Manipulation of the coccyx with anesthesia for the management of coccydynia

The Journal of the American Osteopathic Association

2012 Dec; 112(12): 805-807.

Emerson SS, Speece AJ.

University of Utah Health Sciences Center in Salt Lake City (Dr Emerson) and the University of North Texas Health Science Center Texas College of Osteopathic Medicine in Fort Worth (Dr Speece).


Coccydynia is pain in and around the coccyx, with trauma being the most common etiologic factor. The authors describe the case of a 60-year-old woman who was injured in an automobile accident several months before consultation. After the physician recorded the patient's history, performed a physical examination, and reviewed imaging reports, lumbar radiculopathy and somatic dysfunction of the lumbar and sacral vertebrae were diagnosed as the cause of her coccydynia. During a 6-week period, the patient underwent a series of 3 epidural steroid injections, osteopathic mobilization of the lumbar and sacral spine, and manual manipulation of the coccyx with anesthesia. After each treatment session, the patient reported a substantial improvement in radicular pain as well as a subjective increase in her lower extremity range of motion.

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