Evaluation and management of chronic coccygodynia: Fluoroscopic guided injection, local injection, conservative therapy and surgery in non-oncological pain

Galhom, Ayman; El-Fadl, Sameh Abo

doi:10.1016/j.ejrnm.2015.08.010

Cited by 13 publications

(16 citation statements)

References 22 publications

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“…Myofascial trigger points were difficult to address due to patient sensitivity with typical myofascial techniques; IASTM and cupping appeared more tolerable and effective for the treatment of trigger points compared with traditional trigger point approaches. Aside from general conservative treatment, including nonsteroidal anti-inflammatory drugs, cushions, and posture education, literature describing specific physical therapy treatment is lacking for coccydynia 1–3. Of the available research, it appears that intrarectal mobilization and soft tissue massage are common2,3; however, this approach is less favorable in young populations.…”

Section: Discussionmentioning

confidence: 99%

“…Coccydynia is pain located at the tailbone or coccyx region 1–4. The incidence is rare, contributing to less than 1% of nontraumatic spinal vertebral conditions 1.…”

Section: Introductionmentioning

confidence: 99%

“…Coccydynia is pain located at the tailbone or coccyx region 1–4. The incidence is rare, contributing to less than 1% of nontraumatic spinal vertebral conditions 1. Traumatic causes of coccydynia are more common, such as sustaining a backwards fall, repetitive microtrauma, and childbirth 2,3.…”

Section: Introductionmentioning

confidence: 99%

“…Treatment of coccydynia is usually successful with conservative measures in 90% of cases 2. Conservative treatments include use of specialized cushions to alleviate pressure off the coccyx in seated positions, practicing proper posture, nonsteroidal anti-inflammatory drugs, and using heat or cold modalities to alleviate discomfort 1–3. Patients are often referred for pelvic floor physical therapy when the aforementioned measures have failed and chronic pain persists 2.…”

Section: Introductionmentioning

confidence: 99%

“…Local anesthetic injections may provide short-term relief, but evidence for long-term relief is not strong 7,8. As a last resort, coccygectomy surgery is utilized when all other treatments have failed 1–3,7,8. However, removal of the coccyx has been associated with a high risk of postsurgical complications and may fail to alleviate pain long-term 2,7.…”

Section: Introductionmentioning

confidence: 99%

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Multifaceted Physical Therapy Approach in Male Adolescent With Coccydynia: A Case Report

Knepper¹

2022

Journal of Women's Health Physical Therapy

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Background: Coccydynia is a rare condition in the adolescent population, especially in adolescent boys. Chronic coccydynia negatively impacts quality of life, participation in school, and recreational activities. Evidence is largely lacking for physical therapy approach to treatment for chronic coccydynia. Case Description: This case report describes a 14-year–old adolescent boy, presenting with chronic coccydynia. This patient presented with poor posture, myofascial restrictions, coccyx hypomobility, and deficits in soft tissue length and core strength. Treatment was 45 to 60 minutes, twice per week for 12 sessions, then reduced to once per week for 2 sessions. Outcomes: Symptoms appeared to be as a result of prolonged poor posture, contributing to adaptive shortening of soft tissues and pelvic floor overactivity. Treatment focused on improving posture, restoring soft tissue length, addressing myofascial restrictions in the abdomen, and improving core strength to maintain proper posture. Symptoms decreased as diaphragmatic motor control improved, and myofascial restrictions lessened with instrument-assisted soft tissue mobilization and cupping. The patient was able to resume prior level of function with few activity modifications. Discussion: A multifaceted physical therapy treatment approach was utilized, including a combination of therapeutic exercise and manual therapies. Myofascial trigger points were difficult to address due to patient sensitivity with myofascial techniques; instrument-assisted soft tissue mobilization and cupping were effective in treatment of trigger points. Physical therapy was effective in resolving this case of coccydynia.

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Section: Discussionmentioning

confidence: 99%

“…Coccydynia is pain located at the tailbone or coccyx region 1–4. The incidence is rare, contributing to less than 1% of nontraumatic spinal vertebral conditions 1.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Multifaceted Physical Therapy Approach in Male Adolescent With Coccydynia: A Case Report

Knepper¹

2022

Journal of Women's Health Physical Therapy

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A novel radiological classification for displaced os coccyx: the Benditz–König classification

König¹,

Grifka²,

Benditz³

2021

Eur Spine J

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A Review of Current Treatment Options for Coccygodynia

Elkhashab

2018

Curr Pain Headache Rep

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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.

show abstract

Evaluation and management of chronic coccygodynia: Fluoroscopic guided injection, local injection, conservative therapy and surgery in non-oncological pain

Cited by 13 publications

References 22 publications

Multifaceted Physical Therapy Approach in Male Adolescent With Coccydynia: A Case Report

Multifaceted Physical Therapy Approach in Male Adolescent With Coccydynia: A Case Report

A novel radiological classification for displaced os coccyx: the Benditz–König classification

A Review of Current Treatment Options for Coccygodynia

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