From the Guidelines
Lumbar spine steroid injections can potentially cause coccyx pain, although the evidence for this specific side effect is limited and indirect, with most studies focusing on more severe adverse events such as death, spinal cord infarction, and paralysis 1. The potential for coccyx pain following these injections may be related to the procedure itself, post-injection changes in biomechanics, or a temporary flare-up of pain. Given the strong recommendations against the use of epidural injections of local anesthetics, steroids, or their combination for chronic axial and radicular spine pain due to their little to no effect on pain relief and potential for serious adverse events 1, it is crucial to weigh the benefits against the risks, including the potential, though less common, side effects like coccyx pain. Key considerations for managing coccyx pain after a lumbar injection include:
- Using cushions designed for coccyx relief
- Applying ice or heat
- Taking over-the-counter pain medications like acetaminophen or NSAIDs
- Avoiding prolonged sitting If the pain persists or is severe, consulting a healthcare provider for further evaluation is essential. The most recent and highest quality evidence suggests that the risks associated with lumbar spine steroid injections, including potential side effects like coccyx pain, should be carefully considered in the context of their limited efficacy for chronic spine pain 1.
From the Research
Coccyx Pain after Lumbar Spine Steroid Injections
- There is no direct evidence to suggest that lumbar spine steroid injections can cause coccyx pain 2, 3, 4, 5, 6.
- However, the provided studies focus on the treatment of coccydynia (coccyx pain) using various methods, including steroid injections, and do not discuss the relationship between lumbar spine steroid injections and coccyx pain.
- The studies suggest that steroid injections can be an effective treatment for coccydynia, with varying degrees of success depending on the type of steroid used and the duration of symptoms 2, 5.
- Other treatment options for coccydynia include physical therapy, pelvic floor rehabilitation, manual manipulation and massage, transcutaneous electrical nerve stimulation, psychotherapy, nerve block, spinal cord stimulation, and surgical procedures 3, 4.
- Risk factors for developing coccydynia include obesity, female gender, and a history of trauma, such as a difficult or instrumental delivery 3, 6.