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Related Experiment Videos

Coccygodynia: evaluation and management.

Guy R Fogel1, Paul Y Cunningham, Stephen I Esses

  • 1Spine Fellow, Department of Orthopedic Surgery, Baylor College of Medicine, Houston, TX 77030, USA.

The Journal of the American Academy of Orthopaedic Surgeons
|February 3, 2004
PubMed
Summary

Coccygodynia, or tailbone pain, is often linked to abnormal coccygeal mobility shown on dynamic X-rays. Treatment involves injections and physical therapy, with surgery reserved for persistent cases.

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Area of Science:

  • Orthopedics
  • Pain Management
  • Radiology

Background:

  • Coccygodynia is characterized by pain in the coccygeal region.
  • Abnormal coccygeal mobility is frequently observed on dynamic radiographs.
  • The etiology of pain remains unknown in some coccygodynia patients.

Purpose of the Study:

  • To review the diagnostic accuracy of imaging modalities for coccygodynia.
  • To outline current treatment strategies for coccygodynia.
  • To evaluate the efficacy of surgical intervention for refractory coccygodynia.

Main Methods:

  • Review of dynamic standing and seated radiographs for coccygeal mobility assessment.
  • Evaluation of bone scans and MRI for inflammation and edema detection.
  • Analysis of treatment outcomes for non-surgical (injections, massage, stretching) and surgical (coccygectomy) interventions.

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Main Results:

  • Dynamic radiography is more accurate than bone scans or MRI in diagnosing coccygeal abnormalities.
  • Initial treatment for severe coccygodynia includes local anesthetic and corticosteroid injections.
  • Coccygeal massage and levator ani stretching offer symptomatic relief.
  • Coccygectomy is infrequently required and successful in selected patients with radiographic abnormalities.

Conclusions:

  • Dynamic radiography is the preferred imaging technique for coccygodynia evaluation.
  • Non-surgical treatments are effective for most patients.
  • Coccygectomy is a viable option for carefully selected individuals with demonstrated coccygeal mobility issues.