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J Am Acad Orthop Surg, Vol 12, No 1, January/February 2004, 49-54.
© 2004 the American Academy of Orthopaedic Surgeons
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Coccygodynia: Evaluation and Management

Guy R. Fogel, MD, Paul Y. Cunningham, III, MD and Stephen I. Esses, MD

Dr. Fogel is Spine Fellow, Department of Orthopedic Surgery, Baylor College of Medicine, Houston, TX. Dr. Cunningham is Medical Research Fellow, Department of Orthopedic Surgery, Baylor College of Medicine. Dr. Esses is Professor of Orthopedics and Brodsky Chair of Spinal Surgery, Department of Orthopedic Surgery, Baylor College of Medicine.

Reprint requests: Dr. Esses, Baylor College of Medicine, Suite 1900, 6560 Fannin, Houston, TX 77030.

Coccygodynia is pain in the region of the coccyx. In most cases, abnormal mobility is seen on dynamic standing and seated radiographs, although the cause of pain is unknown in other patients. Bone scans and magnetic resonance imaging may show inflammation and edema, but neither technique is as accurate as dynamic radiography. Treatment for patients with severe pain should begin with injection of local anesthetic and corticosteroid into the painful segment. Coccygeal massage and stretching of the levator ani muscle can help. Coccygectomy is done only when nonsurgical treatment fails, which is infrequent. Coccygectomy usually is successful in carefully selected patients, with the best results in those with radiographically demonstrated abnormalities of coccygeal mobility.




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N. H. Lithwick, G. R. Fogel, P. Y. Cunningham III, and S. I. Esses
Coccygodynia: Evaluation and Management
J. Am. Acad. Ortho. Surg., July 1, 2004; 12(4): 289 - 289.
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