Journal der Deutschen Dermatologischen Gesellschaft
Volume 5, Issue 3, pages 252–254, March 2007.
Horst Mlitz, H, Jost, W.
The therapeutic approaches as are complex are the causes of coccydynia. Conservative symptomatic treatment is standard (Valen et al.). Physical measures such as sitz baths, fango packs (Baciu et al.), massage, and mobilization of the coccyx as well as acupuncture have been suggested (Gattaullin et al.). Polkinghorn et al. observed positive effects from chiropractic techniques. Antidepressant drugs can be useful in depression (Maroy). Other potentially helpful drugs include antirheumatics (Nutz et al.), spasmolytics and sedatives (Baciu et al., Stein).
Kersey recommends injection of a local anesthetic together with a corticosteroid into the sacrococcygeal joint space; Buchmann performs peri-coccygeal infiltration. Some authors recommend radiation treatment (Stein, Winkler), others warn against it (Baciu et al.). In cases with modest pain symptoms Buchmann reports success with shortwave diathermy (monodal short-wave). Cure rates with such measures are better in idiopathic coccygodynia than in traumatic forms (Kim et al.).
Surgical measures such as coccygotomy, coccygectomy or nerve ablation should be viewed with caution (Albrektsson, Bayne et al., Grosso et al., Shaposhinkov, Tilscher et al., Valen et al., Winkler). When conservative measures fail and with strict indications, some authors suggest a surgical approach (Buchmann, Hellberg et al., Mszwidobadze et al., Postacchini et al., Zayer).