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Review ArticleReviews and Commentaries

Coccydynia: An Overview of the Anatomy, Etiology, and Treatment of Coccyx Pain

Lesley Smallwood Lirette, Gassan Chaiban, Reda Tolba and Hazem Eissa
Ochsner Journal March 2014, 14 (1) 84-87;
Lesley Smallwood Lirette
Department of Pain Management, Ochsner Clinic Foundation, New Orleans, LA
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Gassan Chaiban
Department of Pain Management, Ochsner Clinic Foundation, New Orleans, LA
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Reda Tolba
Department of Pain Management, Ochsner Clinic Foundation, New Orleans, LA
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Hazem Eissa
Department of Pain Management, Ochsner Clinic Foundation, New Orleans, LA
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Abstract

Background Despite its small size, the coccyx has several important functions. Along with being the insertion site for multiple muscles, ligaments, and tendons, it also serves as one leg of the tripod—along with the ischial tuberosities—that provides weight-bearing support to a person in the seated position. The incidence of coccydynia (pain in the region of the coccyx) has not been reported, but factors associated with increased risk of developing coccydynia include obesity and female gender.

Methods This article provides an overview of the anatomy, physiology, and treatment of coccydynia.

Results Conservative treatment is successful in 90% of cases, and many cases resolve without medical treatment. Treatments for refractory cases include pelvic floor rehabilitation, manual manipulation and massage, transcutaneous electrical nerve stimulation, psychotherapy, steroid injections, nerve block, spinal cord stimulation, and surgical procedures.

Conclusion A multidisciplinary approach employing physical therapy, ergonomic adaptations, medications, injections, and, possibly, psychotherapy leads to the greatest chance of success in patients with refractory coccyx pain. Although new surgical techniques are emerging, more research is needed before their efficacy can be established.

Keywords
  • Coccyx
  • pain–intractable
  • sacrococcygeal region

Footnotes

  • The authors have no financial or proprietary interest in the subject matter of this article.

  • © Academic Division of Ochsner Clinic Foundation
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Coccydynia: An Overview of the Anatomy, Etiology, and Treatment of Coccyx Pain
Lesley Smallwood Lirette, Gassan Chaiban, Reda Tolba, Hazem Eissa
Ochsner Journal Mar 2014, 14 (1) 84-87;

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Coccydynia: An Overview of the Anatomy, Etiology, and Treatment of Coccyx Pain
Lesley Smallwood Lirette, Gassan Chaiban, Reda Tolba, Hazem Eissa
Ochsner Journal Mar 2014, 14 (1) 84-87;
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Keywords

  • Coccyx
  • pain–intractable
  • sacrococcygeal region

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