Treatment of coccygodynia

There are many different approaches to the treatment of coccygodynia including various applicable remedies, sitting in a tub of hot water, local anesthetic creams, massage, muscle relaxants, electric stimulation devices, counseling, biofeedback and sometimes even anti-depressants. However, there are three major types of the most effective treatments:

Manual Treatments

This is a classic treatment of coccygeal disorders, which consist of manual manipulations of the coccyx or massages of the pelvic muscles.

Before the treatment, patient can gets an intraregional injection that should cause 25% increase in the rate of satisfactory results. All the manipulations of the coccyx in joint and stretching of the coccyx could be performed with the rectal finger. Although the treatment is rather unpleasant, it can relieve most of the problems related to muscles stretching.

According to some researches made in the past, results of the manual treatments are satisfactory in 25% of cases at six months, and in 24% at two years after it.

Medical Therapy

In most cases, the treatment begins with non-steroidal anti-inflammatory drugs, which are being used to reduce inflammation and pain around the joint. Patients may also use small pillows that are donut-shaped. These pillows are being used to decrease coccygeal pressure and local irritation. If this therapy fails, the physician should start thinking about steroid injections therapy. This technique is being done with the help of x-rays imaging. When the doctor chooses the adequate disc, considering radiological abnormalities or tenderness at this level he will insert a 25mm needle under aseptic conditions into the lesion.

The injection is generally effective for one week. There were many studies about this method, which claim that, in the long run, this method may actually do more damage than good.

The truth is that cortisone shots can produce short-term pain relief, but can actually result in long-term loss of function and even more chronic pain because it is proven that the steroid medications are actually inhibiting the healing process of soft tissues.

Surgical Approach

There were many talks and controversies about correct surgical approach to the problems related to chronic pelvis pain. If the pelvis pain is long lasting and unresponsive to treatment, it may result in the surgical removal of the coccyx.

Although, some authors have reported good results, many of them are strongly against this therapy method. The operation is called coccygectomy. Although it probably sounds like a big and massive operation, the actual procedure is relatively simple for any surgeon who knows the region well anatomically. The operation lasts about an hour.

For many years, only total coccygectomy was performed, but in the last couple of years, a limited coccygectomy has been proposed. This operation involves only the resection of the mobile segment of the tailbone.