From the Research
Non-traumatic coccydynia is typically treated with a stepwise approach beginning with conservative measures, with the goal of minimizing morbidity, mortality, and improving quality of life. The treatment options for non-traumatic coccydynia (coccyx pain) include:
- Avoiding prolonged sitting on hard surfaces
- Using donut-shaped cushions or wedge pillows to reduce pressure on the coccyx
- Taking over-the-counter pain medications such as acetaminophen (500-1000mg every 6 hours, not exceeding 4000mg daily) or NSAIDs like ibuprofen (400-600mg three times daily with food) for pain relief, as recommended by 1
- Physical therapy focusing on pelvic floor relaxation exercises, manual manipulation, and stretching to reduce muscle tension contributing to pain
- For persistent symptoms, local injections may be beneficial, including corticosteroid injections into the painful area around the coccyx, as suggested by 2
- In cases resistant to conservative treatment for more than 6 months, ganglion impar blocks using local anesthetics or radiofrequency ablation may be considered, as mentioned in 3
- Surgical intervention (coccygectomy) is reserved as a last resort for severe, persistent cases unresponsive to other treatments, with a high success rate for pain reduction, as reported in 4
The most recent and highest quality study, 5, published in 2020, suggests that low-level laser therapy may be a good conservative therapy option for coccyx fracture, producing analgesic effects and promoting bone healing. However, this study is focused on traumatic coccyx fracture, and its applicability to non-traumatic coccydynia is limited.
Therefore, a stepwise approach starting with conservative measures, followed by local injections, and finally surgical intervention, is the most appropriate treatment strategy for non-traumatic coccydynia, as it prioritizes minimizing morbidity, mortality, and improving quality of life, as supported by 1, 3, 2, 4.