From the Research
The sacrococcygeal junction appearing very superficial on a dedicated lateral view with the patient leaning back suggests coccydynia or coccygeal pain syndrome, and treatment should begin conservatively with NSAIDs such as ibuprofen 400-600mg three times daily or naproxen 500mg twice daily for pain management, as recommended by the most recent guidelines 1. This finding indicates potential abnormal mobility or prominence of the coccyx that becomes more evident during this specific positioning. Patients with this condition typically experience pain when sitting, especially on hard surfaces, and when moving from sitting to standing. Some key points to consider in managing this condition include:
- Using a donut cushion or wedge pillow to reduce pressure on the coccyx when sitting
- Physical therapy focusing on pelvic floor relaxation exercises to provide relief
- Considering local corticosteroid injections at the sacrococcygeal junction for persistent cases It is essential to note that effective pain management is crucial in improving patient outcomes and satisfaction, as highlighted in a study on effective pain management 2. However, the choice of analgesic should be guided by the most recent and highest quality evidence, with NSAIDs being preferred over acetaminophen for acute pain management, given the limited efficacy of acetaminophen in chronic pain conditions 3.