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[Chronic coccygodynia].
Thibault Riant1, Cristina Graur1
1Centre d'évaluation et de traitement de la douleur M Bensignor, hôpital privé du Confluent, Vivalto santé, Centre fédératif nantais de pelvipérinéologie, Nantes, France.
La Revue Du Praticien
|June 23, 2025
Summary
Chronic coccygodynia, persistent tailbone pain aggravated by sitting, requires clinical diagnosis supported by imaging. Identifying causes like coccyx issues or tumors guides treatment from therapies to surgery.
Area of Science:
- Orthopedics
- Pain Management
- Radiology
Background:
- Chronic coccygodynia is defined as tailbone pain lasting over six months, worsened by sitting.
- Diagnosis is primarily clinical but requires imaging to rule out pathologies and understand pain mechanisms.
Purpose of the Study:
- To review the diagnostic and therapeutic approaches for chronic coccygodynia.
- To highlight the role of imaging in identifying causes and guiding treatment.
Main Methods:
- Review of diagnostic imaging techniques including dynamic X-rays, MRI, scintigraphy, and coccygeal ultrasound.
- Discussion of common etiologies such as coccyx hypermobility, rigidity, spicules, trauma, and post-obstetric factors.
Main Results:
- Dynamic X-rays are the reference standard for coccyx examination.
- Coccygeal ultrasound with dynamic maneuver is an emerging, though not fully validated, diagnostic tool.
- Common causes include coccyx abnormalities and trauma.
Conclusions:
- Effective management of chronic coccygodynia involves a stepwise approach.
- Treatment options range from manual therapies and infiltrations to surgery for refractory cases.
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