A Review of Current Treatment Options for Coccygodynia

Abstract

Literature search was performed with the keywords including coccygodynia, treatment, and coccygectomy, on PubMed and Google Scholar between August 2012 and August 2017. Thirteen studies with patients age 18 and over who underwent treatments for coccygodynia were selected for analysis. These treatments include conservative therapies (physical therapy and capsaicin patch), interventional techniques (local injections with steroids and local anesthetic, pulsed radiofrequency ablation of ganglion impar, extracorporeal shock wave therapy), and surgical techniques (complete and partial coccygectomies). The results from these studies demonstrated that most patients had significant pain relief with these techniques. Our literature review demonstrated various interventions including coccygectomy can be effective in the treatment of coccygodynia refractory to conservative therapies. There is a growing body of clinical evidence to support that coccygectomy is an effective treatment for patients with debilitating pain who had failed interventional therapies. Further randomized control studies should be conducted to examine duration of pain relief after coccygectomy and associated surgical complications.

Paramedian Approach to Coccygectomy in the Treatment of Chronic Coccydynia: A Technical Note

“…Coccygectomy for chronic coccydynia has been established as a promising treatment for pain refractory to conservative management [3][4][5][6] . The most common complications after coccygectomy are infection and postoperative wound dehiscence.…”

“…Treatments include conservative therapies (physical therapy and capsaicin patch), interventional techniques (local injections with steroids and local anesthetic, pulsed radiofrequency ablation of ganglion, and extracorporeal shock wave therapy), and surgical techniques (complete and partial coccygectomies). There is a growing body of clinical evidence to support that coccygectomy is an effective treatment for patients with debilitating pain who had failed conservative therapies [3][4][5] . Failure is associated with certain pre-operative characteristics such as psychiatric illness, poor quality of life features, higher levels of pain, and use of opiates 6) .…”

Pharmacoacupuncture Treatment of Coccygodynia Caused by Perforating Cutaneous Nerve Entrapment Syndrome: Two Cases Report

“…꼬리뼈 통증(cogccygodynia)은 J.Y. Simpson에 의해 처음으로 명명되었으며 1) 꼬리뼈 부위에 국한된 깊고 지속적인 통증으로 정의한다 1,2) . '꼬리뼈 부위'는 일반 적으로 꼬리뼈를 포함하여, 엉치뼈 끝부터 항문까지 이 어지는 범위(coccyx and the sacral perianal area)를 의미 한다 2) .…”

“…Simpson에 의해 처음으로 명명되었으며 1) 꼬리뼈 부위에 국한된 깊고 지속적인 통증으로 정의한다 1,2) . '꼬리뼈 부위'는 일반 적으로 꼬리뼈를 포함하여, 엉치뼈 끝부터 항문까지 이 어지는 범위(coccyx and the sacral perianal area)를 의미 한다 2) . 대부분의 꼬리뼈 통증은 국소 병변으로부터 발 생하지만 다른 질환에 의해 속발하기도 하는데, 허리의 척추사이원반 또는 하부 골반 구조물 병변 등에 의해 연 관통으로 발생하거나 심인성 원인에 의해 발생하는 경 우가 있으므로 감별진단에 주의를 기울여야 한다 2) .…”

“…'꼬리뼈 부위'는 일반 적으로 꼬리뼈를 포함하여, 엉치뼈 끝부터 항문까지 이 어지는 범위(coccyx and the sacral perianal area)를 의미 한다 2) . 대부분의 꼬리뼈 통증은 국소 병변으로부터 발 생하지만 다른 질환에 의해 속발하기도 하는데, 허리의 척추사이원반 또는 하부 골반 구조물 병변 등에 의해 연 관통으로 발생하거나 심인성 원인에 의해 발생하는 경 우가 있으므로 감별진단에 주의를 기울여야 한다 2) . 신경포착증후군(nerve entrapment syndrome)은 포착성 신경병증(entrapment neuropathy)이라고도 하며, 말초신 경 주행 경로 중 해부학적으로 협소한 통로에서 병적으 로 신경이 압박될 경우, 그 신경 분포 영역에 동통 및 이상 감각을 초래하는 말초신경질환군이다 [3][4][5][6] .…”