Chronic Coccygodynia
Conditions
Keywords
Chronic Coccygodynia, Coccygodynia, Ganglion Impar Block, Osteopathic Manual Therapy, Chronic Pain, Functional Disability, Rehabilitation, Disability Evaluation, Numerical Rating Scale, Oswestry Disability Index, Randomized Controlled Trial, Pain Management
Brief summary
The goal of this clinical trial is to compare two treatment methods for chronic coccygodynia (tailbone pain) in adults. The study aims to determine which treatment provides better pain relief and functional improvement. The main questions it aims to answer are: Does osteopathic manual therapy reduce pain and disability in people with chronic coccygodynia? Does ganglion impar block reduce pain and disability in people with chronic coccygodynia? Which treatment provides more sustained improvement during follow-up? Researchers will compare osteopathic manual therapy with ganglion impar block to evaluate their effects on pain, function, quality of life, and patient satisfaction. Participants will: Be randomly assigned to one of the two treatment groups. Receive either osteopathic manual therapy or ganglion impar block. Complete pain, disability, neuropathic pain, and quality-of-life assessments before treatment and during follow-up visits. Attend follow-up evaluations at 3 weeks and 3 months after treatment.
Detailed description
Chronic coccygodynia is persistent pain in the tailbone region that can significantly affect daily activities and quality of life. Common treatments include physical therapy, manual therapy techniques, injections, and surgical procedures. However, evidence directly comparing osteopathic manual therapy and ganglion impar block remains limited. This prospective randomized controlled trial will compare the effectiveness of osteopathic manual therapy and ganglion impar block in adults with chronic coccygodynia lasting at least three months and not responding adequately to conservative treatment. Eligible participants will be randomly assigned to one of two groups. The osteopathic manual therapy group will receive a structured treatment program including manual mobilization and soft tissue techniques. The ganglion impar block group will receive a fluoroscopy-guided ganglion impar injection. Outcomes will be assessed using pain intensity, disability, neuropathic pain, quality of life, and patient satisfaction measures. Evaluations will be performed at baseline, 3 weeks, and 3 months after treatment. The primary objective is to compare changes in pain and disability between the two treatment groups. Secondary objectives include comparison of neuropathic pain symptoms, quality of life, and patient satisfaction.
Interventions
PROCEDUREOsteopathic Manual Therapy
A 6-week osteopathic manual therapy program including coccygeal mobilization, levator ani muscle techniques, myofascial release, and neural stretching exercises.
PROCEDUREGanglion Impar Block
A fluoroscopy-guided ganglion impar block performed with local anesthetic and corticosteroid injection for pain management in chronic coccygodynia.
Sponsors
Atlas University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Masking description
Due to the nature of the interventions, participant and provider blinding was not feasible.
Intervention model description
Participants with chronic coccygodynia were randomly assigned in a 1:1 ratio to either osteopathic manual therapy (OMT) or ganglion impar block (GIB). Outcomes were assessed at baseline, 3 weeks, and 3 months.
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
Age 18-75 years Chronic coccygodynia persisting for at least 3 months Unresponsive to previous conservative treatment Baseline NRS score ≥4 Baseline ODI score ≥20 Written informed consent
Exclusion criteria
Acute coccygodynia Previous coccygeal or spinal surgery Malignancy Pelvic fracture Pregnancy Coagulation disorders Severe psychiatric disease Previous osteopathic manual therapy or ganglion impar block Structural pathology identified on MRI or dynamic radiography
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Oswestry Disability Index (ODI) Score | Baseline and 3 months | Assessment of functional disability related to chronic coccygodynia using the Oswestry Disability Index. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Numeric Rating Scale (NRS) Pain Score | Baseline, 3 weeks, and 3 months | Assessment of pain intensity using the Numeric Rating Scale (NRS). Participants rate their pain on a scale from 0 (no pain) to 10 (worst possible pain). |
Countries
Turkey (Türkiye)
Contacts
PRINCIPAL_INVESTIGATORmert sancar, MD
Istanbul Atlas University Faculty of Medicine
Outcome results
None listed