Journal of Back and Musculoskeletal Rehabilitation
2014; 27(3): 349-354
Gopal, H, Mc Crory, C.
Department of Pain Medicine, St. James's Hospital and Trinity College Institute of Neuroscience, Dublin, Ireland.
Chronic coccygodynia accounts for 1% of all back pain referrals and very difficult to treat with an enormous functional deficit.
The purpose of this case series was to examine the effectiveness of pulsed radiofrequency treatment to the Ganglion of Impar in chronic coccygodynia patients unresponsive to comprehensive medical management.
Coccygodynia is defined as pain in and around the coccyx [1,2]. This retrospective review of twenty patients with a clinical diagnosis of coccygodynia and failed medical management treated with pulsed radio frequency applied to the Ganglion of Impar between January 2009 to December 2011 was carried out. A successful outcome was defined as > 50% improvement in pain on the visual analogue scale at 6 and 12 months follow-up.
The application of pulsed radio frequency to the Ganglion of Impar was successful in fifteen (75%) patients and their mean pre treatment visual analogue scale score of 6.53 was reduced to 0.93 at 6 and 12 months follow up. In five (25%) patients the treatment was not successful and there was no difference between mean pre and post treatment visual analogue scale scores.
We conclude that pulsed radio frequency treatment of the Ganglion of Impar should be considered when coccygodynia has proven resistant to medical management.