Coccyx or tailbone is the last bone at the end of the spine. Pain in the region of the 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 tumor.
Most patients present with pain on sitting or getting up from sitting position and localized tenderness around the coccyx. Pain during a bowel movement or sex daycare present. Diagnosis is made based on history and examination findings. Sometimes tests such as x-rays, CT scans and MRIs 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 anesthetics 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 anesthesia.
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 anesthetic and steroid mixture under x-ray guidance close to ganglion impair. 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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Dr. Amod Manocha is a Senior Consultant and Head of Pain Management Services at Max Multispecialty Hospital, Saket. He is trained as a Pain Management Specialist and an Anaesthetist in the UK. He has over 13 years of work experience in the UK including working as a Chronic Pain Consultant in many UK hospitals.