Coccygodynia is painful condition localized in the region of the coccyx. In most cases a traumatic etiology is present. In the idiopathic form other causes such as
infections and
tumor have to be excluded. Coccygodynia can also be the result of
pain referred from visceral structures due to conditions such as disorders of the rectum, the colon sigmoideum, and the urogenital system. In case of a traumatic etiology the diagnosis is made based on the typical medical history whereby the
pain is provoked by prolonged sitting and cycling. Lateral images of the coccyx are always indicated. The same is true for manual examination of the coccyx. In case of absence of provocation of the coccygeal
pain by prolonged sitting and manual examination neurological causes such as lumbar disc
hernias are a possible reason for the coccygodynia. In the acute phase the first choice of treatment are
NSAIDs. Treatment for patients with severe
pain in the chronic phase consists of
manual therapy and/or a local injection of
local anesthetic and
corticosteroid into the painful segment (2 C+). Other interventional treatments such as intradiscal
injections,
ganglion impar block, radiofrequency treatment and caudal block are advised only under study conditions (0). Coccygectomy is not recommended because of long-term moderate results and the chance of major complications.