Efficacy of fluoroscopically guided steroid injections in the management of coccydynia

Pain Physician. 2007 Nov;10(6):775-8.


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.

Conclusion: Patients with acute pain (less then 6 months) are more likely to respond to fluoroscopically guided coccygeal steroid injections.

MeSH terms

  • Adult
  • Anti-Inflammatory Agents / administration & dosage
  • Coccyx / anatomy & histology
  • Coccyx / diagnostic imaging*
  • Coccyx / drug effects
  • Female
  • Fluoroscopy / instrumentation
  • Fluoroscopy / methods*
  • Humans
  • Intraoperative Complications / prevention & control
  • Male
  • Middle Aged
  • Monitoring, Intraoperative / instrumentation
  • Monitoring, Intraoperative / methods*
  • Needlestick Injuries / prevention & control
  • Pain, Intractable / drug therapy
  • Pain, Intractable / etiology
  • Pain, Intractable / physiopathology
  • Pelvic Pain / drug therapy*
  • Pelvic Pain / etiology
  • Pelvic Pain / physiopathology
  • Regression Analysis
  • Retrospective Studies
  • Sacrococcygeal Region / physiopathology*
  • Steroids / administration & dosage*
  • Treatment Outcome


  • Anti-Inflammatory Agents
  • Steroids