From the Research
Coccydynia should be initially managed with conservative treatments, including NSAIDs, physical therapy, and cushioning devices, with surgical intervention like coccygectomy considered only in severe cases that do not respond to conservative treatment for at least 6 months. The management of coccydynia involves a multidisciplinary approach, focusing on reducing pain and improving quality of life.
- Initial treatment options include:
- NSAIDs like ibuprofen (400-600mg three times daily) or naproxen (500mg twice daily) for pain relief
- Cushioning devices specifically designed for coccyx pain when sitting
- Physical therapy focusing on pelvic floor relaxation exercises and stretching
- For persistent pain, local injections with a mixture of corticosteroids and local anesthetic around the coccyx may provide relief, as suggested by 1 and 2.
- In severe cases, surgical intervention like coccygectomy might be considered, though this is rare, with Level III evidence supporting its use for chronic/refractory coccydynia, as noted in 3.
- The pain typically worsens with sitting and improves with standing or lying down, which explains why cushioning devices are helpful in redistributing pressure away from the sensitive area.
- Coccydynia often results from trauma like falls or childbirth, but can also be caused by repetitive strain or idiopathic factors.
- High-level, comparative studies are lacking to guide the treatment of coccydynia, and should be a focus for future research studies, as highlighted in 3.