Lijec̆nic̆ki vjesnik
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Lijec̆nic̆ki vjesnik · Jan 2012
Review[Coccygodynia: etiology, pathogenesis, clinical characteristics, diagnosis and therapy].
The term 'coccygodynia' means the pain in the tailbone area (os coccygis; coccyx). Due to the sitting intolerance, coccygodynia can significantly disturb the quality of life. Coccygeal disorders that could be manifested in coccygodynia are injuries (fracture, subluxation, luxation), abnormal mobility (hypermobility, anterior and posterior subluxation or luxation of the coccyx), disc degeneration at sacrococcygeal (SC) and intercoccygeal (IC) segments, coccygeal spicule (bony excrescence), osteomyelitis and tumors. ⋯ Conservative therapy includes: rest, medicamentous therapy, acupuncture, coccyx cushion, physical therapy, manual therapy (massage and stretching of the levator ani muscle; mobilization of the coccyx) and therapeutic interventions (injections of local anesthetic and corticosteroid in the painful structures; radiofrequency ablation of coccygeal discs and Walther's ganglion). Using different modalities of conservative therapy, satisfactory results are achieved in the majority of patients with coccygodynia. Coccygectomy is indicated in refractory cases, first of all in patients with abnormal mobility of the coccyx and spicules who respond best to surgical treatment.