Skip to main content
Erschienen in: European Spine Journal 5/2018

12.12.2017 | Ideas and Technical Innovations

Management of persistent coccydynia with transrectal manipulation: results of a combined procedure

verfasst von: Ali Seker, Ilker Abdullah Sarikaya, Ozgur Korkmaz, Sercan Yalcin, Melih Malkoc, Ahmet Murat Bulbul

Erschienen in: European Spine Journal | Ausgabe 5/2018

Einloggen, um Zugang zu erhalten

Abstract

Objective

We compared the results of manual therapy combined with steroid injection with single steroid injection in the treatment of persistent coccydynia.

Patients and methods

Combined therapy was performed in 21 patients (Group 1) and steroid injection in 23 patients (Group 2). We compared two groups and investigated the combined therapy group in details. Patients were classified according to the underlying cause, BMI, anatomic type of coccyx and duration of symptoms (< 6 or ≥ 6 months).

Results

Mean age was 30.5 years at the time of procedures. Mean followup time was 27.8 months. VAS scores were decreased in both groups but combined therapy group had much more better results. Complete pain relief was achieved in 61.9% of patients in Group 1 whereas it was only 17.4% in Group 2. In 23.8% of Group 1, the VAS score was significantly decreased but the feeling of uncomfortability persisted. This was 73.9% in Group 2. We had no relapse in Group 1 but in Group 2 the relapse rate was 56.5%. Underlying cause, body mass index, anatomic type of coccyx and duration of symptoms had no effect on results.

Conclusion

Manual therapy combined with steroid injection would be an alternative method in case of persistent coccydynia. It is a safe and easy option before surgical treatment.
Literatur
1.
Zurück zum Zitat Fogel G, Cunningham P, Esses S (2004) Coccygodynia: evaluation and management. J Am Acad Orthop Surg 12:49–54CrossRefPubMed Fogel G, Cunningham P, Esses S (2004) Coccygodynia: evaluation and management. J Am Acad Orthop Surg 12:49–54CrossRefPubMed
2.
Zurück zum Zitat Emerson SS, Speece AJ 3rd (2012) Manipulation of the coccyx with anesthesia for the management of coccydynia. J Am Osteopath Assoc 112:805–807PubMed Emerson SS, Speece AJ 3rd (2012) Manipulation of the coccyx with anesthesia for the management of coccydynia. J Am Osteopath Assoc 112:805–807PubMed
3.
Zurück zum Zitat Wray CC, Easom S, Hoskinson J (1991) Coccydynia. Aetiology and treatment. J Bone Joint Surg Br 73:335–338CrossRefPubMed Wray CC, Easom S, Hoskinson J (1991) Coccydynia. Aetiology and treatment. J Bone Joint Surg Br 73:335–338CrossRefPubMed
4.
Zurück zum Zitat Haddad B, Prasad V, Khan W, Alam M, Tucker S (2014) Favourable outcomes of coccygectomy for refractory coccygodynia. Ann R Coll Surg Engl 96:136–139CrossRefPubMedPubMedCentral Haddad B, Prasad V, Khan W, Alam M, Tucker S (2014) Favourable outcomes of coccygectomy for refractory coccygodynia. Ann R Coll Surg Engl 96:136–139CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Howard PD, Dolan AN, Falco AN, Holland BM, Wilkinson CF, Zink AM (2013) A comparison of conservative interventions and their effectiveness for coccydynia: a systematic review. J Man Manip Ther 21:213–219CrossRefPubMedPubMedCentral Howard PD, Dolan AN, Falco AN, Holland BM, Wilkinson CF, Zink AM (2013) A comparison of conservative interventions and their effectiveness for coccydynia: a systematic review. J Man Manip Ther 21:213–219CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Postacchini F, Massobrio M (1983) Idiopathic coccygodynia. Analysis of fifty-one operative cases and a radiographic study of the normal coccyx. J Bone Joint Surg [Am] 65:1116–1124CrossRef Postacchini F, Massobrio M (1983) Idiopathic coccygodynia. Analysis of fifty-one operative cases and a radiographic study of the normal coccyx. J Bone Joint Surg [Am] 65:1116–1124CrossRef
8.
Zurück zum Zitat Maigne JY, Lagauche D, Doursounian L (2000) Instability of the coccyx in coccydynia. J Bone Joint Surg Br 82:1038–1041CrossRefPubMed Maigne JY, Lagauche D, Doursounian L (2000) Instability of the coccyx in coccydynia. J Bone Joint Surg Br 82:1038–1041CrossRefPubMed
9.
Zurück zum Zitat Thiele GH (1937) Coccydynia and pain in the superior gluteal region. JAMA 109:1271–1275CrossRef Thiele GH (1937) Coccydynia and pain in the superior gluteal region. JAMA 109:1271–1275CrossRef
10.
Zurück zum Zitat Maigne R (1996) Diagnosis and treatment of pain of vertebral origin: a manual medicine approach. Williams and Wilkins, Baltimore, pp 339–340 Maigne R (1996) Diagnosis and treatment of pain of vertebral origin: a manual medicine approach. Williams and Wilkins, Baltimore, pp 339–340
12.
Zurück zum Zitat Jaiswal A, Shetty AP, Rajasekaran S (2008) Precoccygeal epidermal inclusion cyst presenting as coccygodynia. Singapore Med J 49:e212–e214PubMed Jaiswal A, Shetty AP, Rajasekaran S (2008) Precoccygeal epidermal inclusion cyst presenting as coccygodynia. Singapore Med J 49:e212–e214PubMed
13.
Zurück zum Zitat Maigne JY, Chatellier G (2001) Comparison of three manual coccydynia treatments: a pilot study. Spine (Phila Pa 1976) 26:E479–E483CrossRef Maigne JY, Chatellier G (2001) Comparison of three manual coccydynia treatments: a pilot study. Spine (Phila Pa 1976) 26:E479–E483CrossRef
14.
Zurück zum Zitat Maigne J, Doursounian L, Chattelier G (2000) Causes and mechanisms of common coccydynia: role of body mass index and coccygeal trauma. Spine 25:3072–3079CrossRefPubMed Maigne J, Doursounian L, Chattelier G (2000) Causes and mechanisms of common coccydynia: role of body mass index and coccygeal trauma. Spine 25:3072–3079CrossRefPubMed
16.
Zurück zum Zitat Mitra R, Cheung L, Perry P (2007) Efficacy of fluoroscopically guided steroid injections in the management of coccydynia. Pain Physician 10:775–778PubMed Mitra R, Cheung L, Perry P (2007) Efficacy of fluoroscopically guided steroid injections in the management of coccydynia. Pain Physician 10:775–778PubMed
Metadaten
Titel
Management of persistent coccydynia with transrectal manipulation: results of a combined procedure
verfasst von
Ali Seker
Ilker Abdullah Sarikaya
Ozgur Korkmaz
Sercan Yalcin
Melih Malkoc
Ahmet Murat Bulbul
Publikationsdatum
12.12.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
European Spine Journal / Ausgabe 5/2018
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-017-5399-6

Weitere Artikel der Ausgabe 5/2018

European Spine Journal 5/2018 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.