Comparing Treatments for Coccygodynia: Surgery or Injection?
Humans have a tailbone at the end of their spines called the coccyx. The word "coccyx" comes from the Greek for 'cuckoo' because it's shaped like the beak of the cuckoo bird. When pain occurs in the tailbone or coccyx it's called coccygodynia. Treatment for coccygodynia using steroid injection versus surgery is compared in this study.
Two groups of patients with coccygodynia were included. Group one had the coccyx taken out. This operation is called a coccygectomy. Group two received up to three injections into the coccyx over a period of six months. The injections were made up of a numbing agent and a steroid.
X-rays were taken before and after the operation for group one. Patients in both groups answered questions about pain, function, and disability before and after their treatment. Results were compared and reported as follows.
Only 20 percent of the patients receiving injections felt improved.
Two-thirds of the injection group were no better or reported only brief improvement that didn't last.
Almost 20 percent felt they were worse after injection(s). Ninety percent of the surgery group felt better; most of them were completely better. Most surgical patients got the best results by the end of four months; some were as good as they were going to get by the end of two months.
The authors conclude that surgery to remove the coccyx is a safe and effective treatment for coccygodynia. It should be used in patients with pain that doesn't go away with conservative treatment. Results were much better with surgical removal compared to steroid injections.
Kirkham B. Wood, MD, and Amir A. Mehbod, MD. Operative Treatment for Coccygodynia. In Journal of Spinal Disorders. December 2004. Vol. 17. No. 6. Pp. 511-515.