[Chronic coccygodynia]

CHRONIC COCCYGODYNIA. Chronic coccygodynia is defined as pain in the c occyx which has been present for more than six months and which is aggravated by sitting down and/or rising. Although the diagnosis is primarily clinical, additional imaging examinations (MRI, even scintigraphy) are necessary to look for symptomatic forms of curable pathologies such as tumors in the region. These investigations can also help to elucidate the pathophysiological mechanisms responsible for the pain. Dynamic X-rays (sitting and standing) of the coccyx remain the reference exam. Coccygeal ultrasound with a dynamic maneuver (digital intrarectal mobilization of the coccyx) represents an innovative alternative that has not yet been fully validated. The most frequent causes are hypermobile or rigid coccyxes and coccygeal spicules. Traumatic or post-obstetric causes are often found. The social and painful consequences are such as justifying recourse to treatment. Firstly, manual therapies, then infiltrations and possibly the use of topicals, and finally surgery for the most intractable cases.