Coccydynia: Do Corticosteroid Injections Hit the Mark Over NSAIDs?

Authors

  • Naveed Gul
  • Kashif Ramooz
  • Yasir Shehzad
  • Shafiq ur Rehman Jamil
  • Faraz Mehmood
  • Sania Bhatti
  • Eesha Yaqoob
  • Saad Javed

DOI:

https://doi.org/10.36552/pjns.v28i1.954

Keywords:

Coccydynia, Corticosteroid Injection, Fluoroscopic Guidance

Abstract

Objective:  Coccydynia is a medical ailment that causes discomfort at the coccyx, or tailbone, which can make it difficult for a person to go about their regular business. Nonsteroidal anti-inflammatory medications taken orally, and corticosteroid injections are two potential treatments for Coccydynia. However, the most effective and appropriate course of treatment for this condition must be identified. The study aimed to compare the effectiveness of Corticosteroid Injection vs. NSAID for pain relief in Coccydynia patients.

Materials & Methods:  A total of 47 patients with idiopathic coccydynia were allocated to receive either oral NSAIDs plus a tailbone cushion (n=24) or fluoroscopic corticosteroid injection (n=23). Pain levels were measured by a visual analog scale at baseline and 2-, 3-, and 4-months post-treatment. Chi-square and t-tests were used to compare treatment efficacy.

Results:  The two treatment groups showed no significant differences. Both groups demonstrated reduced pain over time, with no significant difference between injections and NSAIDs (p=0.209). While injections provided more relief for mild pain, NSAIDs showed better results for no-pain patients. Overall mean pain scores were similar between groups. The treatments differed in effectiveness for certain pain levels but exhibited comparable efficacy in reducing overall coccyx pain. The hypothesis of differing treatment efficacy was not supported.

Conclusion:  As a result, it can be considered a viable alternative therapy for patients who have difficulty adhering to oral medication regimens due to its one-time administration and affordable cost. To achieve optimal therapeutic outcomes, it is critical to choose the appropriate patients.

References

Seemal P, Ayub A, Diilshad M, Awan A, Nawaz A, Sameen T, Khan MS. Comparing Primal Reflex Release Technique and Stretching Exercises on Pain and Function in Coccydynia. Iranian

Rehabilitation Journal. 2022;20(4):623-32.

Ak?an Ö. Management of Persistent Coccygodynia and Health Behavior: A Survey Study on Patients with Coccygodynia of Age 41 to 69 years. American Journal of Health Behavior. 2022;46(6):821-33.

Safari MB, Tabrizi A, Hassani E, Nabiyi F, Mohammadi S, Dindarian S. Effect of fluoroscopically guided corticosteroid injection versus oral nonsteroidal anti-inflammatory drugs for the treatment of coccydynia: A randomized, controlled, single-blind study. Current Orthopaedic Practice. 2020;31(1):54-7.

Lemmers GP, van Lankveld WG, Westert GP, Van der Wees PJ, Staal JB. Imaging versus no imaging for low back pain: a systematic review, measuring costs, healthcare utilization and absence from work. European Spine Journal. 2019;28:937-50.

Celenlioglu AE, Sir E. Predictive factors affecting treatment success in ganglion impar block applied in chronic coccygodynia. Regional Anesthesia & Pain Medicine. 2022;47(10):598-603.

Kulkarni G, Shen B. Maintenance of a healthy pouch. InPouchitis and ileal pouch disorders 2019 (pp. 313-333). Academic Press.

White WD, Avery M, Jonely H, Mansfield JT, Sayal PK, Desai MJ. The interdisciplinary management of coccydynia: a narrative review. PM&R. 2022;14(9):1143-54.

Mulpuri N, Reddy N, Larsen K, Patel A, Diebo BG, Passias P, Tappen L, Gill K, Vira S. Clinical outcomes of coccygectomy for coccydynia: a single institution series with mean 5-year follow-up. International Journal of Spine Surgery. 2022;16(1):11-9.

White WD, Avery M, Jonely H, Mansfield JT, Sayal PK, Desai MJ. The interdisciplinary management of coccydynia: A narrative review. PM&R. 2022;14(9):1143-54.

Inamdar K, Molinini RM, Panibatla ST, Chow JC, Dusing SC. Physical therapy interventions to improve sitting ability in children with or at?risk for cerebral palsy: a systematic review and meta?analysis. Developmental Medicine & Child Neurology. 2021;63(4):396-406.

Sencan S, Yolcu G, Bilim S, Kenis-Coskun O, Gunduz OH. Comparison of treatment outcomes in chronic coccygodynia patients treated with ganglion impar blockade versus caudal epidural steroid injection: a prospective randomized comparison study. The Korean Journal of Pain. 2021;35(1):106-13.

Hahner S, Ross RJ, Arlt W, Bancos I, Burger-Stritt S, Torpy DJ, Husebye ES, Quinkler M. Adrenal insufficiency. Nature Reviews Disease Primers. 2021;7(1):19.

Panunzio A, Tafuri A, Mazzucato G, Cerrato C, Orlando R, Pagliarulo V, Antonelli A, Cerruto MA. Botulinum toxin-a injection in chronic pelvic pain syndrome treatment: a systematic review and pooled meta-analysis. Toxins. 2022;14(1):25.

Andersen GØ, Milosevic S, Jensen MM, Andersen MØ, Simony A, Rasmussen MM, Carreon L. Coccydynia—the efficacy of available treatment options: a systematic review. Global Spine Journal.

;12(7):1611-23.

Maigne JY, Chatellier G, Faou ML, Archambeau M. The treatment of chronic coccydynia with intrarectal manipulation: a randomized controlled study. Spine (Phila Pa 1976). 2006;31(18):E621-7.

Galhom A, Al-Shatouri M, El-Fadl SA. Evaluation and management of chronic coccygodynia: Fluoroscopic guided injection, local injection, conservative therapy and surgery in non-oncological pain. The Egyptian Journal of Radiology and Nuclear Medicine. 2015;46(4):1049-55.

Song C, Song C, Li C. Outcome of manipulation under anesthesia with or without intra-articular steroid injection for treating frozen shoulder: a retrospective cohort study. Medicine. 2021;100(13).

Downloads

Published

2024-03-01

Issue

Section

Original Articles