Coccydynia-A comprehensive review on etiology, radiological features and management options

Abstract

Coccydynia is a disabling condition characterized by pain in the coccyx region of the spine. The first description of the disease was given in as early as 1859. Since then a number of theories have been proposed by various researchers to explain the pathogenesis of the disease. Treatment options for coccydynia include ergonomic adaptation, manual therapy, injections and surgery. Despite being identified as a disease as early as 18th century, several uncertainties with respect to the origin of pain, predisposing factors and treatment outcomes of a wide range of treatment options persist till date. The current narrative review presents various aspects of the disease including pathoanatomy, clinical presentation, radiological features and management options for the disease.

Comparison of treatment outcomes in chronic coccygodynia patients treated with ganglion impar blockade versus caudal epidural steroid injection: a prospective randomized comparison study

“…The effect of CESI on pain reduction can be explained by the relief of pain associated with lumbar pathology and blockage of the sacrococcygeal nerves, which is an important source of pain in coccydynia. There is a close relationship between coccydynia and lumbar pathologies such as disc herniation, disc degeneration, and spinal stenosis as an important target of CESI [ 1 , 20 ]. Pulsed radiofrequency and neuromodulation interventions can also be performed via the caudal epidural route for the sacrococcygeal nerves as a peripheral target [ 21 , 22 ].…”

“…Coccygodynia (or coccydynia) is defined as the painful and disabling condition of the coccyx (tailbone) located inferior to the sacrum. Although it was known as early as the 18th century, there are still uncertainties in terms of multifactorial pain pathophysiology and effective treatment modalities [ 1 ].…”

Novel approach for pericapsular radiofrequency ablation of sacrococcygeal junction for patients with coccydynia

“…First described in 1859 by Simpson,1 its epidemiology has yet to be elucidated. Various risk factors have been identified for coccydynia: female gender, obesity, a history of childbirth, various trauma, visceral and soft tissue pathologies 2 3. Given the multifactorial nature of the coccygeal pain, its management remains a clinical challenge.…”

“…Given the multifactorial nature of the coccygeal pain, its management remains a clinical challenge. Although there is no practice guideline published on the management of coccydynia, the literature generally suggests a multimodal approach with both conservative measures and procedural interventions 2 3…”

“…Conservative management comprises of ergonomic adaptation, pharmacotherapy, manual and physical therapy, which is successful in 90% of patients with coccydynia 2. In patients refractory to conservative treatment, different types of procedural interventions have been described but local anaesthetic and steroid injections around the sacrococcygeal and intercoccygeal joints under image guidance is the most common procedure reported in the literature 2 3…”