Efficacy of fluoroscopically guided steroid injections in the management of coccydynia.
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.


CONCLUSIONS
Patients with acute pain (less then 6 months) are more likely to respond to fluoroscopically guided coccygeal steroid injections.
Mitra
Raj
R
School of Medicine, Department of Orthopedic Surgery, Stanford University, Stanford, CA 94305, USA. rmitra@stanford.edu
Cheung
Lance
L
Perry
Patrick
P
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D003050:Coccyx / Q000033:anatomy & histology / Q000000981:diagnostic imaging* / Q000187:drug effects; D005260:Female; D005471:Fluoroscopy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000295:instrumentation / Q000379:methods*; D016602:Needlestick Injuries / Q000517:prevention & control; D010148:Intractable Pain / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D017699:Pelvic Pain / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D012044:Regression Analysis; D012189:Retrospective Studies; D012445:Sacrococcygeal Region / Q000503:physiopathology*; D013256:Steroids / Q000008:administration & dosage*; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D013256:Steroids