A comparison of conservative interventions and their effectiveness for coccydynia: a systematic review.

Journal of Manual and Manipulative Therapy

2013 Nov; 21(4): 213-9.

Howard PD, Dolan AN, Falco AN, Holland BM, Wilkinson CF, Zink AM.

Department of Physical Therapy, Jefferson School of Health Professions, Thomas Jefferson University, Philadelphia, PA, USA.



Systematic literature review.


To investigate the various conservative interventions for coccydynia and determine their effectiveness.


Coccydynia is the term used to describe pain in the coccygeal region. Pain in this region is typically caused by local trauma. Sitting is typically the most painful position for patients having coccydynia. Various methods of treating coccydynia are found in the literature but to our knowledge no systematic review has been performed that compared the effectiveness of these interventions.


Searches were performed for research studies using electronic databases (Cochrane Library, CINAHL, Medline, PEDro, Scopus, and Sports Discus) from January 2002 through July 2012. The quality of the papers was assessed using the GRADE approach.


Seven papers were located that satisfied the inclusion and exclusion criteria (2 RCTs, 5 observational studies). The level of evidence ranged from moderate to very low quality and recommendations for use ranged from weak recommendations for use to weak recommendations against use.


Due to the dearth of research available and the low levels of evidence in the published studies that were located we are unable to recommend the most effective conservative intervention for the treatment of coccydynia. Additional research is needed regarding the treatment for this painful condition.

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