Pain of the bony area (tail-bone or coccyx) located between the buttocks is referred to as coccydynia. Coccydynia is associated with pain and tenderness at the tip of the tail-bone between the buttocks. The pain is often worsened by sitting.
Coccydynia is often caused by an injury, but it may occur seemingly spontaneously. There are many causes of tail-bone pain which can mimic coccydynia, including sciatica, infection, pilonidal cysts, pain after Pyle’s operation, and fractured bone.
Coccydynia is commonly diagnosed based solely on the symptoms and the examination findings of local tenderness. Other conditions can be excluded by the examination (such as shingles, which typically would be associated with local rash) and other testing (to exclude bone or tissue disorders, such as with CAT scan or MRI scan).
Patients with coccydynia are advised to use a well-padded seat when sitting and avoid long periods of sitting when possible. If the condition becomes severe or persistently troublesome, then medical attention should be sought to accurately evaluate the cause of the pain.
Rest, avoiding re-injury to the affected area, anti-inflammation and pain medications can relieve symptoms. Some patients with persistent coccydynia are treated with local cortisone injection. This injection is simply performed in the doctor's office and can potentially dramatically relieve the pain and even resolve the symptoms for many.
Rarely, when patients have unrelenting pain, a surgical resection of the coccyx can be performed to remove the irritated bony prominence.
But the most effective treatment is Ganglion Impar Block. Ganglion Impar is a nerve bundle located just infront of the junction of Sacrum and Coccyx. Under the radiological guidance this ganglion is primarily blocked by Local Anesthetics with Steroid and then if we get very good pain relief then Radio-frequency Ablation (RFTC) of Ganglion Impar is the most effective and long term treatment done by Pain Physician.