Coccygodynia

• Published in: Acta clinica Croatica (Tisak) 2023, Vol.62. (Supplement 4), p.97-101
• Main Author: Elezović, Neven
• Format: Article
• Language: English
• Subjects: coccyx; ganglion impar block; nic pain; tailbone pain
• ISSN: 0353-9466; 1333-9451
• DOI: 10.20471/acc.2023.62.s4.14

The coccyx, the last segment of the spine, joins the sacrum at the base. It has three to five vertebrae, which are typically fused. In front of the sacrococcygeal junction is the ganglion impar, the only unpaired autonomic ganglion. The two sympathetic chains come to a close there. The impar ganglion is traversed by sympathetic nerves carrying pain fibers from the perineum, distal sections of the rectum, the vagina and the urethra. The painful disorder known as coccygodynia, which affects the tail end of the spine, is frequently brought on by birth trauma or is caused by an unidentified factor. Even though the pain may go away on its own or with therapy, it may also linger and worsen over time. Due to increased stress from the female pelvis on the coccyx, it affects women five times more frequently than it does men. Conservative, invasive or surgical treatment options are available for coccygodynia (partial or total coccygectomy). Rest, nonsteroidal anti-inflammatory medicines (NSAIDs) or COX-2 inhibitors, acupuncture, coccyx cushions, physical therapy, manual therapy and invasive therapy, which involves ganglion impar block with injections of local anesthetic and corticosteroid under fluoroscopy, followed by radiofrequency ablation, spinal cord stimulation (SCS) or peripheral nerve stimulation, are examples of conservative treatments. Coccygectomy is recommended in refractory situations.