title: Extracorporeal shock wave therapy for the treatment of coccydynia: a series of 23 cases.
abstract: BACKGROUND
  Coccydynia can lead to significant functional disability and worsening of quality of life if not properly managed. In this study, we aim to assess the outcomes of extracorporeal shock wave therapy in patients with coccydynia.
  
  
  METHODS
  A prospective case series study was carried out from January to December 2015. Twenty-three patients, mean age of 38.3 ± 12.1 (range 18-64), were included. The majority were females (13; 56.5%), had pain for at least 6 weeks (17; 73.9%) and had trauma to the sacrococcygeal region (17; 73.9%). They had three sessions (one session per week for three consecutive weeks) of focused shock wave therapy directed to the maximal point of coccygeal tenderness. Numerical pain scale and Oswestry disability index were used to assess outcome.
  
  
  RESULTS
  Six (26.1%) patients did not complete the follow-up because of no, or minimal, improvement of their pain. After 6 months of follow-up, the median numerical pain scale significantly decreased from 7.0 ± 4.0 to 2.0 ± 2.0 among the 17 patients with coccydynia (p < 0.001). The median Oswestry disability index improved from 24.0 ± 9.0 before therapy to 8.0 ± 9.0 at final follow-up (p < 0.001). Before treatment, 12 (70.6%) patients had moderate-to-severe disability. In contrast, no patients had severe disability and only one (5.9%) patient had moderate disability at final follow-up (p < 0.001).
  
  
  CONCLUSIONS
  Extracorporeal shock wave therapy had favorable outcomes in treating coccydynia. The majority of patients had partial relief of their pain and disability following this therapy.
authors.affiliation: Department of Orthopaedic Surgery, Al-Razi Orthopaedic Hospital, P.O. Box 24923, 13110, Safat, Kuwait City, Kuwait. yousefmarwan@hotmail.com.|Division of Orthopaedic Surgery, McGill University Health Centre, McGill University, Montreal, QC, Canada. yousefmarwan@hotmail.com.
authors.forename: Yousef
authors.initials: Y
authors.lastname: Marwan
authors.affiliation: Department of Orthopaedic Surgery, Al-Razi Orthopaedic Hospital, P.O. Box 24923, 13110, Safat, Kuwait City, Kuwait.
authors.forename: Bashar
authors.initials: B
authors.lastname: Dahrab
authors.affiliation: Department of Orthopaedic Surgery, Al-Razi Orthopaedic Hospital, P.O. Box 24923, 13110, Safat, Kuwait City, Kuwait.|Division of Orthopaedic Surgery, Department of Surgery, Faculty of Medicine, Health Sciences Center, Kuwait University, Kuwait City, Kuwait.
authors.forename: Ali
authors.initials: A
authors.lastname: Esmaeel
authors.affiliation: Department of Orthopaedic Surgery, Al-Razi Orthopaedic Hospital, P.O. Box 24923, 13110, Safat, Kuwait City, Kuwait.
authors.forename: Samir Abdulrazik
authors.initials: SA
authors.lastname: Ibrahim
authors.affiliation: Department of Orthopaedic Surgery, Al-Razi Orthopaedic Hospital, P.O. Box 24923, 13110, Safat, Kuwait City, Kuwait.
authors.forename: Jassim
authors.initials: J
authors.lastname: Al-Failakawi
mesh_terms: D000293:Adolescent; D000328:Adult; D000074059:Extracorporeal Shockwave Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000628:therapy*; D010147:Pain Measurement; D011446:Prospective Studies; D012445:Sacrococcygeal Region; D016896:Treatment Outcome; D055815:Young Adult
keywords: Coccydynia; Coccygodynia; Coccyx; Extracorporeal shock wave therapy; Pain