Sunday, August 3, 2008

Treatment of chronic coccydynia

There are 4 different prominent pathologies for coccydynia. There are many popular approaches such as DTFM of cyriax, Graded oscillation of Maitland, per anal manipulation. Many prefer US therapy as an electrotherapy procedure.
My experience with all of them is very frustrating. Reference texts are limited and so also research data base in comparison to the case load of coccydynia in our clinic. Maigne JY et al found a mild effectiveness of intrarectal manipulation in chronic coccydynia.
The main predictors of a good outcome were stable coccyx, shorter duration, traumatic etiology, and lower score in the affective parts of the McGill and Dallas questionnaires.

2 comments:

  1. My overall experience with utilizing prolotherapy as an MD in the U.S. is quite positive and especially with coccydynia. It takes 2-4 sessions about 6 weeks apart each but like other treatments with prolotherapy, it is a permanent answer to coccydynia which can be quite painful and disabling.

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  2. To Irwin's comments:

    prolotherapy may show some promising result but i am currently not sure of about the long term outcome as claimed by you.

    i have seen many cases of injection failure. can you just clarify that is it because of poor technique of administration of the injection or the local biomechanics has to do something to do?

    do you target specific tissues for infiltration? then let me know which tissue you commonly target and you approch such cases.

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