Coccydynia
Conditions
Keywords
Coccydynia, Dextrose Prolotherapy, Landmark-Guided Injection
Brief summary
Coccydynia is a musculoskeletal pain condition that can lead to chronic pain and functional impairment, significantly affecting quality of life. Although conservative treatment is effective in many cases, the number of patients with refractory symptoms appears to be increasing, highlighting the need for effective and accessible treatment options. Prolotherapy is a regenerative injection therapy that aims to stimulate tissue healing and reduce pain through the modulation of nociceptive signaling, most commonly using dextrose solutions. This retrospective study aims to evaluate the effectiveness of landmark-guided (blind) dextrose prolotherapy in reducing pain and improving functional status in patients with mechanical or idiopathic coccydynia. The study includes patients who underwent prolotherapy to coccygeal ligaments between January 1, 2024, and June 1, 2025, with a treatment protocol consisting of 3-6 sessions administered at 3-week intervals using a 15% dextrose solution.
Detailed description
Coccydynia is a musculoskeletal pain condition characterized by pain localized to the coccygeal region, often leading to chronic pain and functional impairment that negatively affects quality of life. Although conservative treatment is effective in many patients, a growing number of cases remain refractory, highlighting the need for alternative therapeutic approaches. Prolotherapy is a regenerative injection technique increasingly used in chronic musculoskeletal pain conditions. It aims to stimulate tissue repair and modulate nociceptive signaling through the administration of proliferant solutions, most commonly hypertonic dextrose. By inducing a controlled inflammatory response, prolotherapy is thought to promote fibroblast activity, collagen synthesis, and strengthening of ligamentous structures. This retrospective cohort study aims to evaluate the effectiveness of landmark-guided (blind) dextrose prolotherapy in reducing pain severity and improving functional status in patients with mechanical or idiopathic coccydynia. The study includes patients who presented to the Physical Medicine and Rehabilitation Clinic of Gaziosmanpasa Training and Research Hospital between January 1, 2024, and June 1, 2025, with coccydynia persisting for at least 3 months and refractory to conservative treatment. Eligible patients received prolotherapy injections targeting the coccygeal ligaments using anatomical reference points without ultrasound guidance. A 15% dextrose solution was administered in 3 to 6 sessions at 3-week intervals according to a standardized treatment protocol. Pain severity and functional status were assessed using the Visual Analog Scale (VAS) and the Dallas Pain Questionnaire (DPQ), respectively. Outcome measures were evaluated at baseline (pre-treatment) and at follow-up after completion of the treatment protocol. A minimum sample size of 30 patients was determined, and a total of 50 patients were included in the study.
Interventions
PROCEDUREDextrose prolotherapy
Landmark-guided (blind) prolotherapy was performed using a 15% dextrose solution under sterile conditions. The procedure was carried out based on anatomical reference points without ultrasound guidance. The coccygeal and sacrococcygeal ligamentous structures were targeted, and injections were administered to 3-4 periosteal insertion points using a 27G needle. A maximum of 0.5 mL was injected per site, with a total volume not exceeding 2-2.5 mL per session. The treatment protocol consisted of 3 to 6 sessions performed at 3-week intervals.
Sponsors
Gaziosmanpasa Research and Education Hospital
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Age between 18 and 75 years * Diagnosis of mechanical or idiopathic coccydynia * Pain persisting for at least 3 months * Refractory to conservative treatment
Exclusion criteria
* Pregnancy * Allergy to the proliferant solution * Active infection * Use of anticoagulant medications * Presence of malignancy * Local abscess * Documented hemorrhagic diathesis * Certain types of septic arthritis * Parafunctional habits
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Visual Analog Scale (VAS) | Baseline and 1 month after completion of treatment | Primary Outcome Measure Visual Analog Scale for Pain (VAS): Change in pain intensity assessed using the Visual Analog Scale (VAS).The VAS is a 10-cm horizontal scale ranging from 0 (no pain) to 10 (worst imaginable pain).Higher scores indicate greater pain intensity, and a reduction in VAS score represents clinical improvement. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Dallas Pain Questionnaire (DPQ) | Baseline and 1 month after completion of treatment | The Dallas Pain Questionnaire (DPQ) is a validated instrument that evaluates the impact of chronic pain on functional status across four domains: daily activities, work and leisure activities, anxiety/depression, and social interest. Scores range from 0 to 100, with higher scores indicating greater functional limitation and a higher degree of pain-related impairment, whereas lower scores reflect better functional capacity and lower levels of impairment. |
Countries
Turkey (Türkiye)
Contacts
STUDY_CHAIRMerve Dikici Yagli
Gaziosmanpasa Educational and Training Hospital
Outcome results
None listed