Managing tailbone pain or Coccydynia
Coccydynia or coccygodynia is the pain in the region of coccyx or the terminal segment of spine. Coccyx not only serves as the insertion site for various muscles, ligaments etc but is one of the leg of tripod along with the ischial tuberosities that provides weight bearing support to a person during sitting position. Trauma, female patients, obesity are the risk factors associated with coccydynia.
The conservative options for management of coccydynia pain include proper sitting posture, application of heat or cold, modified wedge-shaped cushions (coccygeal cushions) which can relieve the pressure on the coccyx while sitting along with NSAID use for short period.
Among pain interventions ganglion impar block is used in resistant cases where pain persists despite conservative measures. The ganglion impar is a sympathetic ganglion which marks the end of two sympathetic chain and is situated anterior to the sacrococcygeal junction. A fluoroscopic guided ganglion impar block is usually successful in managing coccydynia pain. In recurrent cases, a radiofrequency ablation of ganglion impar may be undertaken for long term pain relief.
Surgical intervention (coccygectomy) is the last resort as it is associated with complications and at times failure to relieve pain.
The coccydynia or tailbone pain therefore should not be ignored and appropriate interventions should be undertaken in cases of persistent pain not responding to conservative measures.