Efficacy of Pericoccygeal Local Injection with Rectal Manipulation in the Treatment of Chronic Coccygodynia

Year 2024, Volume: 5 Issue: 2, 146 - 151, 03.09.2024

Mehmet Akif Çaçan , Kadir Uzel , Recep Abdullah Erten , Ali Ihsan Tugrul , Mehmet Kursat Yilmaz

https://doi.org/10.53811/ijtcmr.1512616

Abstract

Introduction: Coccygodynia, predominantly affecting women, involves pain around the coccyx, exacerbated by sitting, sexual activity, defecation, or transitioning from sitting to standing. Despite various conservative treatments like NSAIDs, ice packs, and physical therapy, some patients do not experience relief.

Objective: This study aims to evaluate the efficacy of rectal manipulation combined with paracoccygeal steroid injections in patients with chronic coccygodynia unresponsive to conservative treatments.

Methods: This retrospective study included 24 patients (20 females, 4 males) with chronic coccygodynia unresponsive to over 3 months of conservative treatment. All patients received a combination of steroid-local anesthetic injections and rectal manipulation. VAS scores were recorded before intervention, on the 10th day post-intervention, at one year, and at the last follow-up visit. Patients were assessed for trauma history, BMI, coccyx type, and dynamic radiographic findings.

Results: The mean VAS score significantly decreased from 7.9 pre-treatment to 2.2 on the 10th day post-treatment (p<0.001). This improvement persisted with mean VAS scores of 2.9 at one year and 2.7 at the last follow-up, although a slight, non-significant increase was noted over time. Patients with hypermobility of the coccyx showed significantly higher VAS scores at the last follow-up compared to those without hypermobility (p=0.009). No significant differences in treatment outcomes were observed between traumatic and atraumatic etiologies or between normal and overweight BMI groups.

Conclusion: The combination of paracoccygeal steroid injections and rectal manipulation appears to be an effective treatment for chronic coccygodynia, with a significant reduction in pain scores. Hypermobility of the coccyx may be associated with higher recurrence rates, warranting further investigation into tailored treatments for this subgroup.

Keywords

Coccygodynia, Injection, Manipulation

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