Efficacy of fluoroscopically guided steroid injections in the management of coccydynia

Pain Physician

2007 Nov; 10 (6): 775-8.

Mitra R, Cheung L, Perry P.

rmitra@stanford.edu

School of Medicine, Department of Orthopedic Surgery, Stanford University, Stanford, CA 94305, USA.

Abstract

BACKGROUND: Coccydynia is a rare but painful disorder characterized by axial coccygeal pain which is typically exacerbated by pressure. Management includes physical therapy/rectal manipulation, use of anti-inflammatory medications, modality use, coccygectomy, and fluoroscopically guided steroid injections. There are no studies documenting the efficacy of fluoroscopically guided coccygeal steroid injections in patients with coccydynia.

METHODS: Retrospective chart review was used to collect data on 14 consecutive patients diagnosed with coccydynia who underwent a fluoroscopically guided coccygeal injection of 80 mg triamcinolone acetate and 2mg of 1% lidocaine over a 3-year period at a tertiary care academic medical center.

RESULTS: Using stepwise logistic regression, acute pain was determined to be the best predictor of relief. Fisher's exact test showed that those patients with pain lasting less then 6 months were significantly more likely to have greater than 50% relief (P=0.055). Patients with chronic pain longer than 6 months were not found to have pain relief of >50% to any statistical significance, but every patient with acute pain showed improvement.

CONCLUSION: Patients with acute pain (less then 6 months) are more likely to respond to fluoroscopically guided coccygeal steroid injections.

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