Efficacy of Pericoccygeal Local Injection with Rectal Manipulation in the Treatment of Chronic Coccygodynia

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Abstract
Introduction: Coccygodynia, predominantly affecting women, involves pain around the coccyx, exacerbated by sitting, sexual activity, defecation, or transitioning from sitting to standing. Despite various conservative treatments like NSAIDs, ice packs, and physical therapy, some patients do not experience relief. Objective: This study aims to evaluate the efficacy of rectal manipulation combined with paracoccygeal steroid injections in patients with chronic coccygodynia unresponsive to conservative treatments. Methods: This retrospective study included 24 patients (20 females, 4 males) with chronic coccygodynia unresponsive to over 3 months of conservative treatment. All patients received a combination of steroid-local anesthetic injections and rectal manipulation. VAS scores were recorded before intervention, on the 10th day post-intervention, at one year, and at the last follow-up visit. Patients were assessed for trauma history, BMI, coccyx type, and dynamic radiographic findings. Results: The mean VAS score significantly decreased from 7.9 pre-treatment to 2.2 on the 10th day post-treatment (p

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