Document Detail

14. Coccygodynia.
MedLine Citation:
PMID:  20825565     Owner:  NLM     Status:  MEDLINE    
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.
Jacob Patijn; Markus Janssen; Salim Hayek; Nagy Mekhail; Jan Van Zundert; Maarten van Kleef
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Publication Detail:
Type:  Journal Article; Review     Date:  2010-09-06
Journal Detail:
Title:  Pain practice : the official journal of World Institute of Pain     Volume:  10     ISSN:  1533-2500     ISO Abbreviation:  Pain Pract     Publication Date:    2010 Nov-Dec
Date Detail:
Created Date:  2010-11-02     Completed Date:  2011-02-28     Revised Date:  2011-10-25    
Medline Journal Info:
Nlm Unique ID:  101130835     Medline TA:  Pain Pract     Country:  United States    
Other Details:
Languages:  eng     Pagination:  554-9     Citation Subset:  IM    
Copyright Information:
© 2010 The Authors. Pain Practice © 2010 World Institute of Pain.
Department of Anesthesiology and Pain Management, Maastricht University Medical Centre, Maastricht, the Netherlands.
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MeSH Terms
Coccyx / pathology*,  physiopathology
Evidence-Based Medicine
Pain* / diagnosis,  pathology,  therapy
Comment In:
Pain Pract. 2011 Sep-Oct;11(5):507   [PMID:  21923724 ]

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