Abstract
Introduction
Coccydynia, or Coccygodynia, is pain in the region of the Coccyx. Despite the identification of chronic coccygeal pain hundreds of yearsago, its treatment can be difficult and sometimes controversial because of the multifactorial nature of coccygeal pain.[1] Many Physiologic and psychological factors contribute to its etiology. Most cases of coccydynia resolve within weeks to months with or without conservative treatment, but for a few patients the pain can become chronic and debilitating.[2] Coccydynia is pain located in the coccygeal bone or the surrounding tissues. Coccydynia is a relatively rare condition, occurring more frequently in females and in all ages. Coccydynia is most frequently associated with single axis traumatic injury, childbirth, obesity, and rapid weight-loss related to gastric bypass surgery. There are several etiologies to the occurrence of secondary coccydynia, such as cancer pain, infection.[3] Chronic coccydynia is a condition for which there is limited understanding of the pathology. Patients may experience a marked loss in quality of life and difficulty in performing everyday activities. Coccydynia means ‘’ tail bone pain’’. This disorder can be manifested at any age but most common age is 40 years, ratio between male and female is 1:5. The well known risk factors of coccydynia are obesity, coccygeal sitting, child birth, constipation, tumor, infection, ant direct trauma and it can be idiopathic. The indication & advantages of manual therapy are not perfectly reported yet, because of lack of expertise & existence of variety of management.[4] Radiographs of the coccyx in different positions divide the coccydynia into four etiologic groups according to coccygeal mobility, subluxation, hyper mobility, hypo mobility & normal mobility.
References
1. Lirette LS, Chaiban G, Tolba R, Eissa H. Coccydynia: an overview of the anatomy, etiology, and treatment of coccyx pain. Ochsner Journal. 2014 Mar 20;14(1):84-7.
2. Andersen GØ, Milosevic S, Jensen MM, Andersen MØ, Simony A, Rasmussen MM, Carreon L. Coccydynia—the efficacy of available treatment options: a systematic review. Global Spine Journal. 2022 Sep;12(7):1611-23.
3. Garg B, Ahuja K. Coccydynia-A comprehensive review on etiology, radiological features and management options. Journal of clinical orthopaedics and trauma. 2021 Jan 1;12(1):123-9.
4. Sagir O, Demir HF, Ugun F, Atik B. Retrospective evaluation of pain in patients with coccydynia who underwent impar ganglion block. BMC anesthesiology. 2020 Dec;20:1-5.
5. Gufeld L, Vossen JA, Urquia D. Coccydynia: diagnostic and management guidance. The Journal for Nurse Practitioners. 2020 Nov 1;16(10):735-43.
6. Mabrouk A, Alloush A, Foye P. Coccyx Pain. PMID: 33085286.
7. Hunter CW, Stovall B, Chen G, Carlson J, Levy R. Anatomy, pathophysiology and interventional therapies for chronic pelvic pain: a review. Pain Physician. 2018;21(2):147
8. Woon JT, Maigne JY, Perumal V, Stringer MD. Magnetic resonance imaging morphology and morphometry of the coccyx in coccydynia. Spine. 2013 Nov 1;38(23):E1437-45.
9. Dayawansa S, Garrett Jr D, Wong M, Huang JH. Management of coccydynia in the absence of X-ray evidence: Case report. International Journal of Surgery Case Reports. 2019 Jan 1;54:63-5.
10. Datir A, Connell D. CT-guided injection for ganglion impar blockade: a radiological approach to the management of coccydynia. Clinical radiology. 2010 Jan 1;65(1):21-5.
11. Manfre L, Gil I, Baptista T, Pires PC, de Vivo AE, Masala S, Chandra RV, D'Anna G, Hirsch JA. Coccygeoplasty: preliminary experience with this new alternative treatment of refractory coccydynia in patients with coccyx hypermobility. Journal of Neuro Interventional Surgery. 2023 Jan 1;15(1):82-5.
12. Postacchini FR, Massobrio MA. Idiopathic coccygodynia. Analysis of fifty-one operative cases and a radiographic study of the normal coccyx. JBJS. 1983 Oct 1;65(8):1116-24.
13. Soliman AY, Abou El-Nagaa BF. Coccygectomy for refractory coccydynia: a single-center experience. Interdisciplinary Neurosurgery. 2020 Sep 1;21:100735.
14. Maigne JY, Guedj S, Straus C. Idiopathic coccygodynia lateral roentgenograms in the sitting position and coccygeal discography. Spine. 1994 Apr 15;19(8):930-4.
15. Dave BR, Bang PB, Degulmadi D, Samel P, Shah D, Krishnan A. A clinical and radiological study of nontraumatic coccygodynia in Indian population. Indian Spine Journal. 2019 Jul 1;2(2):128-33.
16. Hadhoud MM, Elzawawi MS, Shams AF. Radiological and Magnetic Resonance Imaging of Idiopathic Coccydynia and Study of the Effect of Prolotherapy.
17. Hadhoud MM, Elzawawi MS, Shams AF. Radiological and Magnetic Resonance Imaging of Idiopathic Coccydynia and Study of the Effect of Prolotherapy.
18. Geneci F, Denk CC, Uzuner MB, Ocak M, Doğan İ, Sayacı EY, Gürses İA, Çay N, Baykal D, Çelı̇k HH, Cömert A. Morphometric Evaluation of Coccyx with Microcomputed Tomography (Micro CT) and Computed Tomography (CT) Technology. Journal of Innovative Approaches in Medicine. 2022;3(1):01-19.
19. Maigne JY, Doursounian L, Chatellier G. Causes and mechanisms of common coccydynia: Role of body mass index and coccygeal trauma. Spine (Phila Pa 1976) 2000;25:3072-9.(radiological parameters)( refrence 5)
20. Maigne JY, Guedj S, Straus C. Idiopathic coccygodynia. Lateral roentgenograms in the sitting position and coccygeal discography. Spine (Phila Pa 1976) 1994;19:930-4.
21. Matthew R. Skalski, Radio Graphics 2020; 40:1090–1106
22. Garg B, Ahuja K. Coccydynia-A comprehensive review on etiology, radiological features and management options. Journal of clinical orthopaedics and trauma. 2021 Jan 1;12(1):123-9.
23. Skalski M.R., Matcuk G.R., Patel D.B., Tomasian A., White E.A., Gross J.S. Imaging coccygeal trauma and coccydynia. Radiographics. 2020;40(4):1090–1106. doi: 10.1148/rg.2020190132.
Corresponding Author
Ms. Mamta Verma
MSc. Radiology, Department of Radiological Imaging Techniques, Assistant Professor, College of Paramedical Sciences, TMU (Teerthanker Mahaveer University) Moradabad, UP
DOI: https://dx.doi.org/10.18535/jmscr/v11i9.15
