem M Alwhaibi, Hoda M Zakaria, Afaf M Botla

S Abdoelmagd, A Kadry, W Ragab, D Alhamaky, Y Lasheen, R Alwhaibi, H Zakaria, A Botla

PMID 39876713 39876713 DOI 10.1089/photob.2024.0140 10.1089/photob.2024.0140 Abdoelmagd et al. 2025, Abdoelmagd 2025

Influence of Photobiomodulation Therapy Combined with Pelvic Floor Exercises on Postpartum Coccydynia: A Randomized Controlled Trial

Abstract

Topics

By this author

Efficacy of Laser Acupuncture on Neurophysiological Parameters of Median Nerve and Hand Function in Postpartum Women: A Randomized Controlled Clinical Trial

Related research

Effects of 660-nm Photobiomodulation Therapy on Pain and Healing of Nipple Trauma in Lactating Women: A Pilot Randomized Double-Blind Controlled Trial

Transvaginal Photobiomodulation Improves Pain in Women with Pelvic Muscle Tenderness and Interstitial Cystitis/Bladder Pain Syndrome: A Preliminary Observational Study

Low-level laser therapy improves pain in postcesarean section: a randomized clinical trial

The Effect of Photobiomodulation on Analgesia During Childbirth: A Controlled and Randomized Clinical Trial