Coccyx or tailbone is the last bone at the end of the spine. Pain in the region of tailbone is called coccydynia. Common causes include trauma, childbirth and repeated strain on the coccyx. Patients may have increased mobility which triggers the inflammation. Other causes include fracture, infection and tumour.
Most patients present with pain on sitting or getting up from sitting position and localised tenderness around the coccyx. Pain during bowel movement or sex day care present. Diagnosis is made based on history and examination findings. Sometimes tests such as x-rays, CT scans and MRI’s are requested. Treatment involves avoiding further strain on the coccyx-using appropriate cushions, weight management, simple painkillers combined with physiotherapy, manipulation and injections such as
Coccyx/ Sacrococcygeal Joint Injection – these are performed under x-ray or ultrasound guidance and involve injecting local anaesthetics and a small dose of steroids in or around the sacrococcygeal joint. It is not uncommon for the ligaments around the coccyx to be the pain generator and these are often injected at the same time. The procedure is performed as a day case under local anaesthesia.
Ganglion Impar block and Radiofrequency - ganglion impar is a collection of nerves located in front of the sacrum and coccyx. This procedure involves injecting a local anaesthetic and steroids mixture under x-ray guidance close to ganglion impar. The needle position is verified by giving a dye (contrast) before injection. Radiofrequency treatment is performed if the benefits of injection are short lasting
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