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A Review of Current Treatment Options for Coccygodynia.
Curr Pain Headache Rep 2018; 22(4):28CP

Abstract

PURPOSE OF REVIEW

Coccygodynia is pain within the coccyx area. The diagnosis is made clinically with symptoms of pain in the coccyx region and worsening pain in sitting position. The initial treatment is conservative therapy. For patients who do not respond to conservative therapies, there are further interventions available. This includes local injection of local anesthetics and steroids, neurolysis of sacral nerve roots, caudal epidural block, pulse radiofrequency (PRF), intra-rectal massage and manipulation, ganglion impar block, levator ani massage and stretching, coccyx manipulation, and coccygectomy. The purpose of this review is to evaluate the efficacies of these interventions in the treatment of coccygodynia.

RECENT FINDINGS

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.

Authors+Show Affiliations

Department of Anesthesiology, Jefferson Pain Center, Thomas Jefferson University Hospital, 834 Chestnut Street, Suite T-150, Philadelphia, PA, 19107, USA.Department of Anesthesiology, Jefferson Pain Center, Thomas Jefferson University Hospital, 834 Chestnut Street, Suite T-150, Philadelphia, PA, 19107, USA. andrew.ng@jefferson.edu.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

29556817

Citation

Elkhashab, Yasmin, and Andrew Ng. "A Review of Current Treatment Options for Coccygodynia." Current Pain and Headache Reports, vol. 22, no. 4, 2018, p. 28.
Elkhashab Y, Ng A. A Review of Current Treatment Options for Coccygodynia. Curr Pain Headache Rep. 2018;22(4):28.
Elkhashab, Y., & Ng, A. (2018). A Review of Current Treatment Options for Coccygodynia. Current Pain and Headache Reports, 22(4), p. 28. doi:10.1007/s11916-018-0683-7.
Elkhashab Y, Ng A. A Review of Current Treatment Options for Coccygodynia. Curr Pain Headache Rep. 2018 Mar 19;22(4):28. PubMed PMID: 29556817.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Review of Current Treatment Options for Coccygodynia. AU - Elkhashab,Yasmin, AU - Ng,Andrew, Y1 - 2018/03/19/ PY - 2018/3/21/entrez PY - 2018/3/21/pubmed PY - 2018/9/5/medline KW - Coccygectomy KW - Coccygodynia KW - Coccygodynia treatment KW - Coccyx pain KW - Ganglion impar KW - Ganglion impar block SP - 28 EP - 28 JF - Current pain and headache reports JO - Curr Pain Headache Rep VL - 22 IS - 4 N2 - PURPOSE OF REVIEW: Coccygodynia is pain within the coccyx area. The diagnosis is made clinically with symptoms of pain in the coccyx region and worsening pain in sitting position. The initial treatment is conservative therapy. For patients who do not respond to conservative therapies, there are further interventions available. This includes local injection of local anesthetics and steroids, neurolysis of sacral nerve roots, caudal epidural block, pulse radiofrequency (PRF), intra-rectal massage and manipulation, ganglion impar block, levator ani massage and stretching, coccyx manipulation, and coccygectomy. The purpose of this review is to evaluate the efficacies of these interventions in the treatment of coccygodynia. RECENT FINDINGS: 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. SN - 1534-3081 UR - https://www.unboundmedicine.com/medline/citation/29556817/A_Review_of_Current_Treatment_Options_for_Coccygodynia L2 - https://dx.doi.org/10.1007/s11916-018-0683-7 DB - PRIME DP - Unbound Medicine ER -